A tendon is a type of fibrous tissue connects your muscles to your bones. These tissues help control actions such as running, jumping, and lifting. Without tendons you would not be able to control the movement of your body.
Tendons are covered by a protective sheath known as a synovium. This sheath produces a fluid (synovial fluid) that keeps the tendon lubricated. Injury to this area of the body may result in the malfunction of the synovium. If this occurs, the sheath may fail to make synovial fluid or may not make enough fluid. This can cause inflammation or swelling of the synovium. This condition is known as tendon sheath inflammation. It is also sometimes called tenosynovitis.
Tenosynovitis is typically caused by injury to the tendon or surrounding muscle or bone. Tenosynovitis is not limited to athletes, but can be found in patients with a variety of repetitive-motion activities such as assembly-line work, weeding, typing, etc. Certain jobs appear to have greater risk, including carpentry, dentistry, musicianship, and office work. It is most common in the tendons of the wrist, hands, and feet. Injury can result from:
- repetitive activities
- prolonged activities
- standing in the same position for long periods of time
Tenosynovitis can also be caused by underlying health conditions. Examples of conditions that can result in this condition include:
- rheumatoid arthritis
- Reiter’s syndrome or reactive arthritis
In some patients, the cause of the disease cannot be determined. In rare cases tenosynovitis is caused by an infection that resulted from a cut or puncture to the tendon.
Certain tendons in the body are more susceptible to injury, primarily those in the hands, feet, and wrists. Tenosynovitis is more common in these areas. However it can occur in any tendon in the body, including the shoulder, elbow, and knee. If you develop this condition, you may have the following symptoms:
- stiffness in the joint making it difficult to move
- swelling in the joint
- pain and tenderness in the joint
- redness on the skin where the tendon is located
Some people may develop a fever. This indicates the presence of an infection and requires immediate medical attention.
Diagnosis of tenosynovitis will require a physical exam of the affected area. Your doctor will check to see if redness and swelling is present. Your doctor may also ask you to move the affected area to see if pain is present. In some cases, your doctor may order an ultrasound or MRI to confirm the diagnosis or to rule out other possible causes such as arthritis.
Treatment for tenosynovitis focuses on reducing inflammation and pain. This can be done by resting the affected area and stopping activities that caused the initial injury. Your doctor may recommend the use of a brace or splint to immobilize the affected area. Applying heat or cold may also help reduce swelling and pain. Other therapies that may be recommended by your doctor include:
- stretching of the affected area
- electrical nerve stimulation or TENS
Medications for tenosynovitis may also be prescribed by your doctor. Over-the-counter nonsteroidal anti-inflammatory (NSAIDs) medications such as ibuprofen may be recommended. Corticosteroids that can be injected into the inflamed area may also be prescribed. If your condition was caused by an infection, your doctor may prescribe antibiotics to fight the infection.
If your condition is caused by an underlying health issue such as rheumatoid arthritis or gout, treatment may also include medications to treat these disorders.
Once the tendon has healed, your doctor may recommend exercises or physical therapy to help strengthen the muscle. Strengthening the muscle will help protect the tendon from injury in the future. If you have recurring tenosynovitis your doctor may recommend surgery to correct the problem.
If you develop tenosynovitis you will likely make a full recovery with treatment. Problems may arise if the activities that caused the condition are not stopped. If this happens, the damage to your tendon may become permanent. If the damage is permanent this may impact the joint. Over time, the joint may become stiff and your motion may be limited.
If your condition develops as a result of an infection, you will need antibiotics to prevent the spread of infection. If the infection is not controlled, the infection may become life threatening. If you develop an infection that is not promptly treated, your prognosis may not be as good.
Tenosynovitis can be prevented by avoiding movements or motions that are repetitive or forceful. Muscle strengthening around the site of the joint can also help prevent this type of injury, as well as stretching and range of motion (ROM) exercises.
If you cut your hands, wrists, or feet, proper cleaning of the wound will help prevent infection and the development of tenosynovitis.