From the Guidelines
Treatment for tenosynovitis should prioritize a combination of rest, anti-inflammatory medications, and physical therapy to reduce inflammation and pain, and improve quality of life. Initially, patients should rest the affected area and avoid activities that worsen symptoms. Over-the-counter NSAIDs like ibuprofen (400-800mg three times daily with food) or naproxen (250-500mg twice daily) can help reduce inflammation and pain, as supported by 1. Ice application for 15-20 minutes several times daily can also decrease swelling. A wrist or finger splint may be recommended to immobilize and protect the affected tendon, typically worn for 2-3 weeks.
Some key considerations for treatment include:
- Rest and avoidance of activities that worsen symptoms to prevent further irritation and allow healing
- Use of NSAIDs for pain and inflammation management, with consideration of potential risks and benefits as discussed in 1
- Physical therapy exercises to improve range of motion and strengthen surrounding muscles, which should begin once acute pain subsides
- Potential use of corticosteroid injections for more severe cases, although the optimal approach and potential risks are still debated, as noted in 1
It's essential to weigh the benefits and risks of different treatment options and consider the individual patient's needs and circumstances. By prioritizing a comprehensive and multi-faceted approach to treatment, patients with tenosynovitis can experience improved outcomes and enhanced quality of life.
From the Research
Treatment Options for Tenosynovitis
- Conservative management is a common approach for treating tenosynovitis, including De Quervain's stenosing tenosynovitis, Dupuytren disease, and trigger finger 2.
- Physical modalities such as ultrasound therapy, low-level laser therapy, phonophoresis, and anodyne therapy have been found to be effective in treating De Quervain's disease 2.
- Extracorporeal shock wave therapy (ESWT) has been found to be the most efficient and safe therapy for Dupuytren disease, while laser therapy and therapeutic ultrasound are effective for De Quervain tenosynovitis 2.
- A combination of conservative rehabilitation strategies, including activity modification, Graston Technique, and eccentric training, can be used to treat De Quervain's stenosing tenosynovitis 3.
Specific Treatments for De Quervain Tenosynovitis
- Surgery has been found to be the most effective treatment method for improving clinical symptoms and preventing recurrence in nursing women with De Quervain tenosynovitis 4.
- Corticosteroid injections can be effective in treating De Quervain tenosynovitis, but may not be as effective as surgery in preventing recurrence 4.
- Wrist splints can be used as a conservative treatment option, but may not be as effective as surgery or corticosteroid injections in improving clinical symptoms and preventing recurrence 4.
- Eccentric training has been found to be a effective complementary treatment to conservative management, improving pain intensity and hand and wrist functionality in patients with De Quervain's tendinopathy 5.
Other Forms of Tenosynovitis
- Trigger finger is a common condition that can be treated with corticosteroid injections, which are effective in about 60% to 92% of cases 6.
- Intersection syndrome is a condition that can be diagnosed by crepitus with wrist motion at the distal one-third of the radial aspect of the forearm 6.
- Extensor pollicis longus (EPL) tenosynovitis is a rare condition that can be treated with corticosteroid injections, but caution should be taken due to the potential for rupture 6.