Tenosynovitis is a medical condition characterized by the inflammation of the fluid filled sheath that surrounds a tendon, the fibrous cords of tough tissue that connect muscles to bones. Known as synovium, this sheath provides a protective covering to the tendon, the cord that joins muscle to bone.
The most commonly affected areas include wrists, hands and feet. However, the disorder can occur with any tendon sheath. Prominent examples of this disorder include:
· De Quervain tenosynovitis (on the thumb side of the wrist)
· Volar flexor tenosynovitis (i.e. trigger finger)
· Gonococcal (GC)
· Peritendinitis (involves tendons of the deep muscles at the back of the forearm)
In most of the cases, tenosynovitis also presents itself along with tendonitis, which is the inflammation of a tendon.
The main symptoms of tenosynovitis include:
· Difficulty in moving a joint
· Pain and tenderness around a joint, especially the hand, wrist, foot and ankle
· Pain on movement of a joint
· Swelling of the joint in the affected area
The tendon sheaths also become inflamed, painful and accumulate fluid. At times, friction rubs can even be felt or heard with a stethoscope.
If the symptoms of tenosynovitis persist for long or if they are left untreated, the tendon may become permanently restricted or it may also rupture. Besides, the infection in the tendon might also spread to other places in the body, which could further have serious consequences.
When the gliding surfaces of the tendon and sheath become roughened and inflamed from overuse, tenosynovitis presents itself as aching, tenderness and swelling of the affected area.
The most prominent cause of tenosynovitis is overuse or exertion of the part involved. It commonly results from a repetitive physical activity, normally related to occupational requirements. Here we list some of the other specific causes of tenosynovitis:
· Tendon stress
· Bacterial disease (gonorrhea, tuberculosis)
· Rheumatic disease
One of the classic examples of the occurrence of tenosynovitis is amongst computer users who spend long hours at the keyboard or computer mouse.
In routine, specialists such as physiotherapists, chiropractors and osteopaths are experts in the treatment for tenosynovitis.
For immediate relief, the following remedies are normally suggested:
· Hot and cold compresses
· Anti-inflammatory drugs, such as aspirin
· Corticosteroids such as dexamethasone, methylprednisolone or triamcinolone
· Local anesthetics, such as lidocaine
Usually, treatments might have to be repeated every 2-3 weeks over the course of a month or two before the inflammation subsides completely. Surgery is occasionally recommended in order to remove the calcium deposits from the areas of long-standing tendonitis.
It is to be noted that a laceration to the hands or wrists that results in infection that causes tenosynovitis is medical emergency and might call for an immediate surgery.