Tendonitis used to be a common disease among middle-aged and elderly women, so some people call it “mother’s hand”; however, more and more people are suffering from this disease, including white-collar workers, blue-collar workers or housewives. People who use computers and those who work in the service industry, such as cleaning, are now the most common victims of tendinitis. These people may feel pain in their wrist joints in addition to fatigue in their fingers.
What is tendon sheath and tendonitis
The tendon sheath is a cannula-like, closed synovial tube that sits outside of the tendon, and is wrapped around the tendon in two layers, with a cavity, or synovial cavity, between the two layers. The inner layer fits closely to the tendon, while the outer layer is lined with the inner part of the tendon fibrous sheath. The tendon sheath has the function of maintaining the normal flexion and extension of the fingers and wrist and the gliding of the tendon.
When the fingers and wrist bend and straighten activities, the tendon will shuttle in the tendon sheath and rub with the tendon sheath, due to strain factors when the hand does repetitive, excessive activity, it will make the tendon sheath chronic inflammation, edema and hyperplasia and adhesions, resulting in tendon sheath hypertrophy and narrowing, the tendon in the sheath sliding becomes very difficult, the disease process for a long time tendon will be narrowed tendon sheath stuck and can not straighten flexion, but also pain and The tendon may become painful and impaired and requires external force to move normally. This is called tenosynovitis, also known as stenosing tenosynovitis.
Symptoms of tenosynovitis: painful swelling of the affected area
Tenosynovitis of the fingers is most likely to occur in the thumb, index finger and middle finger. The affected finger cannot be flexed or extended after the onset of the disease, which is heavier in the morning and lessens after a day of activity. When the affected finger flexes and extends, the tendon passes through the narrow tendon sheath, often emitting a “banging” sound.
The “cackling” sound, so also known as “popping finger”. In severe cases, the finger cannot be flexed or extended and requires the help of the other hand to do so.
Tenosynovitis of the wrist often occurs in the wrist on the thumb side (radial tuberosity tendon sheath), there are two tendons passing through the sheath, because the thumb and wrist activities are more, larger, the tendon sheath here is often inflamed, causing pain, pressure and swelling of the radial side of the wrist, thumb flexion and extension is limited, and there are hard knots and popping phenomenon, the affected area usually pain, swelling, weakness, burning sensation and reduced mobility, serious In severe cases, it can affect daily life and work ability.
Predisposed people: middle-aged and elderly women who do a lot of housework, manual workers, and people who frequently type on Twitter and computer keyboards.
The main cause of tendinitis is overuse of the finger and wrist joints and repetitive strain. It is most commonly seen in perimenopausal women, where the decrease in estrogen secretion causes a change in the composition of the synovial fluid in the tendon sheath, which tends to clot and thicken the inner layer of the tendon sheath. In addition, women during this period work hard and do more housework, which increases the friction between tendons and tendon sheaths, making it easier for tendonitis to develop over time.
In addition, some occupations that require long-term repetitive strain on the finger joints, such as typists, instrumentalists, cargo handlers and people in the IT industry who need to operate computers for long periods of time, are also at high risk for this disease, which is also known as “keyboardist” because it is mostly seen in people who operate computers and type.
Tenosynovitis classification
A. Radial stenosis tendovaginitis This disease starts slowly and gradually worsens, with pain at the thumb side of the wrist (radial stenosis) and around the thumb, obstruction of thumb movement, pressure and friction at the radial stenosis, and sometimes a slight elevation of pea-sized nodules at the radial stenosis. If the thumb is held tightly within the other four fingers and the wrist is flexed to the medial side of the wrist (ulnar side), severe pain can occur at the radial styloid process. In the acute stage, there is local swelling.
Second, the flexor tendon tenosynovitis this disease mostly occurs in the thumb and middle finger. The affected finger may have dysfunction in flexion and extension, especially when waking up in the early morning, which can be relieved or disappeared after activity. There is pressure pain in the flexion of the metacarpophalangeal joint, and sometimes thickened tendon sheaths and nodules the size of peas can be palpated. When bending the affected finger, it suddenly stays in the semi-bending position, the finger can neither be straightened nor flexed, as if it was suddenly “stuck”, with unbearable soreness and pain, and after using the other hand to assist in triggering, the finger can move again, producing a trigger-like action and popping sound, so it is also known as “trigger finger”. The “trigger finger” is called.
Treatment of tendovaginitis
If you are unfortunate enough to have tendovaginitis, you can apply ice to the affected area if it is acute and causes redness, swelling and fever in the hand. Since this disease is caused by excessive activity, try to control the activity of the affected part, reduce hand work, and immobilize the affected part for 2 to 3 weeks of full rest if necessary. If the tendon sheath structure is not rested after damage, or if it is not treated in time and the damaged area is used repeatedly, it will delay the development of chronic lesions, which are characterized by scarring of the relevant tissues and limitation of movement.
If it is already chronically inflamed, the hot compress method is used. This is done by using 500 grams of salt, frying it in a pot and putting it in a cloth bag and sealing it, applying hot compresses to the affected area 3 times a day to accelerate blood circulation in the hand and doing some appropriate stretching exercises regularly, preferably as soon as possible to a doctor or physical therapist. If early consultation and appropriate physical therapy is received within 3 months of the damage, it can basically be cured.
Local closure therapy can provide relief from early tendonitis. A small amount of glucocorticoid and a small amount of local anesthetic (such as prednisolone with procaine) is injected into the tendon sheath at the hospital, which has an immediate effect because it acts directly on the area. It can usually be cured. However, the amount of activity of the affected area should be controlled after closure, otherwise it is prone to recurrence in the future.
If the above methods are ineffective or recurrent, tenosynovectomy should be performed, and postoperative activities of flexion and extension of fingers should be done as early as possible to prevent tendon adhesions. Avoid hand work for 1 month after surgery.
Prevention is better than cure
For the daily prevention of tenosynovitis, you should pay attention to hand warmth during domestic work, do not often wash your hands and dishes with cold water, it is best to use warm water, do not force the mop and towel to wring dry without water marks.
Domestic work should be careful not to work continuously for too long, to let the fingers and wrists work and rest, remember to let the hand more rest, do housework or work during the need to rub the fingers, more small breaks, do some stretching exercises to avoid excessive strain on the tendons. When resting, you can lightly clench your fist without releasing it for a few seconds before relaxing it and then opening it to straighten your fingers, which can strengthen the finger force and help relieve pain and tendonitis from occurring.
The same exercise of flexing the wrist can strengthen the wrist. Daily at home, hot water can be used to dip the wrist to speed up blood circulation.
For office workers, they should adopt the correct working posture, try to make the hands balanced, wrists can touch the real thing, not hanging. In terms of hardware, in addition to buying wrist guards to enhance wrist protection, the easiest way is to add a wrist pad in front of the keyboard to increase the support of the wrist and thumb. In addition, some specially designed tools can also reduce wear and tear, try to use the ergonomic keyboard, can reduce wear and tear.