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Tendon Sheath Inflammation (Tenosynovitis)

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 it 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 patients 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:

  • carpenters
  • dentists
  • musicians
  • office workers

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. Examples of conditions that can result in this condition include:

  • rheumatoid arthritis
  • scleroderma
  • gout
  • diabetes
  • reactive arthritis, such as Reiter’s syndrome
  • gonorrhea

The cause of the disease can’t be determined in some patients. 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 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 also ask you to move the affected area to see if pain is present. In some cases, your doctor may order an ultrasound or MRI to confirm the 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. 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

Your doctor may also prescribe medications for tendon sheath inflammation. Over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, or injectable corticosteroids are other options. 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.

Once the tendon heals, your doctor may recommend exercises or physical therapy to help strengthen the muscle. 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 Patients with Tendon Sheath Inflammation?

If you develop tendon sheath inflammation, it’s likely that you’ll make a full recovery with treatment. Problems may arise if the activities that caused the condition aren’t stopped. If this happens, the damage to your tendon may become permanent. Permanent damage may impact the joint. Over time, the joint may become stiff and your motion may be limited.

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 prognosis depends on treating an infection promptly.

How can tendon sheath inflammation be prevented?

Tendon sheath inflammation is preventable if you avoid excessive movements or motions that are repetitive or forceful. Muscle strengthening around the site of the joint can also help prevent this type of injury, as well as stretching and range-of-motion (ROM) exercises.

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.

Content licensed from:

Written by: Darla Burke
Medically reviewed on: Oct 23, 2015: Steven Kim, MD

This feature is for informational purposes only and should not be used to replace the care and information received from your health care provider. Please consult a health care professional with any health concerns you may have.
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