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Guide to Tendonitis of the Wrist

Dr. Z • Apr 29, 2020

What is Tendonitis of the Wrist?

If your wrist, arm or hand hurts or if you feel numbness in these areas, you might have tendonitis of the wrist. Actually, it's one of the most common musculoskeletal disorders today. But don't worry: The simplest treatments (rest and bracing) usually work wonders for this condition.


There's nothing mysterious about what causes tendonitis of the wrist. It happens when you simply overwork your fingers and hand.



At the microscopic level, overworked tendons in the wrist form tiny adhesions, These adhesions make the tendon less supple, and therefore restrict its movement. The restriction causes irritation on the tendon, which in turn causes swelling.


Swelling keeps tendons from functioning properly. Instead of normally gliding smoothly to make your fingers move, the swelling restricts movement even further. That restriction is what causes all of the pain and other symptoms associated with tendonitis of the wrist.




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But are you sure you have tendonitis of the wrist? Several disorders can cause similar symptoms. So your pain or numbness may be due to a condition other than wrist tendonitis. 


For instance, you may have a simple wrist sprain, which is also quite common. But the symptoms may also be due to carpal tunnel syndrome, which is also common, and (by far) a more serious condition. 


How to tell the difference?*

  • Wrist tendonitis & sprains usually hurt more when your fingers are moving.
  • Carpal tunnel syndrome usually hurts more when your fingers are resting.


*This difference occurs in the early stages of carpal tunnel syndrome. More advanced stages will hurt whether or not your fingers are moving.


The chart below is a useful side-by-side symptoms comparison symptoms of carpal tunnel symptoms versus tendonitis of the wrist.



Infographic showing carpal tunnel versus wrist tendonitis

Therefore, be 100% certain about what's causing the problem to begin with. When you confirm that you indeed have tendonitis of the wrist, then you can treat it relatively easily.


Ordinary tendonitis symptoms are treated effectively with:

 

  • Rest & avoidance
  • A wrist brace

 

These remedies will treat mild and moderate wrist tendonitis. But severe wrist tendonitis or another hand pain condition may not respond to these simple treatments. See your doctor if your wrist tendonitis is severe.

Woman holding her wirst due to pain.

Rest & avoidance to treat tendonitis of the wrist

If you have tendonitis it's usually easy to figure out what's causing it. For example, too much typing strains fingers and wrists. As a result, the pain will focus around your fingers or hand. Likewise, too much lifting will probably cause pain focused at the wrist instead of the fingers. So it's usually no mystery what caused the symptoms you have.


Rest is the first thing any damaged tissue (tendon, muscle, etc.) must do. The human body is remarkably good at healing itself. And rest is the body’s best defense against such injury and disease.


For example, when you’re sick or injured, you often feel tired. That’s because your body is telling your brain to temporarily shut down so that it can start the process of restoration (healing). 


Therefore, almost any problem in the body can be healed by simple rest. So rest your hand as often as you can. That also means to avoid doing what was causing your tendons to become strained. 


Simply not performing the stressful activity will allow tendon micro-structures to repair themselves. Depending on the amount of tendon damage you have, restoration & healing can take a few days to several weeks.


Sometimes you just can't stop the activity that caused the tendonitis. If your job requires typing for instance, then take multiple short breaks. Take that breaking opportunity to stretch out your hands. Here are hand exercises for hairdressers (who are notorious for straining their hands) that apply to everybody with tendonitis of the wrist.

Diagram of where carpal tunnel syndrome numbness and tingling occurs.

Wrist brace to treat tendonitis of the wrist

Before discussing wrist braces to treat tendonitis, let's get some terms straight.  You might have heard the term "splint" and “brace” used interchangeably. In fact, they're a bit different. Here's their medical definition:


  • A wrist splint refers to a device that immobilizes the wrist. 
  • A wrist brace supports the wrist in the neutral position. (The neutral position is essentially "straight".) 

 

For everyday purposes there's little difference between the two terms. So we’ll use “brace” here.

About night bracing

In most instances a wrist brace for tendonitis is useful to aid your joint's natural healing abilities. That’s because the brace allows the wrist joint to rest at night - again, that all-important "rest" your body needs. 


The brace gives your hand the opportunity to rest in it's natural and "neutral position". That means there's no stress on the joint. And that restful time is most crucial at night.


You should always wear a wrist brace at night while you sleep if you have tendonitis of the wrist. (At that point, we can call it a "nocturnal brace" or "night brace".) 


When we sleep, we unconsciously over-bend our hand. Hyper-flexing and hyper-extending the hand does tremendous damage inside the wrist joint. But a wrist brace prevents that movement while we sleep. That's why it’s the best way to rest the hand at night. 


Most people find that sleeping with a night brace for tendonitis is uncomfortable at first. However, that discomfort will disappear soon. You won’t even know you’re wearing a brace after a few nights.

Wearig a blue wrist brace while typing on a keyboard.

About bracing during the day

As mentioned above, it’s nearly impossible for us to rest our hands and wrists 100 percent of the time. We're always doing something with our hands - usually it's our jobs! 


But if you have tendonitis of the wrist and wear a brace while using your hand, you'll surely make matters worse.


That's because your injured hand will subconsciously fight the immobilization - if even a little bit. And that can make healing go a lot slower. 


Fighting the brace produces isometric movements (movement against a solid object). This is very bad for the healing process in general.  As a result of the isometric movements from wearing a wrist brace, you cause more stress damage to the tendons. That's because they work harder against the immovable brace. 


This is why many doctors now recommend you do NOT wear a brace for wrist tendonitis on a 24/7 basis.


The only time you should wear a wrist brace during the day is if you you'll be over-straining your hand. For instance, if you know you'll be lifting something heavy, then a wrist brace can help support the extra weight.

Attractive brunette woman wearing a night brace in bed.

Cautions about wrist bracing

Bracing can actually do more harm than good

There are many instances where a brace obstructs the healing process. It can also make the condition even more painful. The most common way this happens is if you wear a brace when you shouldn't. 


Some conditions require you wear a wrist brace 24/7. Sprains, fractures, ligament tears, etc. all require absolute immobilization. But if you immobilize your wrist, you also discourage restorative blood flow and fluid drainage from the joint. That's a necessary compromise with a sprain or fracture. But it's harmful if you have tendonitis of the wrist.


Also, wrist and finger movement keeps tendon adhesions from forming deep inside the wrist joint. And since tendons are swollen, you need to drain the fluid from the joint as often as possible. If the wrist joint is stationary all the time, fluid drainage doesn't occur efficiently. 


Therefore, if you have wrist tendonitis, complete immobilization (24/7) may do more harm than good. 

Wrist bandages and braces sold in pharmacies.

Only brace when necessary during the day

If we could completely rest our hands for 2 weeks we would surely relieve the tendonitis. But in today’s busy world you cannot let your hands just dangle all day while they rest. They must work. And we need our hands for just about everything, and all the time. Therefore, they move all the time.


Be mindful that if you wear a brace during the day (while working), your hand will subconsciously fight the brace. That will certainly make your wrist work harder, and may make the original problem worse.


Therefore, patients with tendonitis of the wrist should brace only sparingly during the day - when necessary. Brace only when you expect to over-bend your wrist joint, as when lifting heavy objects. Then remove the brace.

Never use a wrist brace to relieve pain

No wrist brace whatsoever is intended to be a pain reliever. They merely keep the wrist joint from moving too much, which may otherwise hurt. 


But that's not a good thing, either. As discussed above, your hand will subconsciously fight the brace while working.


Therefore, a wrist brace that immobilizes your wrist joint may be harmful if used when working. That means don't wear a wrist brace for tendonitis during the day unless you absolutely have to - as when over-bending your hand to lift heavy objects.

Summary

The bottom line is that if you have tendonitis of the wrist, you should always wear a wrist brace while you sleep. During the day, wear it sparingly - if at all. And if you do, wear it only when doing heavy lifting. The brace will keep you from over-extending your wrist.

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