ELBOW, HAND and

WRIST TENDONITIS

Dr. Masci has experience dealing with common overuse injuries. 

He also directs a hand and wrist sports injury clinic in central London.

Many cases of upper limb pain are treatable.  

Generally, the road to recovery begins with an accurate diagnosis. Our knowledge and experience can help determine the source of your elbow, hand, and wrist pain. Moreover, we aim to streamline services so imaging can often be accomplished during the first visit. Finally, various treatment options can calm joint pain and promote recovery.  

Our upper limbs are prone to injury and overuse.

Our hands are such an essential part of everyday living. Unfortunately, this reality means more vulnerability to injury. A fall onto an outstretched hand can spell trouble for any part of the arm. Usually, the pain is often immediate. However, in some cases, it might appear a few days later.   

Perhaps a visit to hospital A&E reveals that a bone is not broken. That’s a relief…maybe. But, in general, we must always be mindful that a ‘normal’ X-ray does not exclude the potential existence of a break or fracture. Sometimes, fractures are overlooked by busy doctors. Even more problematic is a fracture involving a wrist bone called the scaphoid. Therefore, it is often essential to follow up an X-ray with another form of imaging, such as an MRI scan.  

Other trauma-related injuries to the hand include ligament damage affecting the dorsal aspect of the wrist, called the ‘scapholunate ligament.’ Depending on the extent of damage to the ligament, some cases will require a cast or surgery.

Overall, this paper spells out the challenges of managing sporting hand and wrist pain

Dreaded elbow tendonitis

Further up the arm, common elbow injuries include overuse tendonitis, such as tennis elbow and golfer’s elbow—these elbow injuries present with elbow pain when lifting. Traditionally, we treated these tendon injuries with a cortisone injection. However, recent studies suggest that patients who have a cortisone injection do worse than those who receive no treatment. The best care for patients with tennis elbow includes a thorough assessment using MSK ultrasound and exercise therapy. Occasionally, other treatments, such as shockwave therapy and different ultrasound-guided injections (without cortisone), are needed to hasten recovery. Recently, PRP has been used for tennis elbow with good effect. Overall, tennis elbow can be a complex condition to treat. 

Common hand and wrist conditions include thumb arthritis, carpal tunnel, trigger finger, and wrist tendonitis.

The thumb joint is the most common site of arthritis in the wrist and is treated with hand therapy, a thumb splint, and ultrasound-guided cortisone injection into the thumb joint. At Sportdoctorlondon, we use ultrasound and ultrasound guidance to improve the accuracy and effectiveness of an injection. Other common injuries include trigger finger and carpal tunnel syndrome, treated with a cortisone injection. We also treat cases of wrist tendonitis, such as De Quervain’s tenosynovitis, which is common in new mums or individuals who use their thumbs and wrists repetitively, such as gardeners or knitters. In addition, wrist tendonitis is common in active athletes such as tennis players, rowers, and gym participants. Finally, trigger finger is where the tendon of the finger or thumb gets caught in a small pulley causing pain and clicking. An ultrasound-guided trigger finger injection is usually effective. Overall, hand and wrist conditions are common in sporty people. 

Can you treat a lump in the wrist?

A ganglion cyst is one of the most common causes of a slowly growing lump in the wrist. Ganglion cysts are benign and arise from the small wrist joint or tendon sheath. These ganglion cysts are diagnosed using musculoskeletal ultrasound. Reassurance is all that is required. However, occasionally, a sports doctor must drain the ganglion cyst using a needle, local anaesthetic, and MSK ultrasound. Generally, the use of musculoskeletal ultrasound to perform this procedure is essential. Images enable the doctor to drain the entire ganglion cyst and avoid harming structures, such as tendons or blood vessels.

Click on your pain location to identify possible causes:  

 

wrist pain chart
Volar radial wrist pain Dorsal radial wrist pain Dorsal ulnar wrist pain Volar ulnar wrist pain Volar hand pain Finger pain Thumb pain

Volar radial wrist pain

Dorsal radial wrist pain

Volar ulnar wrist pain

Volar hand pain