The wrist contains a total of three joints. This makes the wrist much more stable similar to having only one joint. The joints also give your wrist and hand a wide range of movement. Furthermore, the wrist joints let your wrist move your hand up and down, for example, when lifting your hand to wave around. These joints give you the ability to bend your wrist forward and backward, side to side, and rotate your entire hand. The three wrist joints are known as the radiocarpal joint, ulnocarpal joint, and distal radioulnar joint, with additional details following below:
- Radiocarpal joint – This is where the radius (the thicker forearm bone) connects the bottom row of your wrist bones, which are the scaphoid, lunate, and triquetrum bones. This joint is mainly on the thumb side of your wrist.
- Ulnocarpal joint – This is the joint between the ulna (the thinner forearm bone) and the lunate and triquetrum wrist bones. The ulnocarpal joint is located on the pinky side of your wrist.
- Distal radioulnar joint – This joint is in the wrist but does not include the wrist bones. It connects the bottom ends of the radius and ulna.
Tendonitis normally occurs after repeated injury to a specific area such as the wrist or ankle, thus causing pain and soreness around the joint. It also happens when an individual overuses a tendon, for example, during a sporting event that involves heavy use of a certain muscle. It is typically accompanied by an acute injury with inflammation. In addition, tendonitis can occur almost anywhere in the human body whereas the tendons exist and are usually classified by their location.
Wrist tendonitis (also spelled ‘tendinitis’) is the inflammation of one or more tendons in the wrist. This inflammation typically causes symptoms such as pain, swelling, stiffness, and warmth in the affected wrist. Wrist tendonitis is caused due to small tears in a tendon as a result of sudden or repetitive injury. Movements such as opening and closing the hand and / or bending / rotating the wrist in one or more directions may be painful. Generally, the wrist’s tendons are bundles of long fibrous bands of protein that connect a forearm muscle to a hand bone. Therefore, here is a list of tendons of the wrist:
- Tendons during wrist flexion – The action of bending the wrist forward or inward. These tendons also help in rotating the wrist.
- Tendons during wrist extension – The action of bending the wrist backward. These tendons help move the wrist toward the thumb or little finger.
- Tendons during any finger motion – which go from muscle bellies in the forearm to bones in the fingers or thumb.
Causes & Symptoms of Wrist Tendonitis
There are two different types of wrist tendonitis depending on which tendon has been affected, such as:
Flexion wrist tendonitis
A condition that results from repeatedly bending the wrist forward.
Extension wrist tendonitis
A condition that results from repeatedly bending the wrist backward. Extensor carpi ulnaris tendonitis and intersection syndrome (inflammation of a group of four tendons in the wrist area) are both examples of extension wrist tendonitis.
Wrist tendonitis may be caused by either an acute injury or repetitive injury:
Acute injury
An acute injury in the wrist is usually the result of falls, motor vehicle accidents, playing sports, and non-penetrating blunt injury. In severe cases, the tendon may also tear. An acute tendon injury may cause pain, swelling, and stiffness in the affected area. Oftentimes, a tendon injury does not cause symptoms initially, however, over time the injury can worsen, and tendonitis symptoms may gradually develop.
Repetitive injury
These are caused by playing sports or doing other activities that involve the repetitive use of the wrist. Repetitive injury may cause pain and stiffness in the tendon. The symptoms normally develop over a period of time and may worsen as the injury progresses.
Overall, the symptoms of wrist tendonitis and other tendon problems depend on the severity of the injury. Sometimes, chronic tendon injury may intensify over time, resulting in acute pain. Other common symptoms of wrist tendonitis may include the following:
Reduced strength
A feeling of weakness in the wrist and forearm area may be experienced while using the affected arm to do any physical work. Additionally, pain may begin after performing a physical activity, and in other cases, the pain may remain constant or increase during activity.
Inability to bear weight
Reduced strength in the wrist may also cause weight-bearing actions to be more painful. For instance, push-ups, lifting and throwing heavy objects, and pushing on armrests to get out of a chair may cause a significant amount of wrist pain.
Muscle fatigue and cramping
In cases where the injury extends to the corresponding muscle of the tendon, muscle fatigue may occur. Muscle cramps and spasms are also reported to be a symptom of wrist tendonitis.
Bruising and warmth to the touch
Tearing of small blood vessels can cause the skin over the affected tendon to appear red, blue, or black. Increased blood flow to the area may also result in a feeling of warmth in the affected wrist and parts of the hand and/or forearm.
In some people with wrist tendon pain, decreased pain tolerance may cause depression. Avoiding physical work in anticipation of pain can increase the result in developing anxiety, irritability, and frustration.
Who gets Wrist Tendonitis?
Some risk factors to wrist tendonitis are lifestyle-related, and therefore avoidable, while others are related to age, diseases, and genetics, which cannot be preventable. Therefore, factors that may increase the risk of developing tendonitis of the wrist include:
- Metabolic disorders – such as diabetes, increased uric acid, and high cholesterol are examples of disorders that can lead to wrist tendonitis.
- Medications – Some medications such as non-steroidal anti-inflammatory drugs (NSAIDs) may reduce the chances of tendon healing and weaken the structure of tendons if taken frequently or for longer durations.
- Age-related changes – such as stiffness, irregular tissue formation, and up to 50% reduction in the tendon’s ability to bear weight.
How Does Wrist Tendonitis Affect You? How Serious is it?
If you are experiencing wrist tendonitis, and leave your affected tendon untreated, you are at an increased risk of being led to more severe tendon injuries and even breakage. Once this occurs, surgical interventions will be the only solution, thus increasing a larger amount of risks while undergoing surgical procedures in order to repair your ripped tendon. Some of these complications following a wrist tendon surgery include:
- Persistent wrist pain.
- Bleeding.
- Infection.
- Scarring.
- Delayed wound healing.
Recommended Treatment & Rehabilitation for Wrist Tendonitis
In order to diagnose wrist tendonitis, your healthcare provider will most likely begin with a physical exam and review your symptoms. They may palpate on certain parts of your forearm, wrist, hand, or fingers to check for swelling or tenderness.
Your doctor may also ask you to perform certain movements, such as forming a fist or rotating your wrist, so they can isolate the source of your pain. Oftentimes, symptoms of this condition are similar to other conditions that affect the wrist and fingers, such as:
- Arthritis – causes painful swelling and inflammation in your joints.
- Carpal tunnel syndrome – This condition is a compression of a nerve in your wrist that can lead to numbness and tingling.
- Wrist fractures – are breaks in the bones of your wrist.
- Trigger finger – This is a condition that occurs when inflamed tendons cause your finger to remain stuck in a bent position.
Your doctor may order imaging scans, such as an X-ray, magnetic resonance imaging (MRI), or ultrasound, to rule out these conditions mentioned above.
Physiotherapy is a great effective treatment for wrist tendonitis. You will work with a physiotherapist to devise a treatment plan that is specific to your condition. Your specific treatment plan may include:
Pain management
Your physiotherapist will help you identify and avoid painful movements, and show you how to correct abnormal postures to reduce stress on the wrist. He or she will recommend resting the wrist short-term and applying ice to the area to help alleviate the pain. Your therapist may also apply a wrist brace to restrict wrist movement, allowing the tendons to heal.
Manual therapy
Your physiotherapist may use manual techniques, such as gentle joint movements, soft-tissue massage, and wrist stretches to get your wrist moving properly.
Range-of-motion exercises
You will learn exercises and stretches to reduce stiffness and help your wrist, hand, and forearm begin to move properly.
Strengthening exercises
Your physiotherapist will determine which strengthening exercises are perfect for you, depending on your specific areas of weakness. The entire arm, including the shoulder, elbow, and wrist, can potentially be weakened and contribute to the movement dysfunction that causes tendonitis. Therefore, your therapist will design an individualized home-exercise program to meet your needs and goals.
Patient education
Depending on the activities you plan on continuing, your physiotherapist will teach you different ways to perform actions, while protecting your wrist and hand. For instance, keeping the wrist in a neutral position to reduce excessive force while performing repetitive tasks, and taking frequent breaks are ways to decrease your chances of reinjury.
Below are some examples of exercises for you to try. The exercises may be recommended to reduce symptoms linked to wrist tendonitis:
Wrist flexion and extension
Place your forearm on a table, with your hand and affected wrist extended beyond the table, palm down. Next, bend your wrist to move your hand upward and allow your hand to close into a fist, then lower your hand and allow your fingers to relax. Hold each position for 6 seconds, then repeat 8-12 times a day.
Wrist radial and ulnar deviation
Hold your affected hand out in front of you, palm down. Slowly bend your wrist as far as you can from side to side. Hold each position for 6 seconds, then repeat 8-12 times a day.
Hand flips
While seated, place your forearm and affected wrist on your thigh, palm down. Flip your hand over so the back of your hand rests on your thigh and your palm is up. Alternate between palm up and palm down while keeping your forearm on your thigh. Repeat this method 8-12 times a day.
Wrist extensor stretch
Extend your arm with the affected wrist in front of you and point your fingers toward the floor. With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm. Hold the stretch for at least 15-30 seconds, then repeat 2-4 times a day.
Wrist flexor stretch
Extend the arm with the affected wrist in front of you with your palm facing away from your body. Then, bend back your wrist, pointing your hand up toward the ceiling. With your other hand, gently bend your wrist farther until you feel a mild to moderate stretch in your forearm. Hold the stretch for at least 15-30 seconds. Repeat this exercise 2-4 times a day.
Alternative & Homeopathic Treatment for Wrist Tendonitis
If you experience mild wrist pain symptoms, you may be able to ease your symptoms with lifestyle changes and medication. Here are 7 homeopathic treatments for wrist tendonitis:
Take breaks from repetitive activities
Whether you are typing, playing guitar, or using a hand drill, try setting a timer beforehand for 15 minutes. When it goes off, stop what you’re doing and wiggle your fingers. Stretch your hands and move your wrists to help improve blood flow to these areas.
Rest
If you ever find yourself straining or forcing tasks such as writing, typing, or using a cash register, relax your grip or reduce the force you are using. Try using a soft-grip pen or tapping keys more lightly.
Stay warm
Keeping your wrist and hands warm can help with pain and stiffness. Consider wearing a fingerless glove or keeping hand warmers nearby.