How can tenosynovitis be treated?

It is important to rest the affected area, and in particular to avoid the movements that led to the inflammation in the first place. To do this, you may have to get a sick note from your doctor and stay home from work. If it isn’t possible to completely avoid a specific movement, you can try to do it less often or with less force. A plaster cast, tight bandage or special orthopedic brace can help as well, for instance by keeping the thumb or wrist still.

Inflammation-reducing painkillers such as non-steroidal anti-inflammatory drugs (NSAIDs) can be swallowed or applied to the skin too, particularly if the inflamed area hurts even when it isn't being moved. These medications relieve pain as well as reducing inflammation and swelling. Many people say that cooling the affected area helps, but heat is sometimes applied too. You can try applying cold or heat yourself to see what works for you.

Although it’s important to rest the affected part of your body, some movement is a good idea. For instance, if the tenosynovitis means you can no longer move your finger or wrist properly, you can try to reduce the symptoms using stretching or mobilization exercises. Massages or other treatments in a physical therapy practice can help too. Sometimes tenosynovitis is also treated with acupuncture or transcutaneous electrical nerve stimulation (TENS).

If tenosynovitis is very persistent, doctors sometimes try to reduce the symptoms using injections. In most cases, a corticosteroid and the anesthetic lidocaine are injected directly into the inflamed area.

Some tendons – for instance, in the fingers and wrists – run through a narrow tunnel made of bones and ligaments. They are protected by tendon sheaths. The swelling in tenosynovitis can make it difficult or even impossible for the tendon to slide through the tendon sheath. The medical term for this is stenosing tenosynovitis.

Conservative treatment approaches such as rest, physical therapy and painkillers can help here, too. If they don’t provide any relief, the narrow part of the “tunnel” can be operated on. This involves removing or cutting the obstructing tissue to give the tendon more room to move again.

The short procedure is often carried out in an outpatient setting (in other words, you can go home again on the same day), and there's usually no need to make big cuts in the skin. It is important to rest and protect the affected part of the body until the wound has healed. But that doesn't mean that you aren’t allowed to move it. On the contrary: It is a good idea to move the affected tendons several times a day – without using too much force, though. After a few weeks, you can move that part of your body normally again without it hurting.

Like all operations, this procedure can have adverse effects such as wound healing problems and infections. Side effects such as abnormal sensations or limited mobility are possible, too.