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Upper Extremity Tenosynovitis
WHAT YOU SHOULD KNOW:
- Upper extremity tenosynovitis 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.
AFTER YOU LEAVE:
- Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
- Take your medicine as directed: Call your healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
- NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- 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.
- Occupational therapy: Occupational therapy (OT) uses work, self-care, and other normal daily activities to help you function better in your daily life. OT helps you develop skills to improve your ability to bathe, dress, cook, eat, and drive. You may learn to use special tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.
- Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.
Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.
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.
- 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.
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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.