My wrist hurts, making it difficult to brush my teeth (beware of wrist tendinitis!).

I was only thinking about carpal tunnel syndrome...

There was also wrist tenosynovitis...

 

I only sit in front of my office computer and just tap the keyboard and mouse.

I should be careful...

 

I highly recommend using an ergonomic keyboard and a vertical mouse.

I've been working at a computer for over 20 years, but my wrist pain has definitely decreased!

 

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[Health is the best] Wrist tenosynovitis without hand numbness, different from carpal tunnel syndrome symptoms

 

As the use of smartphones and computers increases, the number of people complaining of wrist pain is also rising.

The wrist is a part that moves frequently in daily life, and it consists of various components such as tendons, muscles, and fascia, so improper use can lead to pain and inflammation.

When tendinitis occurs in the wrist, it can cause various discomforts such as pain, and you may also become afraid to use your hand.

 

Wrist tenosynovitis is a condition caused by damage to the tendons (extensor tendons) that connect the wrist to the thumb, often resulting from overuse of the hand or wrist, leading to inflammation.

 

The 'sheath of tendon' is a thin membrane that surrounds the tendon like a sheath. When the muscle moves, the tendon slides back and forth inside the sheath, which helps the tendon move smoothly. It has a two-layer structure: the outer layer is made of fibrous tissue (fibrous sheath), and the inner layer is composed of fluid (synovial fluid). It is also called 'De Quervain Disease.' The name of the disease is derived from Swiss surgeon Fritz de Quervain, who first reported it in 1895.

 

Sometimes it is confused with carpal tunnel syndrome, but although both conditions share the commonality of pain caused by excessive wrist use, their symptoms are different.

Carpal tunnel syndrome is a condition caused by nerve compression, resulting in numbness or pain in the fingers, whereas tenosynovitis of the wrist does not cause numbness symptoms.

 

Professor Lee Sang-wook of the Department of Orthopedics at Incheon St. Mary's Hospital, Catholic University, said, "When tenosynovitis occurs, even light movements can cause pain, and tingling sensations in the wrist may make it difficult to even hold light objects." He added, "If you feel a catching sensation and increased pain in the wrist area when bending or straightening the wrist or moving your fingers, and if writing or using chopsticks becomes difficult, you should suspect tenosynovitis."

 

◇ Excessive wrist use as the cause... suspect if brushing teeth is difficult

 

Wrist tenosynovitis usually occurs from overuse of the wrist muscles or joints. It is commonly seen in occupations that heavily use the wrists, such as pianists, artisans, chefs, and gamers.

 

It also occurs frequently when someone who doesn't use their wrist much suddenly overuses it. It can appear if you engage in intense exercise that you don't usually do, such as golf, cycling, or tennis.

 

Frequent use of smartphones or computers also has an impact. In women, pregnancy and childbirth can also be causes.

 

Additionally, the incidence rate is higher among older people rather than the young. Young individuals have active metabolism, so even if inflammation occurs, it subsides quickly, but as one ages, inflammation accumulates and symptoms become more severe. Furthermore, female patients have an incidence rate more than three times higher than males, which is due to female hormones making them more susceptible to inflammation and swelling. Also, women generally have thinner bones and weaker wrist strength, which can put more strain on the wrists even when performing the same tasks.

 

The main symptoms are pain and swelling. Additionally, there may be tenderness when pressed, joint movement difficulties, and muscle weakness. As the symptoms worsen, pain may occur even during rest.

There is a method to self-diagnose wrist tenosynovitis called the Finkelstein test, which involves wrapping the thumb with the other fingers and then bending the wrist downward while making a fist.

 

If severe pain or radiating pain occurs during this test, wrist tenosynovitis should be suspected. However, for an accurate diagnosis, it is best to visit the hospital when the pain occurs. Delayed treatment can lead to chronic pain.

 

Professor Lee Sang-wook said, "The pain caused by wrist tenosynovitis disappears with rest, but even simple actions like turning a bottle cap or brushing teeth can be difficult in daily life."

 

◇The best treatment is 'rest'... avoid repeated strenuous movements

 

The best treatment for wrist tendinitis is rest. It is especially recommended to refrain from using the thumb and wrist. If it occurred after starting a new exercise, you should stop the exercise. Whenever possible, rest the hand with wrist tendinitis and use anti-inflammatory medication to reduce swelling.

 

If symptoms persist, a local steroid injection is administered to the affected area. It reduces swelling with a powerful anti-inflammatory and pain-relieving effect. If symptoms do not improve despite treatment, surgery should be considered.

 

The surgery is performed by cutting a part of the synovial sheath (ligament) covering the tendon to relieve pressure on the tendon.

 

Professor Lee Sang-wook said, "Wrist tenosynovitis occurs due to excessive use of the wrist, and it can improve simply by wearing a brace or cast that restricts wrist movement," and added, "Pain and inflammation can be alleviated by combining exercises and physical therapy that relax the wrist, along with medication or injections."

However, in most cases, wrist tenosynovitis is left untreated even when symptoms appear. Many people seek medical attention when the pain becomes severe and daily life becomes difficult. In the early stages, it can be completely cured with rest and simple conservative treatments, but the longer it is neglected, the more intense the treatment becomes and the higher the likelihood of recurrence.

 

Self-treatment based solely on self-diagnosis without an accurate diagnosis from a professional is also problematic. When applying a hot or cold pack, it is important to choose the appropriate temperature based on the symptoms and timing. Cold compresses during chronic stages can worsen the symptoms. If you get acupuncture when your hand is swollen, it can exacerbate inflammation. You should consult a specialist in hand conditions to receive an accurate diagnosis.

 

To maintain wrist health, it is best to avoid repetitive and strenuous movements. If you frequently use your wrists, taking adequate breaks and doing wrist stretches regularly can also be helpful.

 

Kwon Dae-ik Medical Journalist (dkwon@hankookilbo.com)

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