WRIST TENOSYNOVITIS

Your wrist pain can result from factors such as repetitive grasping and twisting of the thumb and wrist, chronic strain from childcare or household chores, sports or hobbies involving repetitive wrist motion, direct trauma to the thumb, or hormonal changes.

The primary cause is the repetitive grasping of the fingers and thumb, combined with a twisting motion of the wrist, which creates excessive strain on the tendons. This includes repetitive actions common in many professions and in the care of young children, where the wrist is moved sideways while the thumb is gripped. 

Common household chores, particularly those that require force like wringing and drying wet clothes, or pouring water from a heavy jug or kettle, can significantly aggravate the condition. Actions such as opening of doors and turning of keys or opening tight jar lids also contribute to the strain.

Activities like racquet sports (badminton, tennis), gardening, or using a hammer put chronic stress on the involved tendons and can trigger or worsen the pain.

A direct blow to the thumb can initiate the inflammation.

Menopausal women are also noted to be at a higher risk, suggesting hormonal factors may also play a role in the susceptibility to this type of tendon inflammation. 

Symptoms of Wrist Tenosynovitis can range from mild discomfort to severe functional limitation. If your symptoms continue or worsen despite rest and home care, it's important to have them assessed by a pain specialist. 

• Pain: Pain at the side of the wrist near the base of the thumb typically worsens with increased activity or repetitive motions such as swinging a badminton racquet or driving for long periods. Common household chores tend to trigger pain, including washing plates, wringing or drying wet clothes, opening jar lids, and pouring water from a kettle. 
• Difficulty Moving Your Thumb: You might have difficulty pinching or gripping objects as the thumb has a limited range of movement. In severe cases, wrist and thumb movements such as flexion or extension become restricted. You may experience weakness when carrying a bowl of hot soup or closing and tightening a jar lid. 
• Swelling: The affected area at the base of the thumb becomes inflamed, causing swelling and tenderness. Some patients also experience weakness while using the wrist. 

Consult a pain specialist if you experience:

• Persistent wrist pain from moving the thumb.
• Swelling of the wrist joint that does not improve with rest.
• Tenderness at the location of pain.
• Inability to rotate the wrist or significant restriction of movement.

If your wrist tenosynovitis symptoms are mild or in the early stages, conservative treatments may help. 

• Hot and Cold Compress Home Remedy: Hot or cold compresses can provide effective relief for wrist tenosynovitis. Cold compresses or ice packs help reduce pain and inflammation in the affected area. After a few days of cold therapy, hot compresses can be applied to stimulate blood flow and promote healing. 
• Splinting: Wrist tenosynovitis may require splinting to reduce inflammation and allow for recovery. These splints are typically worn continuously for four to six weeks. When treated early, approximately 50% of patients experience significant improvement through wrist immobilization alone. 
• Physiotherapy: Targeted exercises play a crucial role in reducing stiffness and restoring wrist function. A structured physiotherapy program can help strengthen the affected tendons, improve flexibility, and prevent recurrence.  

If your wrist tenosynovitis symptoms have been persistent or more severe, minimally invasive treatments can address the real source without the need for open surgery. At Singapore Paincare, we offer precise procedures designed to relieve pain at its origin.

Coreflex injections are designed to calm that discomfort at its source by delivering a combination of local anaesthetic, anti-inflammatory medication, and muscle relaxant into the affected tendon sheath, as well as the strained muscles and ligaments around it. This helps ease pain, reduce inflammation, and support more comfortable movement.

Wrist tenosynovitis usually develops when the tendon sheath becomes inflamed, creating irritation with movement and tenderness around the wrist. In most cases, this inflammation improves with non-surgical treatments that calm the irritated tissues and allow the tendon to move more comfortably again.

In rare situations, however, the problem is not only inflammation. The tendon may also feel restricted because of pressure from the tight retinaculum band of the wrist, which can compress the tendon as it moves. This ongoing pressure can keep the area swollen and painful despite conservative care.

If non-surgical treatments do not reduce the pain and swelling, surgery may be recommended to release the tight structure. By relieving that pressure, the tendon can glide more freely again, helping restore more comfortable wrist movement and daily function.

• Surgical Release of the Tendon: This procedure is usually carried out with local anaesthetic, where the extensor tendon is freed from the constricting retinaculum band. During surgery, a small incision is made in the sheath, allowing the tendons to slip more easily. Post-surgery, patients are recommended to use a splint for a few weeks to ensure a smooth recovery.