Treating Wrist Tendonitis Without Surgery

Nonsurgical treatments are usually adequate to promote healing in wrist tendonitis. In general, tendonitis injuries heal in a few days to weeks, depending on the severity. Some chronic cases may take up to two months. ¹ Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Phys. Sep 1 2005;72(5):811e8.

See Treating Acute Sports and Exercise Injuries in the First 24 to 72 Hours

Common non-surgical treatments for wrist tendonitis are discussed below.

Rest

It is important to get adequate rest following a wrist tendonitis injury. A few methods to rest the wrist are by:

• Using splints, slings, or soft straps around the wrist
• Avoiding any irritating activity
• Encouraging tendon repair by using the wrist intermittently to perform small tasks

Repair of tendon fibers happen when the tendon is moved. For this reason, periods of rest must be kept short and just enough for the symptoms to subside. ² Buttaravoli, P. & Leffler, S. (2012). Minor emergencies. Philadelphia, PA: Elsevier/Saunders.

See Soft Tissues of the Wrist

Exercise

Exercise is an important treatment in promoting tendon healing. ² Buttaravoli, P. & Leffler, S. (2012). Minor emergencies. Philadelphia, PA: Elsevier/Saunders. While implementing exercise techniques for wrist tendonitis the following factors are considered:

• Eccentric exercises. In these exercises, the muscle elongates under tension, which is beneficial for tendon healing. These exercises stimulate collagen production and produce less heat in a tendon, thereby limiting inflammation. ³ Cooper, 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. ^{, 4} Ahmad 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. ^{, 5} Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.
• Using loads. Exercising with a lighter load and more repetitions is more beneficial than using a heavy load and fewer repetitions. ³ Cooper, 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.

Exercises are usually performed under the guidance of a physical therapist or an occupational therapist. Exercise is particularly important for individuals who need to return to sports after a tendonitis injury. ³ Cooper, 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. ^{, 5} Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.

Medications

The use of anti-inflammatory and pain-relieving medications has been controversial in treating tendonitis and other tendon injuries.

• Medication may relieve pain. Some experts recommend the use of medications such as non-steroidal anti-inflammatory drugs (NSAIDs) and steroids (tablets or injection) to relieve pain. ² Buttaravoli, P. & Leffler, S. (2012). Minor emergencies. Philadelphia, PA: Elsevier/Saunders. ^{, 5} Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50. These drugs may help relieve tendonitis pain in some cases.
• Medication may delay tendon healing. Some experts argue treating tendonitis with NSAIDs or steroids may worsen the tendon’s healing process. ⁵ Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50. ^{, 6} Rees JD, Stride M, Scott A Tendons – time to revisit inflammation. Br J Sports Med. 2014;48:1553-1557. ^{, 7} Oliva F, Via AG, Maffulli N. Physiopathology of intratendinous calcific deposition. BMC Med. 2012;10 95-7015-10-95. Long-term use of these medications may also cause complications in the stomach, heart, and/or kidneys. ² Buttaravoli, P. & Leffler, S. (2012). Minor emergencies. Philadelphia, PA: Elsevier/Saunders. ^{, 5} Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.

Due to the associated risks, NSAIDs and/or steroids are usually recommended for short-term use (7 to 14 days). ⁵ Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50.

Platelet-Rich Plasma (PRP) Injection

PRP is a portion of a patient’s own blood that is concentrated and administered in the form of an injection. PRP contains numerous growth factors that promote growth and healing of soft tissues such as tendons. ⁸ Yuan T, Zhang CQ, Wang JH. Augmenting tendon and ligament repair with platelet-rich plasma (PRP). Muscles Ligaments Tendons J. 2013;3(3):139-49. Published 2013 Aug 11. Depending on the severity, one or more injections may be prescribed.

See PRP Therapy for Chronic Tendon Injuries

Extracorporeal Shock Wave Therapy (ESWT)

Extracorporeal shock wave therapy is a technique that administers a series of shock waves to an inflamed tendon through a hand-held device. The goal of this therapy is to prevent pain by inhibiting the growth of new nerve tissue in an injured tendon. ⁵ Skjong CC, Meininger AK, Ho SS. Tendinopathy treatment: where is the evidence?. Clin Sports Med. 2012;31(2):329-50. Both low energy and high energy shock waves are used. Sometimes, a local anesthetic may be required to numb the area. This treatment is usually performed at a doctor’s office and may require more than one cycle of treatment depending on the severity of the injury. However, not much research has been conducted on this technique, and its use is limited.

Tips to Avoid Wrist Tendonitis Pain

Self-care methods can help some people manage their wrist tendonitis pain from starting or getting worse. A few tips include:

• Using softer force for pinch and grip activities may transfer lesser force on tendons.
• Padding objects such as the steering wheel of the car or other tools may help reduce the grip strength required to hold these objects. Using kitchen tools with larger handles may also help.
• Using both hands to do an activity rather than just one helps divide the strain among more tendons.
• Applying a cold pack to the wrist at regular intervals (with regular breaks of at least 2 hours in between to help skin warm up and recover) may help reduce pain and inflammation.
• Maintaining a neutral position of the wrist whenever possible helps reduce strain on wrist tendons. This position is achieved by positioning the wrist straight in alignment with the forearm, such as in a handshake position.

Watch: Video: How to Make 5 Quick and Easy Ice Packs

Using these tips help reduce excessive strain on wrist tendons.

Treating Wrist Tendinosis

The non-surgical methods described for wrist tendonitis may also be used for tendinosis injuries. Tendinosis injuries usually take 2 to 6 months to recover. ¹ Wilson JJ, Best TM. Common overuse tendon problems: a review and recommendations for treatment. Am Fam Phys. Sep 1 2005;72(5):811e8. In some cases, surgery may be required.

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