How to treat tenosynovitis?

Written by Na Hong Wei
Orthopedics
Updated on September 20, 2024
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In clinical practice, the treatment of stenosing tenosynovitis is divided into three stages. The first stage involves general treatments, including early immobilization, followed by localized heat therapy, microwave therapy, and shock wave therapy, as well as the topical application of anti-inflammatory and pain-relieving medications. If there is no improvement after one week of conservative treatment, the second stage is initiated. The second stage involves an injection treatment, which is quite effective for this type of tenosynovitis in clinical practice. Generally, one or two injections can significantly alleviate symptoms, and some people may even fully recover. However, if after three injections the symptoms do not improve or worsen, further injections should be avoided, as this method is not beneficial for you, and you would then proceed to the third stage. The third stage involves surgical treatment. There are two types of surgical treatments: one involves a minor procedure using a small needle knife in traditional Chinese medicine, and the other involves conventional surgery. However, for radial styloid stenosing tenosynovitis, surgery is generally recommended due to the proximity of the radial nerve, which could be at risk of damage.

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Written by Na Hong Wei
Orthopedics
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How to completely cure tenosynovitis?

The only definitive treatment for tenosynovitis is surgery, because the clinical treatment of tenosynovitis is divided into three steps. The first step is general treatment, which mainly involves immobilization, medication, and topical application of analgesic and anti-inflammatory drugs; the second step is injection therapy; if these two methods do not work, then surgery is the only option. Therefore, surgery is the only way to completely cure tenosynovitis.

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Written by Guan Jing Tao
Orthopedics
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Diagnosis methods for tenosynovitis

Diagnosis relies on the doctor's physical examination, as well as the patient having localized pain and restricted movement, with definite tender points. Moreover, if local symptoms are atypical, an X-ray can be performed to rule out other conditions such as osteoarthritis, or bone hyperplasia, allowing for a localized diagnosis. In addition, localized symptomatic treatment can be administered, and if there is improvement, it can indirectly confirm the diagnosis of tendinitis. Typically, when there is localized pain with significant movement restriction, and apparent pain and hyperplasia at the tendon's central axis, a clear diagnosis can be made.

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Written by Li Jin
Orthopedics
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Can tenosynovitis heal itself?

Tendon sheath inflammation is primarily due to long-term engagement in certain frequent activities, causing inflammatory damage to the tendons and tendon sheaths. This results in symptoms such as swelling and limited mobility. It is difficult to cure without treatment intervention. For the treatment of tendon sheath inflammation, it is firstly important to rest and stop the frequent activity. Medications such as non-steroidal anti-inflammatory analgesics can also be used. Additionally, treatments such as applying heat, physiotherapy, and local encapsulation can be employed. Through these treatments, some patients can recover effectively. When there is a significant impact on life due to functional impairment, surgical treatment may also be considered. Post-surgery, it is important to start functional exercises early to prevent adhesion. (Medication should be used under the guidance of a physician.)

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Written by Guan Jing Tao
Orthopedics
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How is tenosynovitis diagnosed?

Tendinitis mostly occurs in the wrist joints that frequently flex and extend, as well as in the thumb and corresponding metacarpophalangeal joints. It is largely due to the repetitive flexion and extension movements of the fingers and wrist joints, such as those performed by noodle makers in restaurants, vegetable cutters, and some handcraft laborers. Repeated movements irritate the local tendon sheaths causing inflammation, leading to relative narrowing, which prevents the tendons from flexing and moving normally. This results in a condition known as stenosing tendinitis. These are the common causes and symptoms of the condition, enabling a clear diagnosis.

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Written by Guan Jing Tao
Orthopedics
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Tendon sheath inflammation X-ray manifestations

Tendon sheath inflammation typically shows no noticeable abnormalities in the early stages on X-rays. However, in cases of recurrent constrictive tendon sheath inflammation, it may lead to abnormal changes in the local ligaments and joints, such as ectopic ossification, calcification, and bone proliferation. Generally, an X-ray examination of tendon sheath inflammation shows no significant local abnormalities. In stubborn cases, which relapse after multiple treatments, X-rays may reveal changes such as bony proliferation or ectopic ossification with high-density shadows.