Tenosynovitis

Medically Reviewed by Poonam Sachdev on May 20, 2024
Written by Paul Frysh, Kathryn Whitbourne
8 min read

Tenosynovitis is an inflammation of the protective sleeve of tissue surrounding your tendons. Tendons are the cords of tissue that connect muscle to bone. They let your bones move when you move your muscles. Your tendons are surrounded by a sleeve of tissue called the synovial membrane. This membrane protects your tendons. Tenosynovitis can cause pain and make it hard for you to move your joints.

Tenosynovitis is quite common, but people with certain conditions are much more likely to have it. As much as 20% of people with diabetes and 55% of people with rheumatoid arthritis have it.

Stenosing tenosynovitis

This is the formal term for a condition commonly known as trigger finger or trigger thumb. It's a more severe form of tenosynovitis. The tendons in your finger or thumb get inflamed and lock, preventing you from bending or straightening your digits. You might feel pain or stiffness in your fingers or a lump at the base of the fingers or thumb. The ring finger and thumb are the digits most likely to get stenosing tenosynovitis.

Symptoms of tenosynovitis include:

  • Pain, especially when moving the affected body part in a repeated motion, like swinging a hammer or a tennis racquet 
  • Swelling at the joint
  • Difficulty moving the affected body part
  • Discoloration along the line of the tendon

When the synovial membrane gets inflamed, fluid can build up and make your symptoms worse. You may feel swelling and in some cases, see it too. The area can get so tender that it hurts even to touch it.

Tenosynovitis can show up in any part of the body that has tendons but is mostly seen in the wrists, hands, and feet.

Tenosynovitis of the wrist

This is a specific type of tenosynovitis called De Quervain’s tenosynovitis. It results from an inflamed tendon at the base of your thumb. You might feel:

  • Pain along the thumb side of the wrist
  • Catching or clicking when you use it
  • Your symptoms typically worsen when you try to squeeze or grab something or turn your wrist

Tenosynovitis of the hand

The typical signs are:

  • Pain
  • Swelling
  • Redness
  • Limited movement of the hand

If you have rheumatoid arthritis, your hand may look deformed, or if you have a joint disorder called crystalline arthropathy, crystal deposits might show up on an X-ray. 

Tenosynovitis of the foot

This specific type is called posterior tibialis tenosynovitis, and it affects your foot. The posterior tibialis tendon runs along the inside of your foot, connecting the calf muscle to the bones inside your foot. The tendons help support the arch in your foot. Symptoms of posterior tibialis tenosynovitis include:

  • Pain in the foot and ankle
  • Swelling in the tendon 
  • A fallen arch, if there's no treatment

If you play sports that put a lot of pressure on your ankles and feet, such as tennis and basketball, you're more likely to get posterior tibialis tenosynovitis. It can also happen suddenly if you fall or injure your foot.

Tenosynovitis of the ankle

Peroneal tenosynovitis is an inflammation of the synovial membrane surrounding the tendons in your ankles. The peroneal tendons run along your outer ankle bone and the side of your foot, connecting the muscles in your lower leg to the bones in your feet. These tendons help support your foot and ankle and lessen the risk of injury. Symptoms include:

  • Pain in the ankles
  • Swelling and tenderness in the tendon
  • Difficulty walking

You can get this from overuse of the ankle, for instance from playing sports or dancing, or from an ankle sprain.

It isn’t always clear what causes tenosynovitis. Sometimes, there is no reason for it (this is called idiopathic tenosynovitis). But some factors increase the chances you might get tenosynovitis, such as:

Getting older. Tenosynovitis usually starts in middle age.

Certain medical conditions. Conditions such as diabetes or rheumatoid arthritis may increase your risk. Arthritis and inflammatory diseases that wear down your joints may cause problems in surrounding tendons and tissues. This can sometimes lead to the long-term, or chronic, form of tenosynovitis.

Overuse of body parts. Repeated motions such as jumping, throwing, and running; lifting an unusually heavy load; or performing movements over your head, like painting a ceiling, can also play a role.

Infections. Common pathogens like Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) from other infections can spread to your tendons.

Taking certain medications. Fluoroquinolone antibiotics (Cipro, Noroxin) and statins, which treat high cholesterol, can raise your risk for tendon damage, which can lead to tenosynovitis.

Also, you’re more likely to get tenosynovitis when you’re pregnant, though doctors aren’t sure why. Women tend to be more at risk for some types of tenosynovitis than men.

The doctor can usually diagnose you from your symptoms and a physical exam. They might push on affected areas or ask you to make specific motions and see if they hurt.

Let them know how the area feels. Does it tingle? Burn? Does it get better when you rest? Be sure to tell them about any new increase in work or exercise patterns.

If all this isn’t enough to diagnose you, the doctor might take pictures of the area with an MRI or ultrasound machine to confirm or rule out other causes.

  • Rest is usually the first treatment. The quicker you start, the better. Where possible, stop the activities that cause your symptoms. You might even need a splint, cast, or brace to keep that part of your body from moving.
  • When swelling flares up, ice the inflamed area for 20 minutes at a time. If that doesn't work, some experts recommend trying heat.
  • Over-the-counter medications , such as nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, can also help. Your doctor might suggest larger-than-standard doses depending on your level of pain and swelling or if you have conditions such as rheumatoid arthritis. In some cases, they might inject a corticosteroid to reduce inflammation.
  • If your tenosynovitis is due to an infection, your doctor will prescribe antibiotics.
  • Once swelling and pain are down, start to slowly and gently increase your range of motion. If your tenosynovitis is severe, your doctor or physical therapist might give you a set of exercises to help with this. You may need to do them several times a day.

Tenosynovitis surgery

if you haven't gotten better within 3-6 months, your doctor may recommend surgery. This would involve removing, cutting, or cleaning out dead tissue around the affected tendon so it has more room to move again. The surgery is short and performed on an outpatient basis, so you don't have to spend the night in a hospital.

If your tenosynovitis is due to an infection, the surgeon may make some small incisions and insert a catheter to flush out the tendon sleeve and get rid of the infection.

Most people recover from tenosynovitis, after getting treatment or surgery. If your tenosynovitis is due to an infection or diabetes, you may have more trouble recovering.

Tenosynovitis typically starts with tendinitis (inflammation of the tendons). Though it isn’t always clear what causes either one, there are some things you can do that might lower your risk.

Take breaks. Try not to stay in the same position for too long. For example, if work keeps you sitting for hours on end, move around every 30 minutes or so if you can. Don’t do the same thing over and over without a break. Whether it’s typing, throwing a baseball, or playing piano scales, mix up your movements to stay balanced and give your body a chance to rest.

Learn how to lift. Use a firm but not overly tight grip when the load is unusually heavy, and avoid lifting with just one arm or only one side of your body.

Move the right way. Whether you lift weights, shoot free throws, or play the cello, there are proper techniques that can prevent injury. Trainers, teachers, coaches, and physical therapists can help you learn proper form. If you notice that some movement causes pain, stop and ask questions.

Warm up before you exercise. About 5-10 minutes of light jogging or jumping jacks should be enough.

Here's some advice for living with tenosynovitis:

  • Rest as soon as you notice symptoms. If you don’t, you could rupture a tendon or its sheath, which can be hard to repair.
  • If your symptoms are very painful, won’t go away, or stop you from living your life normally for more than a few days, see your doctor. They might notice an underlying condition that you can treat. Tenosynovitis is often mistaken for other conditions.
  • Try to change your habits if they're causing tenosynovitis. For instance, if it's due to repeated use of a computer mouse or keyboarding, make your workspace more ergonomically correct.

Complications for infectious tenosynovitis can be quite common. As many as 38% of people with this condition have complications. They include:

  • Long-term finger stiffness
  • Deformation of the tendons
  • Infection in the deep spaces of the hand
  • Dead tissue (necrosis) in the tendon
  • Possible need for amputation

People with the noninfectious form of tenosynovitis may end up getting the stenosing form of tenosynovitis, which can lead to chronic contractures (a permanent tightening of the muscles, tendons, and skin) and flexion deformities (inability to fully straighten a joint) that may need surgery to correct.

Tenosynovitis is a common condition where the protective sleeve of tissue surrounding your tendons gets inflamed. You're more likely to get it if you repeat certain gripping motions (like in some sports) or have health issues such as diabetes or rheumatoid arthritis. You can usually treat it with rest, ice, and physical therapy but occasionally you might need surgery.

 

Does tenosynovitis go away on its own?

It may go away by itself in some cases, especially if you stop doing the motion that caused it and use ice to reduce the swelling. But if these don't work, see your doctor.

Is tenosynovitis the same as tendonitis?

Tenosynovitis might sound a bit like another condition called tendinitis. Both are inflammations. The difference is tendinitis is the inflammation of your tendons, the cords of tissue that hold muscle to bone. Tenosynovitis is the inflammation of the synovial membrane around the tendons. This membrane is to protect the tendons.