Wrist tendonitis: symptoms, causes and treatment

Tendons connect muscles to bones. The NHS explains that there are tendons all over the body, in joints such as the knees, elbows and shoulders, and that tendonitis is when a tendon swells after an injury. In the wrist, the tendons of the forearm muscles pass across the joint to move the hand and fingers, and they can become inflamed with overuse.

Tendonitis caused by repeated use may also be described as a repetitive strain injury (RSI). The NHS says RSI is a term sometimes used for pain caused by repeated movement of part of the body, can affect the shoulders, elbows, forearms and wrists, hands and fingers, and often gets better on its own.

The NHS lists the main symptoms of tendonitis. For RSI it adds that symptoms usually start gradually and can include pain that feels like burning, aching or throbbing, stiffness and weakness, tingling, pins and needles or numbness, muscle cramps and swelling.

• Pain in a tendon that gets worse when you move.

• Difficulty moving the joint.

• A grating or crackling sensation when you move the tendon.

• Swelling, sometimes with heat or redness.

The NHS says tendonitis is usually caused by sudden, sharp movements or repetitive exercise such as running, jumping or throwing, and can also be caused by repetitive movements or poor posture or technique at work or when playing a sport. For RSI it lists repetitive activities like hairdressing, decorating, typing or assembly line work, sports like golf or tennis, poor posture, and regular use of hand-held power tools.

It stresses that repetitive or strenuous work does not always cause RSI and that many people do the same job for years without a problem; pain in the arm is often caused by a combination of things, including ageing.

The NHS suggests following simple steps for 2 to 3 days to manage pain and support the tendon, then trying to keep moving it when you can do so without pain stopping you so the joint does not become stiff.

The NHS says to see a GP if you have injured a joint and your symptoms do not improve within a few weeks, and for RSI if symptoms are not going away or are getting worse. It says to get help from NHS 111 if you are in a lot of pain or think you have ruptured a tendon: if the pain is sudden and severe and happened during an accident or activity, you may have torn a tendon, and you might have heard a popping or snapping sound.

Other wrist conditions can mimic tendonitis. The NHS says carpal tunnel syndrome is pressure on a nerve in the wrist causing tingling, numbness and pain in the hand and fingers, usually worse at night, and that it is diagnosed by asking about symptoms and checking the hand. If numbness and tingling dominate rather than pain on movement, ask a GP or physiotherapist to consider it.

The NHS says if you need treatment for tendonitis you may be prescribed a stronger painkiller or recommended an ibuprofen gel. If the pain is severe, lasts a long time or movement is limited, you may be offered physiotherapy, and some people with severe tendonitis may be offered steroid injections, which may provide short-term pain relief.

If physiotherapy does not help, you may be referred to an orthopaedic specialist, who may recommend surgery to remove damaged tissue or repair a ruptured tendon. For RSI the NHS describes physiotherapy to strengthen muscles and improve posture, occupational therapy to work out what is causing the problem and suggest exercises, equipment or workspace changes, and says physiotherapy is free on the NHS throughout the UK but waiting times can be long, with private physiotherapy an alternative.

The NHS says you cannot always prevent tendonitis, but you can reduce the chance of a tendon injury by warming up before exercising and gently stretching afterwards, wearing supportive shoes or insoles for exercise, and taking regular breaks from repetitive exercise. It advises not overexercising tired muscles, not starting a new sport without some training and not doing the same repetitive exercises.

For RSI it suggests speaking to your employer about ways they can help you continue working, such as changing the way you work or reducing your hours, and not resting the affected area for more than a few days because resting for too long can make it weaker and less flexible. A workplace assessment through occupational health can help if the problem is linked to your job.