Wrist Tendonitis: An Overview

Wrist tendonitis—sometimes spelled tendinitis—is the inflammation of one or more tendons in the wrist.¹Cooper, C. (2014). Elbow, Wrist, and Hand Tendinopathies. In Fundamentals of Hand Therapy (pp. 383–393). Elsevier. https://doi.org/10.1016/b978-0-323-09104-6.00028-6. This inflammation typically causes symptoms such as pain, swelling, stiffness, and/or warmth in the wrist.¹Cooper, C. (2014). Elbow, Wrist, and Hand Tendinopathies. In Fundamentals of Hand Therapy (pp. 383–393). Elsevier. https://doi.org/10.1016/b978-0-323-09104-6.00028-6. Wrist tendonitis is caused due to small (micro) tears in a tendon as a result of sudden or repetitive injury.²Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7.^,3Mcauliffe JA. Tendon disorders of the hand and wrist. J Hand Surg Am. 2010;35(5):846-53.

See Wrist Tendonitis vs. Sprain

Movements such as opening and closing the hand and/or bending/rotating the wrist in one or more directions may be painful.

Wrist Tendonitis May Actually Be Tendinosis

Research suggests what is often diagnosed as tendonitis may actually be tendinosis.²Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7.^,3Mcauliffe JA. Tendon disorders of the hand and wrist. J Hand Surg Am. 2010;35(5):846-53.^,4Ahmad Z, Siddiqui N, Malik SS, Abdus-samee M, Tytherleigh-strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J. 2013;95-B(9):1158-64.^,5Bishai SK, Plancher KD. !e basic science of lateral epicondylosis: Update for the future. Tech Orthop. 2006;21:250–255.^,6Abate M, Silbernagel KG, Siljeholm C, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009;11(3):235. Tendinosis is a chronic, non-inflammatory condition where the tendon’s collagen fibers degenerate from chronic overuse without adequate time to heal.

See What Is the Difference Between Tendonitis, Tendinosis, and Tendinopathy?

However, tendinosis may often be overlooked due to:

• Similar symptoms. Symptoms such as pain, stiffness, and reduced strength occur in both tendonitis and tendinosis.¹Cooper, C. (2014). Elbow, Wrist, and Hand Tendinopathies. In Fundamentals of Hand Therapy (pp. 383–393). Elsevier. https://doi.org/10.1016/b978-0-323-09104-6.00028-6.
• Chronic injury. When tendonitis becomes chronic, it may develop into tendinosis.²Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7.
• Similar cause. Both tendonitis and tendinosis can be caused by repetitive injury to a tendon.

Tendinosis is also more common than tendonitis.²Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7.

Tendons of the Wrist

The wrist’s tendons are bundles of long fibrous bands of protein that connect a forearm muscle to a hand bone. Tendons of the wrist include:

• Tendons involved in wrist flexion, the action of bending the wrist forward/inward. These tendons also help in rotating the wrist.
• Tendons involved in wrist extension, the action of bending the wrist backward. These tendons also help move the wrist toward the thumb or the little finger.
• Tendons involved in finger motion, which go from muscle bellies in the forearm to bones in the fingers or thumb.

See Soft Tissues of the Wrist

Some wrist tendons run along the dorsal (back) part of the wrist and others run along the volar (palm-side) part of the wrist.

Types of Wrist Tendonitis

Depending on the type of tendon affected, wrist tendonitis may be classified as⁷Adams JE, Habbu R. Tendinopathies of the Hand and Wrist. J Am Acad Orthop Surg. 2015;23(12):741-50.:

• Extension wrist tendonitis, a condition that results from repeatedly bending the wrist backward. Extensor carpi ulnaris tendonitis and intersection syndrome (inflammation of a group of four tendons in the wrist area) are examples of extension wrist tendonitis.
• Flexion wrist tendonitis, a condition that results from repeatedly bending the wrist forward. Flexor carpi radialis tendonitis is an example of flexion wrist tendonitis.

Tennis, golf, rock climbing, and rowing are some examples of sports that may cause these injuries. The tendon degeneration or inflammation triggers chemical changes that are sensed by nerves and relayed to the brain as pain signals.⁸Sharma P, Maffulli N. Biology of tendon injury: healing, modeling and remodeling. J Musculoskelet Neuronal Interact. 2006;6(2):181-90.

Why Are the Wrist’s Tendons Prone to Tendonitis and Other Tendon Problems?

The muscles and tendons of the forearm, hand, and wrist are at continual risk for injury due to a variety of factors, including participation in certain sports, repeated movements from house work, load-bearing activities, poor workplace ergonomics, and accidents. Other factors that may contribute to the development of wrist tendonitis are:

• Nerves. Small tendons of the wrist that are involved in fine movements may contain more nerve fibers and nerve-endings compared to other bigger tendons⁶Abate M, Silbernagel KG, Siljeholm C, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009;11(3):235.—sending more pain signals when the tendon tissue is damaged.
• Blood vessels. In general, tendons have less blood supply than their muscles.⁴Ahmad Z, Siddiqui N, Malik SS, Abdus-samee M, Tytherleigh-strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J. 2013;95-B(9):1158-64. Tendons may also experience a break in blood supply when the muscles are contracted for long periods of time, such as while riding a motorcycle or bottle-feeding a baby.⁴Ahmad Z, Siddiqui N, Malik SS, Abdus-samee M, Tytherleigh-strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J. 2013;95-B(9):1158-64. Lack of adequate blood supply to a wrist tendon on a regular basis may cause long-term wrist tendon pain.
• Heat. Tendons that go through repetitive use may experience up to a 10% rise in the tendon’s internal temperature.⁴Ahmad Z, Siddiqui N, Malik SS, Abdus-samee M, Tytherleigh-strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J. 2013;95-B(9):1158-64. This phenomenon may put the wrist’s tendons at a risk for injury.

See Guide to Wrist Anatomy

When tendonitis progresses to tendinosis, the tendon begins to degenerate.⁶Abate M, Silbernagel KG, Siljeholm C, et al. Pathogenesis of tendinopathies: inflammation or degeneration? Arthritis Res Ther. 2009;11(3):235.

When to Seek Medical Attention

Certain symptoms of wrist tendonitis may indicate serious medical conditions. A few examples of dangerous symptoms include:

• Numbness and/or tingling in the fingers, hand, and/or forearm
• A sudden increase in pain and swelling in the wrist, hand, and/or forearm
• Inability to move the wrist
• Severe, persistent swelling of the wrist

Such symptoms may indicate bone fractures or nerve injuries in the hand, wrist, and/or forearm region. Sometimes, wrist tendonitis may cause swelling of the tendon, which may pinch or irritate an adjacent nerve, leading to conditions such as carpal tunnel syndrome.²Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7.

Evaluation by a doctor can help accurately diagnose wrist tendonitis and initiate treatment. In most cases, wrist tendonitis may be managed with non-surgical treatment methods.

See What to Do When a Wrist Injury Occurs