A Physical Therapy Guide to Wrist Tendinitis

When your wrist hurts, every day tasks like typing or pulling up your pants can become daunting and downright impossible. Fortunately, wrist tendinitis is a common condition that can be treated successfully with conservative management through occupational or physical therapy.

In a given year, up to 19% of people complain of wrist pain. This number jumps to 24% for athletes.¹ Pushing and pulling become challenging, and putting weight through your hand becomes nearly impossible. Luckily, with proper care and guidance, you can heal your wrist tendinitis quickly and most often, without surgery.

This guide will give you a quick breakdown of wrist tendinitis, its treatment, and how seeing a Certified Hand Therapist or physical therapist can help.

Table of Contents

• Understanding Wrist Tendinitis
• Symptoms of Wrist Tendinitis
• What Are The Most Common Causes of Wrist Tendinitis?
• Diagnosing Wrist Tendinitis
• What to Expect from Hand Therapy
• What If Conservative Treatment Doesn't Work?
• Preventing Wrist Tendinitis
• Is It Time to Seek Treatment?

Understanding Wrist Tendinitis

Wrist tendinitis is a broad term that describes inflammation of any of the six tendons that move the wrist. This may begin as a generalized ache around your wrist and can progress to sharp, searing pain. Depending on which tendon is the culprit, treatment can vary.

Your wrist tendons work by running underneath an anchor to make the tendons more efficient, like a puppet with strings. This anchor looks a bit like a potato chip with ridges where each tendon runs underneath its own ridge. In the wrist, this is called the retinaculum or the tendon sheath. To make each tendon move smoothly under the ridge, there is a fluid called synovial fluid. Let's take a quick peek at the definitions of injuries to these structures:

• Tendinitis: When the tendon itself becomes irritated and inflamed, your wrist may hurt when you move it in certain directions or resist pressure. This is usually the early stages indicative of tendinitis of that tendon.
• Tenosynovitis: If the synovial fluid becomes sticky under the retinaculum or the tendon sheath, you develop tenosynovitis.
• Tendinopathy: If the tendinitis progresses, the problem can become chronic in nature or more long term and earns the name tendinopathy.
• Subluxation: Sometimes, the anchor can be torn which causes the tendon underneath to slip and slide with motion of the wrist. The tendon is said to sublux when this is the problem.²

Symptoms of Wrist Tendinitis

What are the symptoms of wrist tendinitis? Let's review:

• A dull ache in the wrist especially with movement of the wrist in certain directions
• Progresses to a sharp, searing pain with motion or with loading the wrist
• Difficulty moving your wrist
• Decreased ability to perform daily tasks like opening jars, pulling and pushing, or bearing weight in the wrist
• Tenderness with touch or palpation or with stretching
• Decreased motion due to pain
• Swelling in the wrist over the most painful area

What Are The Most Common Causes of Wrist Tendinitis?

Wrist tendinitis has many different causes. Below highlights the most common causes:

• Repetitive stress on the tendons (yoga, golfing, or gymnastics)
• Overuse (typing, writing)
• More rarely, trauma, like a fall
• Co-morbidities like Diabetes, Autoimmune Disorders (such as rheumatoid arthritis), or gout

Diagnosing Wrist Tendinitis

If you are experiencing wrist pain, you can see your primary care doctor, orthopedic surgeon, or local Certified Hand Therapist (CHT), physical or occupational therapist. To get the best conservative care with less need for pain medications, injections, or surgery, it's best to see a CHT for long-term relief and sustainable results.

In other words, get a proper diagnosis for your wrist condition from a specialist like a CityPT CHT who is an occupational or physical therapist with additional specialty training. This will help you get better quicker and return to those daily activities that are most meaningful to you, pain-free.

The sooner your wrist pain is properly diagnosed, the better the results will be. Therefore, it's best to seek treatment as soon as possible.

What to Expect from Hand Therapy

Going to get your painful wrist checked out can be scary and overwhelming. Here at CityPT, we strive to make it simple and approachable for you to reduce those anxieties.

During your first visit, your CityPT therapist will ask questions to get to know you and what exactly is troubling you. The questions may be like:

• How long has your wrist pain been bothering you?
• How did it start?
• What makes it better or worse?
• Do you have any medical conditions we should know about?
• What sorts of meaningful daily activities are frustrating you because of your hand pain?
• What major life changes have you experienced in the last year?

Your CityPT therapist will also perform a thorough physical evaluation which may include:

• Testing to rule out other common conditions
• Measuring range of motion and strength
• Testing functional use of your hand(s)
• Evaluating sensory changes, like numbness or tingling
• Palpating areas of tenderness
• Observing swelling (edema)

Treatment for wrist tendinitis may include:

• Custom splinting to allow the tendons to heal
• Modalities to reduce pain and inflammation
• Manual therapy techniques to increase your range of motion and decrease swelling and pain
• Functional activities and adaptive techniques to help increase your independence with daily activities that are most meaningful to you

What If Conservative Treatment Doesn't Work?

Wrist tendinitis, especially if caught early, has a high success rate for conservative management. Occasionally, though, conservative management does not work — especially if you have been experiencing symptoms for a long time. If you have tried conservative management and continue to experience pain and dysfunction, your therapist may refer you to your physician who may offer:

• Injections: Cortisone injections, while not always effective, can offer temporary relief from the pain to allow your body to heal itself.

• Surgery: When all else has failed, your physician may offer surgical intervention to address your wrist pain. You will likely be referred to therapy post-operatively as well to ease you back into meaningful daily activities. Your hand therapist will help by addressing range of motion, functional adaptations, tendon gliding, swelling and scar management, and increased strength.

Preventing Wrist Tendinitis

Maybe your wrist pain is recent or you have a job that requires repetitive motion, and you want to know how to prevent wrist pain from developing or from getting worse. Here are some suggestions from CityPT:

• Stay active: An overall active lifestyle can reduce swelling and inflammation in the body. Good circulation means healthy muscles and tendons, and less chance of developing inflammatory processes like wrist tendinitis.
• Sleep positioning: Use an over-the-counter wrist support splint while you sleep to assist with ergonomic positioning of your wrist. This can actually help reduce your pain during the day.
• Make healthy lifestyle choices: Nutrition can go a long way in the health of your muscles and tendons. Eating nutrient dense foods and staying hydrated help prevent inflammation in your body. Fortunately, CityPT can get your nutrition on track with one of our Registered Dietitians.
• Talk to a Certified Hand Therapist: If you have concerns or want professional advice on custom splinting, treatments at home, and functional adaptations, make an appointment with a CityPT CHT.

Is It Time to Seek Treatment?

Perhaps you are tired of waking up with wrist pain, or maybe you have already tried at-home remedies for your wrist tendinitis without relief. If this sounds like you, it may be time to seek professional help. A CityPT Certified Hand Therapist can customize your care to get you back to living your best life with minimal interruption.

Schedule an appointment with one of our hand specialists today. They will work with you to find the root of your pain and improve your independence with daily activities, getting you on the path to recovery.

This guide is intended for informational purposes only. We are not providing legal or medical advice and this guide does not create a provider-patient relationship. Do not rely upon this guide (or any guide) for medical information. Always seek the help of a qualified medical professional who has assessed you and understands your condition.

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