What is tenosynovitis?
Tenosynovitis is the inflammation of the protective sheath that surrounds your tendons. This inflammation can be painful and make it hard to move your joints as usual. This is different than tendinitis, which is the inflammation of the tendon itself.
Stenosing tenosynovitis is a specific kind of tenosynovitis. This occurs when the inflammation around a tendon makes it hard to move smoothly through a small area of your body that it normally does. Different kinds of stenosing tenosynovitis include:
- Trigger finger or trigger thumb – tendon sheath becomes inflamed which makes it hard to extend or flex the finger or thumb.
- DeQuervain’s tenosynovitis – swelling in the tendon sheath of the tendons in the thumb.
- Forearm tenosynovitis – swelling in the tendons around your forearm.
What causes tenosynovitis?
Because tenosynovitis can affect anyone it is caused by a variety of issues and conditions. However, you are more likely to develop if you have:
- Rheumatoid arthritis
- Diabetes
- Hand infections
- Gout
- COPD
- Thyroid disease
- Dupuytren’s disease
- Certain cancer treatments
Specific causes can include:
- Autoimmune diseases
- Repeated motion or movement over a long period of time.
- Infections
- Trauma
What are symptoms of tenosynovitis?
Tenosynovitis is usually painful for those who have it. It can affect tendons that help with pushing, pulling or extending limbs. The most common places to experience tenosynovitis are in your hands, wrists and feet. The most common symptoms include:
- Pain
- Swelling at a joint
- Difficulty moving a limb or joint as usual.
- Pain when moving part of your body.
- Discoloration in a straight line along a tendon.
How is tenosynovitis diagnosed and treated?
Tenosynovitis will not always go away on its own. If left untreated, it can cause long term damage to your tendons. Your provider will perform a physical exam and review your medical history. Diagnostic images, such as X-ray or MRI, as well as blood work may be needed to diagnose further.
The treatment for tenosynovitis will vary depending on the cause. Your provider will likely recommend nonsurgical treatment options first, such as:
- Resting and stopping the activity causing it.
- Wearing a brace or splint.
- Applying heat or cold to the area.
- Steroid injections.
If the nonsurgical treatment options do not improve pain, your provider may recommend surgery. It is typically needed if your tenosynovitis is caused by an infection, if the inflammation is so severe it is on the verge of permanent damage, or conservative treatments have failed to work.
During surgery, your surgeon will make incisions around the affected tendon to reduce the pressure on it and clear out the dead tissue. In some cases, they may clear out the tendon sheath to clean out the infection.
Recovery time will depend on what caused your tenosynovitis and what treatments were used to treat it. You should expect to make a full recovery from tenosynovitis in a few weeks to a few months. If it was caused by infection, you may have a higher risk of complications and longer recovery time.
What are risk factors of tenosynovitis surgery?
As with any procedure, the treatment of tenosynovitis comes with certain risks, such as:
- Stiffness in the affected body part
- Deformed tendons
- Spread of the infection to other parts of the body.
- Scarring