Adult
Tendinitis
Tendons · gliding
What it is
This is irritation of a tendon or of the sheath it runs through. In the hand and wrist the problem is usually mechanical: the tendon no longer glides freely.
Trigger finger is caused by a thickened pulley catching the flexor tendon. De Quervain’s tenosynovitis is a narrowing of the first extensor compartment on the thumb side of the wrist. Tennis and golfer’s elbow, by contrast, are degenerative changes at the tendon’s attachment rather than true inflammation.
Symptoms
Pain triggered by specific movements, tenderness over a single spot, local swelling.
In trigger finger the finger catches, clicks, or stays locked in bending — typically on waking, so that it has to be straightened with the other hand. In de Quervain’s, pain comes on lifting something with the thumb held out: the classic presentation in new parents lifting an infant many times a day.
Non-operative treatment
Resting the triggering movement, a splint, therapy — including eccentric loading for the elbow — and anti-inflammatories are the first line.
A corticosteroid injection is particularly effective in trigger finger and de Quervain’s, where it settles a good proportion of cases for good. At the elbow, well-conducted therapy gives better long-term results than injection.
Surgical treatment
The operation is short and consists of releasing the structure that is constricting the tendon: dividing the A1 pulley for trigger finger, opening the first compartment for de Quervain’s — taking care of the superficial sensory nerve branches that cross the area — or debriding the degenerate tendon at the elbow.
These are usually done under local anaesthesia as day surgery.
Recovery expectations
After a trigger finger release, movement is encouraged immediately and the hand is used for light tasks within the same week. The triggering stops at once; residual stiffness of the finger, if it was present beforehand, takes a few weeks of therapy.
After a de Quervain’s release, a splint is worn for comfort and movement then resumes. Elbow procedures take longer, with progressive strengthening over several months.
These pages give general information for patients and referring physicians. They do not replace an individual assessment: the treatment plan is decided in consultation, based on your examination and your goals.