From the Guidelines
Treatment for intersection syndrome should primarily involve conservative management with rest, ice, and anti-inflammatory medications, as well as addressing the underlying mechanical causes, to reduce morbidity and improve quality of life. When evaluating tendon injuries of the hand and wrist, including intersection syndrome, ultrasound (US) evaluation is well-suited due to the superficial location of the tendons and the ability to dynamically assess them 1. Key components of treatment include:
- Reducing or stopping aggravating activities, particularly those involving repetitive wrist movements
- Applying ice to the affected area for 15-20 minutes several times daily to reduce inflammation
- Taking non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen for 1-2 weeks to manage pain and inflammation
- Wearing a wrist splint in a neutral position, especially during sleep and activities, to immobilize the area and promote healing
- Gradually introducing gentle stretching and strengthening exercises as pain subsides For persistent cases, a corticosteroid injection into the affected compartment may be necessary, and physical therapy focusing on proper biomechanics can help prevent recurrence 1. Surgery is rarely needed but may be considered for cases that don't respond to conservative treatment after 3-6 months. It is essential to address the underlying mechanical causes of intersection syndrome, which typically involve repetitive wrist extension and radial deviation movements, to achieve long-term resolution and minimize morbidity and mortality.
From the Research
Treatment Options for Intersection Syndrome
- Rest and avoidance of activities that aggravate the condition 2, 3, 4
- Use of a thumb spica splint to immobilize the wrist and thumb 2, 3
- Analgetic and oral nonsteroidal anti-inflammatory drugs to reduce pain and inflammation 2, 3, 4
- Progressive stretching and muscle strengthening exercises after 2-3 weeks of rest 2
- Corticosteroid injections adjacent to the site of injury for persistent symptoms 2, 3, 4
- Surgical intervention in refractory cases 2, 3
- Ultrasound-guided glucocorticoid injection for symptoms not improved by conservative methods 4
- Adjustment of activities, use of braces, and physical or occupational therapy 4
Diagnostic Tools
- Clinical examination to provide necessary information for diagnosis 2
- Magnetic resonance imaging scans and ultrasonography to assist in diagnosis 2, 5
- Ultrasound findings, such as peritendinous edema and synovial fluid within the tendon sheaths, can be diagnostic 5