Tendonitis

About Tendonitis

Tendons connect muscle to bone throughout the body. These strong cords of tissue are enclosed in a protective sheath with a lining of lubrication cells (called the synovium) to ease movement.

Tendonitis (or tendinitis) occurs when tendons become inflamed causing uncomfortable to debilitating stiffness and pain.

The multiple causes of tendonitis (or tendinitis) are common in the everyday life of most people, so, over time, many individuals suffer from tendonitis.

The condition can occur anywhere in the body where muscle and bone are connected, very often in the hand. Depending upon the level and type of activity, tendonitis of the hand can occur early in life and may come about from a single injury.

More commonly, a combination of injury, stress and strain, along with aging, bring on the pain and swelling of tendonitis.

Types of Tendonitis

Tendonitis of the hand is very common, although most people have heard of tennis elbow, tendons in the hand can also be injured in tennis, when swimming or on the pitcher’s mound. (Yes, there is a form of tendonitis known as “pitcher’s shoulder”).

Tendonitis of the hand is also common on the golf course and even the basketball court. Young and old can fall victim to sports injuries due to repetitive stress or improper form.

It’s not just sports, of course, that require the types of movement that lead to tendonitis of the hand. Stress and strain from work, other leisure pursuits or everyday household activities can also cause tendonitis.

New mothers and dads sometimes feel their first symptoms of tendonitis when caring for an infant, which often leads to sudden and awkward hand positioning. Women especially may be susceptible because pregnancy and breastfeeding hormonal fluctuations can affect the tendons.

Not all types of tendonitis are named (or mis-named) after sports. DeQuervain’s tendonitis is a painful wrist and hand problem that occurs when tendons on the side of the wrist become irritated, including the tendon that moves the thumb toward or away from the palm of the hand.

This can progress to forearm pain traveling up from the side of the thumb in certain wrist positions or movements and may also cause finger joint pain.

Hand Tendonitis Symptoms

Tendonitis pain, stiffness and swelling often come and go. Symptoms may last for a day, a week or several weeks, then improve. Unfortunately, symptoms often return in the same place over and over again.

Tendonitis should be treated non-invasively whenever possible, however surgery may be needed to avoid permanent damage, which can be disabling.

Causes of Hand Tendonitis

Tendonitis can be caused by many years of repetitive use (or overuse) or by an injury, and occurs in people of all ages. In younger people, the cause is often a sudden injury, such as a sports-related injury or perhaps repeated motion done with incorrect body position.

As we age, tendons become less flexible, which brings about tendonitis in middle aged and older people. Often all of these causes combine over a lifetime, leading to tendonitis. The ailment can occur in any joint, but it is often found in hands.

Seeking Hand Surgery for Tendonitis

When tendonitis interferes with daily life, and mild pain medications, avoidance of painful motion and other conservative treatments have helped only temporarily, hand surgery may be the solution to restore pain-free movement to the tendons of the hand.

Here are some common activities that can become painful or impossible with tendonitis of the hand, leading sufferers to seek surgical help from Northern NJ surgeons:

• Grasping or grabbing items from a shelf or a desk causes hand pain in the muscles or joints.
• Essential activities are impaired; simple tasks such as opening doors or buttoning a shirt can become difficult with severe tendonitis of the hand.
• Driving is affected by hand pain, numbness or swelling.
• Writing becomes painful and handwriting suffers.
• Using a computer keyboard or mobile phone is painful.
• Work activities become painful.
• Individuals may drop items often.
• Painful swelling of the base of the thumb may extend down into the palm and fingers, or up through the forearm.
• The thumb “catches” or “snaps” when making certain movements or completing tasks.
• Hobby activities become impossible, such as drawing or painting, building model planes, playing video games, playing musical instruments or home improvement projects.
• Simple daily tasks are painful.
• Over-the-counter medications and other conservative treatments only work temporarily.

How is Surgery Performed?

The tendonitis surgeon will make a small incision in the skin covering the damaged tendon to see the damaged area. If the tendon is torn, the surgeon will sew the torn ends together. If there is not enough healthy tendon remaining, a tendon graft can be done.

Part of a tendon from the toe or another body part can be grafted into the hand and reconnected to the surrounding tissue so that movement will be restored. Your northern NJ surgeon will check for any injury to nearby nerves or blood vessels. The incision is closed and covered with a sterile dressing.

Good Candidates for Tendonitis Hand Surgery

If conservative treatments for tendonitis have not been successful, hand surgery may be the solution. In addition to over-the-counter pain medicine, splints may help some people suffering from tendonitis. Physical therapy along with the application of heat and cold may offer some improvement.

Cortisone shots into the sore area of the hand are typically helpful for tendonitis, but are temporary, lasting up to 2 months. After a couple of cortisone shots, certain patients get profound relief for years. Cortisone cannot be continued indefinitely, however, without adverse effects.

When temporary treatments become frustratingly ineffective, many tendonitis patients turn to their Bergen County hand surgeon. Hand surgery is the only option in cases where the tendon has torn or ruptured.

Tendonitis surgery has an excellent record of success when performed by a plastic surgeon who specializes in hand surgery, providing relief for more than 80 percent of patients (four out of five).

Risks and Recovery

Risks

Twenty percent of patients may experience some numbness on the back of the hand and/or scar tenderness long term. All surgery carries the risk of scar tissue, blood loss, infection and other risks specific to the patient’s health condition and age, which will be carefully explained.

Risks can be minimized by choosing a hand surgeon with microsurgery experience and board certification in plastic surgery.

Recovery

Healing, typically supported by a splint or cast, can take up to 12 weeks. Recovery time is variable depending upon whether grafting was required and the patient’s overall health.

Movement will gradually return and stiffness will ease with physical therapy. Scar tissue treatment may be necessary during recovery.

Choosing the Best Hand Surgeon for Tendonitis Surgery

At Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County, NJ, we are dedicated to helping tendonitis patents banish hand pain and limited movement from their lives with expert surgical treatment.

Our keys to success include meticulous surgical technique, years of experience and functional and aesthetic awareness of the complex hand anatomy.

Cohen/Winters delivers personalized surgical care tailored to the unique anatomical and functional needs of each hand surgery patient.