Tendons connect muscles with bones to achieve movement. In the hand and wrist, the tendons are held in place by “pulleys” to assist with smooth movement. These pulleys are tight naturally, and are located where the tendons change directions. For reasons that are not well understood, the pulleys and the tendons inside can become inflamed, and this is “tendonitis”. The tendons no longer glide well, and so the fingers sometimes “snap”, “pop”, “catch”, or feel “dislocated”. The most common tendonitis is called “trigger finger”, and can happen to any of the fingers including the thumb. Tendonitis also commonly occurs on the sides of the wrist. The common condition of “Dequervain’s tendonitis” is common in young mothers.
The easiest treatment for tendonitis is to avoid the activity that is causing the pain, rest, non-steroidal pain pills, and ice applied onto the inflamed areas. If these simple maneuvers do not suffice, a steroid shot is often given to reduce inflammation and improve pain. Typically, 1 to 3 shots are given before any procedures are offered.
Procedures can be done for tendonitis that fails to respond to cortisone, and these procedures work by opening the pulley. Numbing medicine is used, and these tendonitis procedures are done painlessly in the office. This can be done with an incision, and in some instances a needle can be used to open the tight pulley without an incision.