Inflammation of the flexor tendons of the hand

Inflammation of the flexor tendons of the hand is an acute inflammation and is called tendinitis (tendonitis), the chronic form is called tendinosis, leads to degeneration of the inner fibers and takes time to develop.

Tendons are strands of connective tissue that connect muscles and bones.
The outer lining of the tendon is called the tendon skin (peritendineum) and is the only vascularized part of the tendon that can become inflamed.

Risk groups that consistently perform the same hand movements can develop tendinopathy.
The acute inflammation is called tendonitis (tendonitis); on the other hand, a chronic disease that results in the degeneration of the inner fibers and takes time to develop is called tendinosis.
If the inflammation affects the skin of the tendons, it is referred to as tendovaginitis or peritendinitis. The tendons originating in the elbow and forearm end
at the level of the hand and fingers ; The flexors run in the palm area and the extensors run on the back of the hand.
Inflammation at the tendon insertion is called enthesitis.
Tendinitis can have post-traumatic causes, ie caused by an accident, slipping, falling, ball contact, etc.
A tendon cyst can form on the wrist where the inflamed tendon runs.
People who suffer from hand tendinitis often have other problems with the tendons in the arm, such as tendinitis in the shoulder or trigger finger.


What are the causes of tendonitis of the hand flexors?

This tendinitis can occur in three different ways:

  • through trauma .
  • Due to physical overload during sports, at work, in leisure time; Usually the tendinitis occurs in the right hand, but in left-handed people it is primarily the left hand that is affected.
  • By applying pressure for hours, such as when kneading dough (rarely).
  • Due to the hormonal imbalance in the female body, tendinitis can develop more easily during pregnancy.
  • When breastfeeding, the mother often holds the child in her arms and thereby overloads the tendons, these women then come to the practice with tendonitis on the middle finger.

The tendinopathies of the hand and finger flexors mainly affect musicians , especially guitarists , bassists , piano and saxophone players .
The thumb flexor tendons rarely become inflamed, tendinitis of the short thumb extensor and long thumb spreader is more likely ( Quervain’s disease ).

Repeating the same movement for hours overstrains the tendons , creating friction and heat as they slide over the other structures of the hand: bursae, bones, other tendons, ligaments, etc.; this is how peritendinitis develops.
A less common cause is post-traumatic inflammation caused by an accident, a fall on the palm of your hand, a sprained finger playing volleyball or goalkeeping activities, etc.
There are also organic diseases of a rheumatological nature such as lupus, rheumatoid arthritis , or even metabolic syndromes such as diabetes and gout , which can lead to tendon weakness.

What are the symptoms of tendonitis of the hand flexors?

The main symptom is pain during the stretching movement and when pressing on the tendon, which then occurs like a knife stab in a matter of seconds.
A small effusion usually forms internally, but there are no external signs of a swollen hand.
In some people, the hand falls asleep, because if the tendinitis is severe, carpal tunnel syndrome can also occur, which causes numbness and tingling in the first three fingers (thumb, index and middle finger).
The pain is not particularly severe or unbearable, but over time it is unnerving.
In the case of affected athletes, musicians and housewives/househusbands, this condition can have a major impact on the mood and worsen the mood because the preferred activities can no longer be carried out or can only be carried out with difficulty.
Motorcycling and cycling can increase symptoms; those suffering from tendonitis may feel tingling in their fingers after 10-15 minutes.

How is tendinitis diagnosed?

The diagnosis can be made with a simple visit to the doctor; the doctor asks about the patient’s medical history in order to gain knowledge of the risk factors, any trauma suffered, occupational risks and the types of sports practiced.
During the exam, he will have the patient do movement tests, tensing the muscles ending in the affected tendons; the tendons are stretched and the painful area is palpated to see if the pain is increasing.
The doctor may also order an ultrasound scan to get clarity on the condition of the tendon and to identify possible inflammation, degeneration, or tendinosis. If the tendon is thickened and there is fluid effusion, the ultrasound shows a hypoechoic zone.

What is the right therapy for tendonitis of the hand and finger flexors?

The symptoms are cured by eliminating the causes , because if only the inflammation is treated, the symptoms can quickly reappear.
Immobilization in the acute phase is essential in order not to aggravate the situation.
If the cause of the inflammation is improper posture (for example, the guitarist may be bending the wrist toward the palm instead of keeping it in a neutral position), correct it to relax the tendon as much as possible.
If you have to perform physical activities, you should put on support bandages or a bandage, otherwise it is sufficient to keep your hand and fingers still.

The most effective physiotherapy is manual therapy; the hand consists mainly of bones, tendons, ligaments and connective tissue; it is rare for the muscles and other structures to be the cause of the symptoms, so the tendons and connective tissues must be freed of the adherences that form between them in order to cure tendinitis.

Myofascial manipulation is used in rehabilitation centers specializing in hands and fingers.
Of the physical therapies, laser , shock wave and ultrasound therapy show the greatest effect.
Avoid swimming unless it causes pain; Tennis, basketball and volleyball should be avoided.
Anti-inflammatory drugs such as diclofenac (Voltaren) provide temporary relief but do not eliminate the cause.
Cortisone infiltration is not recommended for treating tendinitis because it weakens the tissue and increases the risk of tendon injury.

Natural Remedies

Stretching can help healing in some cases, but care should be taken to avoid recurrence of symptoms with stretching.
Ice packs are only helpful in the acute phase, i.e. within the first 24 hours; Ice pads have no effect on chronic tendinitis.
After a few days, applying heat helps to encourage cellular response.
Natural remedies include arnica ointment, which has anti-inflammatory effects but is not particularly effective.
If you work a lot on the computer, you should use a mouse pad with gel wrist support.

How long are the healing times?

Acute tendinitis lasts about two weeks if the hand is rested.
If the pain persists for a longer period of time, it indicates that the tendinitis has become chronic; in this case, with appropriate treatment, recovery takes 2-4 months.

Read more