Tendinitis and Tenosynovitis

The tendon is the rope that connects muscle to bone. Some tendons are very short and others are long and cross over joints (such as the ones that bend and straighten the fingers). These tendons may pass underneath ligaments which hold the tendon close to the bone. When the muscle belly contracts during movement, it pulls on the rope (tendon) that is attached to the bone causing movement. The ligamentous bridges prevent the tendon from “popping out”, or bow-stringing, during movement. This makes movement more efficient. Where the tendon needs to pass around a bony bend, the tendon may be covered by a sheath which provides lubrication so that the tendon passes smoothly through these challenging areas.

Tendinitis and tenosynovitis are the result of microscopic tears and damage caused by overuse of a particular muscle or by excessive repetition of particular motions. Tendinitis is the result of excessive wear and tear on the muscle and tendon unit. The tendon itself can become swollen, thick and painful. Tenosynovitis is inflammation caused by friction between the tendon and it’s sheath causing an over-production lubricant fluid. The excess fluid builds up and causes the sheath to become painful and swollen.

With swelling, either of the tendon or the tendon sheath, the tendons no longer glide smoothly through tight areas but begin to catch. Movement may begin to feel “creaky” or movements may “catch”.

Symptoms of Tendinitis or Tenosynovitis

• Usually tender close to a joint
• Area of tenderness is localized and usually superficial (close to the surface of the skin)
• May have swelling around the area of tenderness
• Pain increases with activity and usually feels better with rest
• Pain may begin radiating up or down the arm as symptoms get worse

General Treatment Recommendations

• Splinting to rest the injured area by preventing the muscle movement causing the friction
• Ice massage or use of cold packs during the initial stages to reduce swelling and pain
• Use of hot packs during the chronic stages to reduce pain and increase flexibility
• Gentle but frequent stretching
• Massage (cross friction) across the tendons to increase circulation and promote healing
• Incorporate tendon and nerve protection and ergonomic practices into home, work and leisure activity. Be aware of posture, position and work habits.
• Muscle strengthening and conditioning once symptoms are under control

You can also use the symptom guidelines below to find more information about your particular symptoms.

Finger Pain

• Trigger Finger

Thumb Pain

• Trigger Thumb
• DeQuervain’s Tenosynovitis

Hand Pain

• Trigger Finger

Wrist Pain

• DeQuervain’s Disease
• Tendonitis of the Wrist Flexors or Extensors

Forearm Pain

• Intersection Syndrome
• Myofascial (muscle) Pain

Elbow Pain

• Lateral Epicondylitis (Tennis Elbow)
• Medial Epicondylitis (Golfer’s Elbow)