Pain in inner wrist

For many office workers, they need to use computers frequently in their daily lives, which causes some friends to experience pain in the inner wrist tendons. In fact, if this happens, it is very likely that you have tendonitis. Tenosynovitis is a common wrist disorder. When the disease occurs, it will cause pain in the wrist, and in severe cases it will affect our daily life and work. So, how to treat tenosynovitis?

The tendon sheath is a double-layer, sleeve-like, closed synovial tube that is wrapped around the tendon. It is a synovial sheath that protects the tendon. It is divided into two layers that wrap around the tendon, and there is a cavity between the two layers, namely the synovial cavity, which contains tendon sheath synovial fluid. The inner layer is closely attached to the tendon, and the outer layer is lined inside the tendon fiber sheath. Together they are combined with the bone surface to fix, protect and lubricate the tendon, protecting it from friction or compression. If the tendon is excessively rubbed here for a long time, damaging inflammation of the tendon and tendon sheath may occur, causing swelling, which is called tenosynovitis. If left untreated, it may develop into permanent disability.

1. Radial styloid stenosing tenosynovitis

Two tendons pass through the first fibrous bone sheath on the dorsal side of the wrist, namely the tendons of the abductor pollicis longus and the extensor pollicis brevis. After passing through the narrow sheath, the two tendons form a certain angle with the sheath and end at the base of the first metacarpal bone and the base of the proximal phalanx of the thumb, respectively. When the wrist and thumb have a wide range of motion, the angle of the tendon increases. Over time, the local synovium becomes inflamed and thickened, the tendon becomes thicker, the fibrous sheath wall also thickens, and subcutaneous nodules appear at the radial styloid process, making it difficult for the tendon to slide in the sheath, causing symptoms such as pain. Due to endocrine changes in lactating and menopausal women, the synovium is easily affected and this is the main reason why the disease is more common in women. In addition to the above reasons, according to our surgical observations and foreign literature reports, there are many anatomical variations that can easily cause the occurrence of this disease. For example, if the belly of the palmaris pollicis longus or the extensor pollicis brevis is too low, part of the belly may enter the sheath; because there are more vagal tendons in the sheath, the number of tendons increases significantly, sometimes with more than ten tendons; there are also hard, thick and tough fibrous septa in the first dorsal wrist sheath, which makes the originally narrow sheath even narrower and the tendons are easily incarcerated. These anatomical variations cause the disease to occur at a younger age and make conservative treatment difficult to be effective.

2. Myosinitis

The radial extensor carpi longus and brevis muscles are located on the deep side of the proximal end of the dorsal carpal ligament, and the extensor pollicis brevis and abductor pollicis longus muscles pass through the superficial side at a certain angle. When muscles are overactive, the muscles, tendons, and the surrounding fascia and peritendinous tissues become congested and edematous. The synovial fibrinous exudate increases, and symptoms such as local redness, swelling, and pain appear.