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. Special splints or braces, or a tight bandage, can also help to relieve pressure on the thumb or wrist or to temporarily keep it from moving (immobilization).

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. This group of drugs includes acetylsalicylic acid (the drug in medicines like Aspirin), ibuprofen and diclofenac. These medications relieve pain as well as reducing inflammation and swelling. But they should not be taken for a longer time, because they can cause side effects like stomach problems. It can also help to cool the inflamed area.

If the pain is especially bad or long-lasting, it can be treated with steroid injections. Steroids are injected into the inflamed area – sometimes in combination with the anesthetic lidocaine. Studies show that steroid injections, when used in combination with rest, can relieve symptoms more effectively than rest alone.

Although it’s important to rest the affected part of your body, some movement is still 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 strengthening exercises. Massages or other treatments in a physical therapy practice can help too.

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, physiotherapy 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. This is typically done using local anesthesia. 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 complications such as wound healing problems and infections. In addition, unusual sensations or limited mobility may occur, but these usually go away over time.