Wrist tendinitis is the inflammation of tendons in the wrist, often causing pain and limited movement.
Many tendons cross the wrist, each gliding inside a lubricated sheath. When a tendon and its sheath become irritated, the result is tendinitis (also spelt tendonitis) or tenosynovitis, where the sheath itself thickens and inflames. The wrist is one of the most common places for this to happen.
Two tendons are affected particularly often: extensor carpi radialis longus and extensor carpi radialis brevis. They run along the back of the wrist on the thumb side, straighten the wrist and hold it steady during grip, which means they are loaded during almost everything the hand does. Extensor carpi radialis tenosynovitis, irritation of these tendons and their sheaths, is a frequent cause of pain over the back of the wrist and lower forearm. Where these tendons cross the thumb tendons a few centimetres above the wrist, a distinct pattern called intersection syndrome can develop.
Wrist tendinitis is an umbrella rather than a single diagnosis. Other extensor tendons and the flexor tendons on the palm side can be affected, and De Quervain's tenosynovitis is a specific, well-known form at the thumb side of the wrist, covered on its own page. What these conditions share is the impact: typing, lifting, gym work and manual tasks all become painful, and untreated symptoms tend to grumble on.
Wrist tendinitis is usually a condition of load outpacing what the tendon is conditioned for. Common triggers include a sudden increase in activity, such as a new gym programme, a renovation project or a season of heavy gardening; long hours of sustained keyboard and mouse work; rowing, racquet sports and golf; and occupations involving repeated wrist extension and grip.
Extensor carpi radialis pain from intersection syndrome is classically seen in rowers, weight trainers and skiers, where repeated wrist movement causes friction at the crossing point of the tendons.
Inflammatory conditions such as rheumatoid arthritis can also cause tenosynovitis without any overuse at all, which is one reason persistent or multi-site tendon symptoms deserve proper assessment. Sometimes no single cause is found.
Typical symptoms of wrist tendinitis include:
The location helps distinguish the diagnosis: extensor carpi radialis tenosynovitis and intersection syndrome cause pain over the back of the wrist and forearm, while De Quervain's tenosynovitis causes pain right at the thumb side of the wrist that is provoked by thumb movement.
Most wrist tendinitis settles without surgery, and treatment starts with settling the irritated tendon while correcting the load that caused it.
Early treatment includes relative rest and modifying the aggravating activity, a wrist splint for a short period to let the tendon settle, ice, and simple pain relief or anti-inflammatory medication. Physiotherapy is central: a graded strengthening programme conditions the tendon to handle load again, and technique and workstation adjustments address the cause rather than just the symptom.
Where symptoms persist, a corticosteroid injection into the affected tendon sheath can settle inflammation and is often effective for tenosynovitis. An ultrasound or MRI scan may be arranged if the diagnosis is unclear or symptoms are not improving as expected, both to confirm which tendons are involved and to exclude other causes of pain over the back of the wrist.
Surgery is uncommon for wrist tendinitis and is reserved for persistent cases that have not responded to a proper course of non-surgical care. It involves releasing the tight tendon sheath and clearing thickened, inflamed tissue so the tendons glide freely again.
The outlook for wrist tendinitis is good. Most cases settle over weeks to a few months once the load is corrected and a strengthening programme is followed. Symptoms can recur if the underlying cause, whether training load, technique or workstation setup, is not addressed, which is why treatment focuses on both.
Persistent cases are the minority, and for those that do need an injection or, uncommonly, surgery, the results are generally good. Tendinitis caused by an inflammatory condition follows the course of that condition and is managed alongside it.
Wrist tendinitis, including extensor carpi radialis tenosynovitis and intersection syndrome, is a common and very treatable cause of pain over the back of the wrist. Most cases settle with load management, physiotherapy and time, with injections and surgery reserved for the persistent few. If wrist pain is interfering with work, training or everyday tasks, an assessment can pinpoint which tendons are involved and set out a clear plan.
For help distinguishing this from other causes of wrist pain, see understanding wrist pain.
