Consumer Information

Upper Extremity Tenosynovitis

WHAT YOU SHOULD KNOW:

Upper extremity (ek-strem-IH-tee) tenosynovitis (ten-o-sin-o-VEYE-tis) is a condition affecting the tendons, sheath, and synovium of an upper extremity (limb). Tendons are cords of tissue that connect muscles to the bones. The synovium is the lining of the sheath (covering) of the tendons. With upper extremity tenosynovitis, the sheath and the synovium of the flexor (bending) muscles become inflamed (swollen). The tendons may also become thickened and have a hard time moving through the swollen covering. Upper extremity tenosynovitis usually affects women, athletes, and people of middle age or older. It is also common in piano players, typists, meat cutters, tailors, seamstresses, and dentists.
You may have pain, redness, and swelling in your upper and lower arm, hand, wrist, fingers, or thumb. This pain usually occurs when moving the affected part up and down, while grasping an object, or making a fist. Over time, the pain may become worse and may be present even at rest. You may also have weakness and limited movement of the affected part. Your caregiver will test your shoulder, arm, hand, wrist, or fingers by moving them in different positions. X-rays, arthrograms, a biopsy, or magnetic resonance imaging (MRI) may be done to look for tendon injuries and other problems. Treatment will depend on your symptoms and the length of time you have had them. With treatment, such as medicines, a splint, rehabilitation, or surgery, you may be able to resume your normal daily activities.

INSTRUCTIONS:

Medicines:

Keep a list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.
Nonsteroidal anti-inflammatory medicine: This family of medicine is also called NSAIDs. Nonsteroidal anti-inflammatory medicine may help decrease pain and inflammation (swelling). Some NSAIDs may also be used to decrease a high body temperature (fever). This medicine can be bought with or without a doctor's order. This medicine can cause stomach bleeding or kidney problems in certain people. Always read the medicine label and follow the directions on it before using this medicine.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Activity:

Limit the activities of your affected part: Avoid hand and wrist movements, such as twisting, grasping, or forceful gripping, until your caregiver says it is OK. You may also need to decrease your thumb pressure while pushing buttons on a remote control, typing, or playing the piano. This may help decrease stress on the tendon and prevent further damage, relieve pain, and promote tendon healing.
Proper upper extremity position: It is important to always keep your affected part in a correct position so it will heal faster. This may be done by increasing the height of armrests while working, driving, and sitting. When sleeping, try not to lie on the same side as the affected part.

Cold or warm compress:

Ice pack: An ice pack may be applied on top of the swollen part to decrease swelling and pain. Put crushed ice in a plastic bag and wrap it with a towel. Place the ice pack on the area for 15 to 20 minutes every hour as long as you need it. Do not place the ice pack directly on the skin. If ice is put on the injured area for too long or if it is slept on, it may cause frostbite.
Warm pack: After applying an ice pack, apply a warm, wet washcloth, a heating pad (turned on low), or a hot water bottle. This will also help to decrease pain. You may do this for 30 minutes, 3 to 4 times a day. Do not leave the warm pack on your skin for a long time. Leaving heat on for too long can burn your skin. Sitting in a warm water bath or whirlpool may also help.

Rehabilitation:

Occupational therapy: Occupational therapy (OT) uses work, self-care, and play activities to help you in your daily life. OT teaches special skills for bathing, dressing, cooking, eating, or driving. An occupational therapist may help you choose tools to use, and suggest ways to keep your home or workplace safe. You and your therapist will plan a therapy program that is right for you.
Physical therapy: Your caregiver may want you to go to physical therapy. A physical therapist will help you with special exercises. These exercises help make your bones and muscles stronger.

Rest: You may feel like resting more. Slowly start to do more each day. Rest when you feel it is needed.

Splint care: Caregivers may put a splint on your affected arm, hand, wrist, or fingers. This will keep the affected part from moving while it heals. It may also be used to decrease pain. Make sure your splint is not too tight or too loose. If it is too tight, your fingers may feel numb or tingly. Gently loosen the tape so that your fingers are comfortable. Do not push down or lean on any part of the splint because it may break.

CONTACT A CAREGIVER IF:

You have a fever (increased body temperature).
You have pain and swelling in the affected part, even after taking your medicines.
Your skin is itchy, swollen, or has a rash.
You have questions or concerns about your condition, medicine, or care.

SEEK CARE IMMEDIATELY IF:

You have trouble breathing or have chest pain all of a sudden.
Your shoulder, arm, or fingers feel numb, tingly, cool to the touch, or look blue or pale.
Your symptoms have become worse, or have returned.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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