Tenosynovitis, are all “hardworking” to blame?

Parents circling around their babies, urban white-collar workers typing on keyboards, game lovers who stay up late and play in the dark, etc. These are the common “craftsmen” in our daily life.

Sometimes I hear them complain that their wrists are not as strong as they used to be, and sometimes there is a “click” sound or even a dull pain. So be careful, you may have been targeted by “stenosing tenosynovitis”!

What is stenosing tenosynovitis?

The tendon sheath wraps around the tendon and functions to fix, protect, and lubricate the tendon to prevent friction or compression.

If the tendon is repeatedly rubbed with excessive force at the tendon sheath for a long time, the tendon and tendon sheath will be damaged, swelling (inflammation) will occur, and the tendon sheath will also appear relatively narrow due to swelling, which is the origin of stenosing tenosynovitis Depend on.

There are many types of tenosynovitis, usually referred to as stenosing tenosynovitis.

Susceptible people

Stenosing tenosynovitis is more common in patients who require long-term, rapid, and vigorous use. fingers and wrist. Typically morning stiffness, localized pain, tenderness or pain with movement, and sometimes a snapping or palpable mass are typical symptoms.

Excessive use of electronics, hand porters, orchestral players, and pregnant and nursing women are among the “susceptible groups” for stenosing tenosynovitis.

1. Tenosynovitis of flexor tendon stenosis

Often referred to as “snapping finger” and “trigger finger (thumb)”. Painful nodules the size of soybeans can be palpated at the distal palmar crease, and the nodules can move up and down with the flexor tendons in flexion and extension of the affected finger or appear “plucking”.

2. Pediatric stenosing tenosynovitis

Usually congenital, no symptoms at birth, more than 6 months to about 2 years old, the affected finger is found to be flexed and unable to straighten . The induration of the rounded bulge can be palpated, and it is painful to lightly press, and there is a feeling of bouncing when flexing and extending the fingers.

3. Stenosing tenosynovitis of radial styloid process

Often called “mother’s hand”, it can radiate to the forearm and thumb, and in severe cases, it is unable to lift heavy objects. Pain is markedly increased with ulnar deviation of the wrist and thumb flexion, and there may be limited extension of the thumb.

How to prevent

1. Pay attention to the correct posture of fingers and wrists, do not bend excessively or Reach out, and try to avoid lifting heavy items.

2. Combining work and rest, don’t use your fingers and wrists for a long time. It is best to soak your hands in hot water after working for a long time to relax your muscles, and you can also use self-stretching to relieve hand soreness. .

3. Avoid cold hands. It is best to use hot water for washing dishes and laundry.

4. Change bad behaviors, such as using a mobile mouse for a long time, snapping fingers or arm wrestling.

If you still have pain or limited function after doing the above points, please seek medical attention in time.

Treatment

1. Rest, immobilization:

For patients with mild disease or early onset, splint or brace fixation restricts the movement of the lesion, Inflammation of tendons and tendon sheaths can be effectively controlled by correcting bad movements.

2. Exercise therapy:

Rehabilitation therapists will give professional exercise guidance and training at all stages of the disease, which can prevent muscle atrophy while minimizing the wear of tendons and tendon sheaths , to achieve pain-free movement while restoring function.

3. Physical factor therapy:

Shock wave has a significant effect on pain caused by such diseases. Ultrasound drug introduction, intramuscular tape, magnetic therapy and short wave also help to quickly reduce inflammation Reduce swelling.

4. Traditional Chinese Medicine:

Acupuncture can be used alone or in combination with other methods.

5. Drug treatment:

If the pain affects sleep and function, topical application containing For external use of anti-inflammatory ingredients, non-steroidal anti-inflammatory drugs can also be taken (please use under the guidance of a professional doctor).

6. Local sealing treatment:

The specialist injects an appropriate amount of glucocorticoid (or anesthesia) into the lesioned tendon sheath, and with the development of ultrasound-guided technology, ultrasound Guided intrathecal injection enhances efficacy and reduces complications.

7. Surgical incision treatment:

By incising the narrow tendon sheath to relieve the compression of the tendon and restore its normal sliding, it is the end of severe tenosynovitis. It is usually suitable for patients with ineffective or worsening pain after conservative treatment for 6 months.

Finally, I would like to remind everyone that if you feel that your fingers and wrists are weak at this moment, then throw away the phone and relax your hands!

Source: Tongji Hospital, Huazhong University of Science and Technology

Hubei Radio and Television Health Development Center Graphic Editor: Yuan Jia

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