Tendons are thick fibrous cords which attach the muscles to bones. They often glide in sleeve-like tubes called tendon sheaths. Most of the finger tendon muscles which flex the fingers start in the forearm. The tendons attached to these muscles pass through the wrist in the carpal tunnel and go into the palm. When the muscles contract, such as when making a fist or holding a pencil, the tendons tighten causing the fingers to bend and grasp.
If the tendons in the palm become inflamed or thickened, friction increases inside the tendon sleeves, and the tendons do not glide easily causing swelling and pain.
Tendinitis may cause a painful sticking or catching feeling when grasping or pinching objects. There may be swelling and tenderness of the tendons.
Tendinitis may be caused by new, strenuous and often repetitive activities which cause injury or irritation of the tendons. An injury from unusually heavy or sudden stretching of the fingers, or falling on the outstretched hand may cause injury of the tendons. Frequently, activities such as prolonged use of the hand (such as painting or gardening) may lead to tendinitis. Diseases such as rheumatoid arthritis or gout may cause inflammation in the tendons. If untreated, the fingers may contract, lock or draw down. It may not be possible to straighten them completely, or they may seem tethered to the skin of the palm causing a condition called dupuytren's contractures.
Tendinitis is likely if the tendons feel thickened and painful and the palm is tender with direct pressure. Bending or extending the fingers back stretches the tendons, and if they are inflamed this will cause pain. Usually x-rays or blood tests are not necessary unless other signs suggesting joint inflammation are present.
It is important to rest the tendons, and reduce direct pressure with hard objects. Gloves, and padded grips on tools or sports equipment will help to cushion the tendons. Sometime splinting the fingers at night will provide additional tendon rest.
Various medications may be used to reduce pain. These may include over the counter medications such as Tylenol (generic = acetaminophen) Aleve (generic = naproxen), Motrin (generic = ibuprofen) or aspirin. Prescription medications which belong to a group of medications called ‘non-steroidal anti-inflammatory medications (or ‘NSAIDs’ for short) are commonly recommended. Some of the more commonly prescribed of these include medications such as Celebrex, Motrin, Naprosyn, Mobic,Voltaren, Relafen and Lodine. (A complete list is available at the reference below.)
Occasionally, a cortisone injection into the tendon sleeve is very effective in reducing swelling in the tendon. For advanced dupuytren’s contractures, injections to dissolve fibrous tissue or surgery may be necessary.