Types and treatments of tenosynovitis

Tenosynovitis most often develops from the prolonged repetition of an otherwise harmless movement. "Campaign" cleaning, window washing, typing, even using the mouse during computer games, and spring/autumn gardening (raking, digging, pruning, hoeing), etc. can all be triggers. The result may be pain that hinders movement. Let's look at what you can do to reduce the pain and eliminate the inflammation. 

Tendons play an important role in the function of your muscles. The tendon attaches the muscle to the bone, helps transmit force and delays premature muscle fatigue.

Tendons run inside tunnel-like sheaths. This is the tendon sheath, in which a mucus-like substance helps the tendon move without friction.

If you repeatedly perform a movement or subject it to a greater, sudden load than usual, the tendon sheath can become inflamed. Pain appears, which hinders the execution of the movement. Even grasping and holding a glass of water may become difficult.

Forms of tenosynovitis

The type of tenosynovitis can be fibrinous or purulent.

Fibrinous tenosynovitis typically affects those who perform long-term, one-sided work (typists, cashiers, pianists, etc.). It is triggered by repetitive, monotonous movements, which cause the tendon sheath to become inflamed and swollen, and the composition of the lubricating substance changes. This problem is most common in the finger extensor tendons (on the back of the hand); it is characterized by severe pain when moving the fingers, the hand becomes clumsy, the affected area is tender to pressure, feels warm and becomes swollen. When you move your fingers, a creaking or crackling rubbing sensation can be felt over the tendon sheath.

Purulent tenosynovitis can be caused by infection and may appear after a puncture by a splinter, thorn or needle. It begins with severe pain and tenderness. The area reddens and swells, and this may spread to adjacent fingers and the back of the hand. In severe cases, purulent tenosynovitis can be accompanied by high fever and chills.

It is important to act promptly, because in the case of purulent inflammation, healing and preservation of the finger's function can only be ensured with timely medical treatment! In contrast, fibrinous inflammation is less dangerous but no less painful.

What to do in case of tenosynovitis

If you suspect you have tenosynovitis, first see your doctor. If you have confirmed that it is not purulent inflammation, then treatment can be carried out at home.

• First, rest your wrist — stop the activity or movement that causes the pain.
• Cool the area. Use an ice pack or simply put ice cubes in a bag and apply that. I wrote here about the beneficial effects and practical application of cooling.
• You can apply over-the-counter anti-inflammatory cream or medication.

Physiotherapy solutions you can also use at home:

• The TENS treatment is a drug- and side-effect-free method of pain relief. Although it quickly relieves pain for a time, it has no healing or anti-inflammatory effect.
• Ultrasound therapy effectively reduces inflammation. Ultrasound treatment stimulates your body's healing processes and therefore works gradually, over a few days.
• The microcurrent (MENS) treatment is a form of electrotherapy. In addition to strong pain-relieving effects, it stimulates the cells' energy production, which is essential for the healing of inflammatory processes.
• The softlaser treatment is more effective and faster at reducing inflammation than ultrasound; however, softlaser devices are more expensive. Its advantage is that the laser can be applied for longer periods than ultrasound.
• The magnetic therapy can be used not only for bones but also for soft tissue conditions (muscle, joint, tendon, ligaments). Longer treatment courses are required compared to the methods mentioned above, and the effect also appears more slowly. The magnetic field has a biostimulatory effect — that is, similar to every other physical therapy method, it is not the magnet itself that heals but the processes that the magnetic effect initiates. Generally, a few days are needed before the effect becomes noticeable.