FAQ - Tenosynovitis
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Tenosynovitis?


My daughter has some soft tissue growth on her ankle. There are 5 small knots, that have increased in size. The doctors have already said that they don't believe it is a ganglion cyst. She recently had an MRI and the results showed that it was likely from "tenosynovitis" and that it was "less likely to be an aggressive process such as synovial sarcoma."
My question though is that she has had absolutely NO pain from the bumps. What i have researched on tenosynovitis is there is pain associated with it. Is that correct?
Can anyone help me out? Any ideas as to what it could be?
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Tendonitis

Tendonitis is inflammation or irritation of a tendon. Tendons are the tough, white, stringy and rubbery (fibrous) cords that link muscles to bones. They help to release the power created by a muscle contraction, which helps move the bones and joints. For example, the tendons that you can see on the back of your hands move your fingers and are joined to the muscles in the forearm.

Some tendons are covered with a protective and lubricating sheath of tissues, called the synovium. In many cases the sheath is more affected by inflammation than the tendon is. This condition is called tenosynovitis, although both conditions often happen at the same time. In between the synovium and a tendon is a small amount of greasy fluid that helps the tendon to move around easily and pull on the bone it's connected to.

Tendons around the shoulder, elbow, wrist, finger, thigh, knee or back of the heel (Achilles tendon) are the most common areas to be affected. The condition is more common in adults who do a lot of sporting activities.  (+ info)

How do you treat tenosynovitis and ligament tear in wrist?


I suffer from rheumatoid arthritis and have swear pain in both of my wrist and forearms. An MRI revealed tenosynovitis and tear of External Ulnar Ligament. I am taking NASAID (Mobec) but the pain remains and is worst in the morning. Are there any other treatments for this?
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mobic is good,you can ask your dr about max. dose 7.5mg twice a day,seems to work better than one 15mg once a day. I would stay away from ice though that makes arthritis pain worse,even though you have some inflammation.You may try some mild moist heat...10-15 mins,then range of motion exercises..you may end up with a wrist fusion if pain becomes intolerable down the road.
You are at risk for carpal tunnel as well.  (+ info)

What's the best way to treat chronic tenosynovitis?


I obtained this condition above my left ankle about a couple of years ago playing soccer. It really hasn't gone away; when I poke at that area, it feels like a fresh painful bruise. I'm able to run and move around since the injury is above where my sneaker tops off.

I heard that acupuncture is helpful. Your suggestions are welcome.
Thanks.
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Looks like applying heat for 4-6 weeks/corticosteroid injections or surgery is the basic treatments. Below is a good article on the subject.

ANKLE TENOSYNOVITIS
Inflammation of a tendon or the lining of a tendon sheath in the ankle. This lining secretes a fluid that lubricates the tendon. When the lining becomes inflamed, the tendon cannot glide smoothly in its covering.

BODY PARTS INVOLVED
Any ankle tendon and its lining.
Soft tissue in the surrounding area, including blood vessels, nerves, ligaments, periosteum (covering to bone) and connective tissue.

SIGNS & SYMPTOMS
Constant pain or pain with motion.
Limited motion of the ankle.
Crepitation (a "crackling" sound when the tendon moves or is touched).
Heat and redness over the inflamed tendon.

CAUSES
Strain from unusual use or overuse of muscles and tendons in the ankle.
Direct blow or injury to the ankle. Tenosynovitis becomes more likely with repeated ankle injury.
Infection introduced through broken skin at the time of injury or through a surgical incision after injury.

RISK INCREASES WITH
Contact sports, especially kicking sports such as football or soccer.
Skiing.
If surgery is needed, surgical risk increases with smoking, poor nutrition, alcoholism or drug abuse, and recent or chronic illness.

HOW TO PREVENT
Engage in a vigorous program of physical conditioning before beginning regular sports participation.
Warm up adequately before practice or competition.
Wear protective footgear appropriate for your sport.
Learn proper moves and techniques for your sport.

WHAT TO EXPECT APPROPRIATE HEALTH CARE
Doctor's examination and diagnosis.
Surgery (sometimes) to enlarge the tendon's covering and restore a smooth gliding motion. The surgical procedure under general anesthesia is performed in an outpatient surgical facility or hospital operating room.

DIAGNOSTIC MEASURES
Your own observations of symptoms and signs.
Medical history and physical examination by your doctor.
X-rays of the area to rule out other abnormalities.
Laboratory studies: Blood and urine studies before surgery. Tissue examination after surgery.

POSSIBLE COMPLICATIONS
Prolonged healing time if activity is resumed too soon.
Proneness to repeated injury.
Adhesive tenosynovitis: The tendon and its covering become bound together. Restriction of motion may be complete or partial. Surgery is necessary to remove the covering or transfer the tendon to a less constrictive area.
Constrictive tenosynovitis: The walls of the covering thicken and narrow, preventing the tendon from sliding through. Surgery is necessary to cut away part of the covering.

PROBABLE OUTCOME
Tenosynovitis of the ankle is usually curable in about 6 weeks with heat treatments, corticosteroid injections and rest of the inflamed area. Recovery is usually quicker if the inflammation is caused from a direct blow rather than from a sprain or strain.


HOW TO TREAT
Follow your doctor's instructions. These instructions are supplemental.

FIRST AID
None. This problem develops slowly.

CONTINUING CARE
If surgery is not necessary, you may need a walking-boot cast for 10 to 14 days. See Appendix 2 (Care of Casts). Then wrap the ankle with an elasticized bandage until healing is complete.
Apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Take whirlpool treatments, if available.

MEDICATION
You may use non-prescription drugs such as acetaminophen for minor pain. Your doctor may prescribe: Stronger pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
Injection of the tendon covering with a long-acting local anesthetic and a non-absorbable corticosteroid to relieve pain and inflammation.

ACTIVITY
Resume normal activity slowly.

DIET
During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.

REHABILITATION
Begin daily rehabilitation exercises when supportive wrapping is no longer needed.
Use ice massage for 10 minutes before and after exercise. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.

GOOD LUCK!  (+ info)

What's the best way to treat chronic ankle tenosynovitis?


Iv'e had this condition about a year now.. when I poke at the affected area, it feels like a fresh painful bruise. What are my options? Can I get rid of this? Or like arthriits, is this something that'll stay with me for the rest of my life?
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To start, it is an inflammation, so you can treat it with Motrin, Advil or Aleve.

Since it is a fresh-feeling pain and it has been so long, it is time a doctor looked at it. They may prescribe a more aggressive approach to resolving it. I would guess you don't have to deal with a fresh injury pain the rest of your life, but you may not get it back to a normal healthy feel you had before the condition.  (+ info)

How do you treat tenosynovitis?


In particular, above the left ankle, or to be medically specific, of the extensor hallucis longus & flexor hallucis longus tendons
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Tenosynovitis of the ankle is usually curable in about 6 weeks with heat treatments, corticosteroid injections and rest of the inflamed area. Recovery is usually quicker if the inflammation is caused from a direct blow rather than from a sprain or strain.

If surgery is not necessary, you may need a walking-boot cast for 10 to 14 days. See Appendix 2 (Care of Casts). Then wrap the ankle with an elasticized bandage until healing is complete. Apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments. Take whirlpool treatments, if available.  (+ info)

how much would you recommend surgery for dequervains tenosynovitis? my?


niece got it right after birth of a baby..doctors in U.K. suggest surgery, putting restrictions, not to use hands for 3 months.
I think it is hard to do..what is your advice?
I need an answer from either someone who recovered from it, or a doctor..thanks.
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I had DeQuervain's tenosynovitis about 8 years ago and my doctor said that it was caused by repetitive motion or strain. She told me to take 600 mg ibuprofen 3 times a day for ten days and wear a wrist brace to reduce the inflammation. After that I had to do strengthening exercises daily and limit activities that might re-inflame the tendon sheath.

Every now and then my wrist will bother me a little and then I'll remember to do my strengthening exercises daily again. If the pain is extreme then it might be best to have the surgery done, but I was pretty satisfied with the treatment course that my doctor recommended.  (+ info)

De Quervain's Tenosynovitis has anyone had the surgery?


I have to have this surgery and i'm scared to do it. Caneny one tell me how it went?
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I had surgery for DeQuervain's about 11 years ago. The surgery itself went well. It took a really long time to heal because I didn't listen to my doctor and started using it a lot sooner than I should have (I was a musician in college at the time.) Now, it doesn't really give me any problems and is almost as good as new.  (+ info)

Can De Quervain's Tenosynovitis reccur after surgery?


I am 24 years old and I had surgery for De quervains about a year and a half ago. every thing went well and i have since had normal use of my hand. But for the past week the strength in my wrist has deteriorated and i have found it hard to open bottle tops etc. Then yesterday my wrist became extremely painful and now i can't lift anything or use my wrist at all. It is very similar to before my surgery. I haven't had a fall but am not sure if De Quervains can come back after surgery?
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I have this problem affecting a thumb.I havent required surgery for it but have been wearing a cuff with a splint.This has proved very helpful & has helped reduce the pain considerably & given my wrist support too.Your best bet really is to return to your Dr & see what he can tell you about it as you have already had surgery.Best of luck!  (+ info)

What is Dequervain's Stenosing Tenosynovitis? How is it diagnosed? What are the causes? How is it treated?


DeQuervain's stenosing tenosynovitis is a condition brought by irritation or inflammation of the wrist tendons at the base of the thumb. The inflammation causes the compartment around the tendon to swell and enlarge, making thumb and wrist movement painful.

Tenderness directly over the tendons on the thumb-side of the wrist is the most common finding. A test is generally performed in which the patient makes a fist with the fingers clasped over the thumb.

The cause of DeQuervain’s tenosynovitis is an irritation of the tendons at the base of the thumb, usually caused by taking up a new, repetitive activity.


Non-operative treatments include resting the thumb and wrist by wearing a splint, oral anti-inflammatory medication and cortisone-type of steroid which is injected into the tendon compartment. The goal is to relieve the pain caused by the irritation and swelling. In some cases, simply stopping the aggravating activities may allow the symptoms to go away on their own.
When symptoms are severe or do not improve, surgery may be recommended. The surgery opens the compartment to make more room for the inflamed tendons, which breaks the vicious cycle where the tight space causes more inflammation.

For more information visit www.orthopaedicclinic.com.sg  (+ info)

Tenosynovitis in my left hand?


Hi, about 3 weeks ago I got Tenosynovitis in my left hand. Kept it immobile for 12 days. As a guitar player I worry does this ever clear up? I still feel a slight weakness when I play and have some chord difficulty. Any help welcome
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Rest, ice and talk to your doctor about anti-inflammatories. Outcomes are good and you should heal, it will just take a little longer. You may need to change your hand position when you play to reduce the risk of this happening again. Exercise will not help right now, it will just make it worse.

Good luck.  (+ info)

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Last update: September 2014
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