Middle aged and elderly women, light industrial workers and orchestral instrument performers are the people with high incidence. Repeated attacks of tenosynovitis can be treated surgically

Two months ago, when Jin Juan got up in the morning, she felt the flexion and extension of the fingertip joint of her right thumb was not flexible, and there was a ringing and pain feeling when she moved. Later, this symptom repeated. She went to the hospital for medical treatment and was diagnosed as stenosing tenosynovitis. After medication, the symptoms were mild and severe. According to experts, tenosynovitis is a common disease, which is most common in the hands and wrists, and tends to occur in middle-aged and elderly women, light industrial workers and orchestral players who use their fingers and wrists for a long time, quickly and forcefully.

(From Public Health)

Each hand has 28 bones, 24 long tendons from the forearm and 18 small muscles in the hand, which are connected together by ligaments, joints and skin. A layer of fibrous tissue is wrapped around some tendons of the hand, which is called tendon sheath. It has the function of maintaining normal flexion and extension of fingers and sliding of tendons. When the hand is fixed at a certain position for repeated and excessive activities, friction often occurs between the tendon and the tendon sheath, resulting in edema, fibrous change, and internal cavity stenosis. When the tendon moves in the tendon sheath, the path it passes through is narrow, resulting in pain and dyskinesia. This is tenosynovitis, also known as stenosing tenosynovitis.

Tenosynovitis is a common disease. Fingers move quickly for a long time, such as knitting sweaters, spinning female workers' connectors, orchestral music practice or performance, etc; Or finger long-term forced activities, such as washing clothes, writing manuscripts, computer operations, etc., these chronic strain are the main causes of tenosynovitis. If the patient has congenital tendon abnormalities, rheumatoid arthritis, postpartum or post disease weakness, the disease is more likely to occur.

　 There are two kinds of common tenosynovitis

Stenosis tenosynovitis of radial styloid process: the disease starts slowly and gradually worsens. The bone process (radial styloid process) at the thumb side of the wrist and around the thumb are painful. The thumb movement is blocked. There is tenderness and friction at the radial styloid process. Sometimes there is a slightly raised pea sized nodule at the radial styloid process. If the thumb is tightly held in the other four fingers and flexes the wrist toward the inner side of the wrist (ulnar side), severe pain will occur at the styloid process of the radius. In the acute phase, local swelling may occur. When the swollen tendon passes through the "tunnel" of the narrow tendon sheath, the thumb will make a sound when flexing and extending, so it is also called "snapping the fingers".

Flexor tenosynovitis: mostly occurs in the thumb and middle finger. Dysfunction of finger flexion and extension is especially obvious when waking up in the morning, and can be alleviated or disappeared after activities. Pain sometimes radiates to the wrist. The flexion of the metacarpophalangeal joint may cause tenderness, and sometimes the thickened tendon sheath and pea sized nodules can be touched. When the affected finger is bent, it suddenly stays in the half bent position. The finger can neither be straightened nor flexed. It is as painful as being suddenly "stuck". After pulling with the help of the other hand, the finger can move again, producing a trigger like action and bounce, so it is also called "trigger finger" or "snap finger".

　 Repeated hair can be treated surgically

In the early stage of the disease, it is advisable to reduce finger activity so that local areas can rest; Hydrocortisone acetate, triamcinolone acetonide acetate or prednisolone acetate 0.25ml were injected into the tendon sheath for local sealing, which has a good effect; For patients with a long course of disease and repeated attacks, if these treatments are ineffective, the narrow part of the tendon sheath can be cut open and partially removed in parallel, so that the tendon sheath no longer compresses the tendon, which can achieve the goal of radical treatment.

The following "small actions" can be done in daily life:

1. Wash hands with warm water. Develop the habit of washing hands with warm water after work, not cold water.

2. Move your fingers and wrists and massage yourself. When the sting starts, do some gentle hand exercises to relieve the pain. Rotating the wrist is one of the simple movements. Turning the wrist for about 2 minutes can exercise all wrist muscles, restore blood circulation, and eliminate the bending posture of the wrist.

3. Rotate the head and neck. Take a break between work, put your hand on the table and rotate your head for 2 minutes. Bend your neck forward and backward, point your shoulders with your head, twist your neck, and look at your left shoulder and right shoulder.

4. Regular movement. It is important to exercise every day and relax all aching muscles. Even if you do not feel pain, you should exercise regularly. The local exercise described above should be practiced at least 4 times a day.

5. Use tools carefully. When using tools, do not focus the pressure on the base of the wrist, and try to use the elbow and shoulder.

How to prevent in work?

For people who often use computers or typists, the joint position of the thumb is most likely to cause inflammation. During working hours, you should take more rest, such as doing some stretching exercises, to avoid excessive strain of tendons. When resting, you can hold your fists tightly, and then relax after a few seconds. You can do exercises to strengthen your fingers, flex your palms, and also enhance your wrist strength. After going home every day, you can use hot water to soak your wrists to speed up blood circulation.

The office staff should adopt correct working posture, try to keep their hands balanced, so that their wrists can touch the objects, and do not hang in the air. In terms of hardware cooperation, in addition to buying wrist protectors to strengthen wrist protection, the simplest way is to add a wrist pad in front of the keyboard to increase the support of the wrist and thumb.

In addition, some specially designed tools, such as ergonomic keyboards, can reduce joint wear.