If your job or favourite hobby has you doing repetitive motions like jumping, running, throwing, or even typing you might be familiar with the pain and discomfort associated with tendon sheath inflammation. New movements, especially over your head; like painting the ceiling or perfecting an overhand serve, can also contribute to this condition. Tendon sheath inflammation or tenosynovitis is inflammation of the lining of the tendon sheath around a tendon. When the tendon sheath becomes inflamed it is often accompanied by swelling, pain, and discomfort, and in some cases the affected area can become so tender that it hurts to touch it. Fortunately, your chiropractor can assess the injury and teach you stretches and exercises to help you reduce pain and inflammation while preventing further injury. Read on to learn more about the causes and treatments tendon sheath inflammation.

What is tendon sheath inflammation?

A tendon is a type of fibrous tissue that connects your muscles to your bones. These tissues help control actions such as running, jumping, grasping, and lifting. Without tendons, you wouldn’t be able to control the movement of your body.

A protective sheath known as the synovium covers tendons. This sheath produces synovial fluid, which keeps the tendon lubricated.

Injury to the tendon may result in the malfunction of the sheath. If this occurs, the sheath may fail to make synovial fluid or may not make enough fluid. This can cause inflammation or swelling of the sheath. This condition is known as tendon sheath inflammation. It’s also sometimes called tenosynovitis.

What causes tendon sheath inflammation?

Tendon sheath inflammation is typically the result of injury to the tendon or surrounding muscle or bone. It’s not limited to athletes and appears in people who perform a variety of repetitive-motion activities, such as assembly-line work, weeding, and typing. People working in certain jobs appear to have greater risk of it than others, including:

It’s most common in the tendons of the wrist, hands, and feet. Injury can result from:

  • repetitive-stress activities
  • prolonged physical activities, such as running
  • standing in the same position for long periods of time
  • sudden sprains and strains

Tendon sheath inflammation can also be due to underlying health conditions which include different forms of inflammatory arthritis, diabetes, and infection in the body.

The cause of the disease can’t be determined in some people. In rare cases, tendon sheath inflammation is due to an infection that resulted from a cut or puncture to the tendon.

How to tell if your pain is caused by tendon sheath inflammation

Certain tendons in the body are more susceptible to injury, primarily those in the hands, feet, and wrists. Tendon sheath inflammation is more common in these areas. However, it can occur in any tendon in the body, including those of the shoulder, elbow, and knee. If you develop this condition, you may have the following symptoms:

  • joint stiffness, making it difficult to move
  • joint swelling
  • joint pain
  • joint tenderness
  • redness of the skin that overlies the tendon in question

Some people may develop a fever. This indicates the presence of an infection and requires immediate medical attention.

How is tendon sheath inflammation diagnosed?

Diagnosis of tendon sheath inflammation will require a physical exam of the affected area. Your doctor will check to see if redness and swelling are present. Your doctor may ask you to move the affected area to see the quality of movement and if there is pain present.

In some cases, your doctor may order an ultrasound or MRI scan to confirm a diagnosis or rule out other possible causes such as arthritis.

Treatment options for tendon sheath inflammation

The treatment for tendon sheath inflammation focuses on reducing inflammation and pain. One strategy is to rest the affected area and stop the activities that caused the initial injury for a short period of time. Your doctor may recommend the use of a brace or splint to immobilize the affected area.

Applying heat or cold may also help reduce swelling and pain. Other therapies that your doctor may recommend are:

  • massage
  • stretching the affected area
  • transcutaneous electrical nerve stimulation (TENS)
  • ultrasound

First lines of treatment for tendon sheath inflammation are generally less invasive. Your doctor may prescribe a topical ointment, over-the-counter NSAIDs, or other more natural anti-inflammatory preparations taken orally.

If less invasive treatments are insufficient to return function to the area, injection of the tendon sheath with a steroid is usually successful (in noninfectious cases) and occasionally surgery is necessary to release the tendon sheath about the tendon. If your condition was caused by an infection, your doctor may prescribe antibiotics to fight the infection.

If your condition is due to an underlying health issue, such as rheumatoid arthritis or gout, treatment may also include medications to treat these disorders. If there are other conditions you have been diagnosed with that are contributing to the tendon inflammation, treatment for those conditions must also be ongoing for best results.

Once the inflammation has improved, exercise therapy is necessary to gradually return to normal activities with appropriate strength and endurance. Strengthening the muscle will help protect the tendon from injury in the future. If you have recurring tendon sheath inflammation, your doctor may recommend surgery to correct the problem.

What is the outlook for those with tendon sheath inflammation?

If you develop tendon sheath inflammation, it’s likely that you’ll make a full recovery with treatment. In most cases it is difficult to completely avoid the activities that led to the injury in the first place, therefore, though rest is important for a short period of time, best results come from striking a balance between activity, rehabilitation, and supportive treatment to improve mobility and resilience in the area. It is not uncommon to have periods of aggravation as you return to your normal activities. Prognosis for complete recovery is dependent on many factors, including whether you have any other underlying conditions as well as your ability to appropriately rest and rehabilitate the area: if you have questions about your prognosis, speak with your chiropractor.

If your condition develops as a result of an infection, you’ll need antibiotics to prevent the spread of infection. An uncontrolled infection may become life-threatening. A good outlook depends on treating an infection promptly.

How can tendon sheath inflammation be prevented?

Tendon sheath inflammation is preventable if you have a proactive plan which involves stretching muscles that are used often, and being mindful of repetitive stress and strain in any particular area. Developing well-rounded strength is also preventative as this helps distribute forces more effectively and safely. Your chiropractor is trained to assess movement quality and prescribe exercises that can help prevent repetitive stress injuries.

If you cut your hands, wrists, or feet, proper cleaning of the wound will help prevent infection and the possible development of tendon sheath inflammation.

Please note that the advice in this article doesn’t replace personalized medical advice from a professional.

To learn more or to book a consultation with one of our experienced chiropractors email us at info@evolvevancouver.ca.