Tenosynovitis is an inflammation of the tenosynovium, a sheath that covers tendons. Tendons are the cords that connect bones to muscles in the body. Tenosynovitis can occur in any tendon with a synovial sheath. However, it most often occurs in the hand, wrist, or foot. Usually this condition can easily be treated; contact your doctor if you think you may have tenosynovitis.

Most cases of tenosynovitis are caused by one of the following:

• Injury
• Infection
• Strain
• Repetitive motions
  • Computer operation
  • Assembly line work
  • Cash register operation
  • Sports that involve repetitive actions
  • Sewing
  • Playing musical instruments

If you perform repetitive actions with your hand, wrist, or foot for work or play, you may be at an increased risk of developing tenosynovitis. Diseases such as gout and rheumatoid arthritis can contribute to the swelling of tendon sheaths.

The infections that cause some cases of tenosynovitis occur more often in people with the following conditions:

• Diabetes
• IV drug abuse
• Compromised immune systems

If you experience any of these symptoms, do not assume it is due to tenosynovitis. These symptoms may be caused by other conditions. If you experience any one of them, see your physician. Symptoms of tenosynovitis include:

• Joint pain
• Joint stiffness
• Joint swelling
• Difficulty moving a joint
• Finger sticking in a bent position ( trigger finger )
• Pain and stiffness in the wrist on the thumb side ( de Quervain’s tenosynovitis )

Your doctor will ask about your symptoms and medical history, and perform a physical exam. The physical exam may include:

• Asking you to move the affected joint
• Feeling the joint and along the involved tendon

A blood test may also be performed to look for signs of bacterial infection or other conditions such as rheumatoid arthritis. For certain types of tenosynovitis, your doctor may refer you to a hand specialist.

Talk with your doctor about the best treatment plan for you. The goals of treatment for tenosynovitis are to reduce swelling and pain and to allow the tendon to move freely through the tendon sheath. Treatment options include the following:

Stopping movement in the joint, sometimes with the help of a brace or splint, is often the best treatment for tenosynovitis. Rest may be combined with stretching and strengthening exercises for the muscles attached to the tendon.

Several medications are used to treat tenosynovitis. These include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs) to help reduce inflammation and pain:
  • Ibuprofen (Advil, Motrin)
  • Naproxen (Aleve, Naprosyn)
• Corticosteroids, given as an injection into the tenosynovium, a thin tissue that covers the tendons
• Antibiotics, if your doctor finds that your tenosynovitis was caused by an infection

For severe cases of tenosynovitis, surgery may be used to release the tendon and allow it to move freely within its sheath.