Wrist & Hand Injuries That Mimic “Tendonitis” but Aren’t
Many patients receive diagnoses of “tendonitis” for wrist and hand pain when the actual problem involves entirely different structures and conditions requiring different treatments. The term tendonitis gets applied loosely to any pain around tendons, leading to misdiagnosis of serious hand injuries as simple inflammation. While true tendon inflammation does occur, numerous other conditions produce similar symptoms – pain with movement, localized tenderness, and weakness – causing confusion for patients and sometimes even healthcare providers unfamiliar with the subtleties of hand anatomy and pathology.
At the practice of board certified hand specialist Dr. Uzma Rehman in the Warren, MI area, patients with persistent “tendonitis” that doesn’t improve with standard treatments receive comprehensive evaluation to identify the actual problem. Dr. Rehman understands that accurate diagnosis proves essential for effective treatment, and continuing to treat misdiagnosed hand injuries as simple tendonitis wastes time while allowing conditions to worsen. What seems like straightforward inflammation may actually represent ligament tears, nerve compression, arthritis, or other structural problems requiring specific interventions.
Understanding which hand injuries mimic tendonitis symptoms, how specialists distinguish between these conditions, and why accurate diagnosis matters helps you recognize when your pain deserves more thorough evaluation. Persistent symptoms despite appropriate tendonitis treatment strongly suggest alternative diagnoses that comprehensive hand examination can reveal.
Ligament Injuries vs Tendonitis in Hand and Wrist
Ligament injuries frequently get misdiagnosed as tendonitis because both cause localized pain and tenderness around joints. However, ligaments and tendons are entirely different structures with different functions and healing characteristics. Tendons connect muscles to bones, transmitting force that creates movement. Ligaments connect bones to other bones, providing joint stability. Ligament injuries create instability that standard tendonitis treatments cannot address.
The scapholunate ligament connecting two wrist bones commonly tears during falls onto outstretched hands. This injury causes pain on the thumb side of the wrist that worsens with gripping – symptoms easily mistaken for de Quervain’s tendonitis affecting thumb tendons. However, scapholunate ligament tears create wrist instability that anti-inflammatory medication and rest cannot fix. Without proper treatment, the instability progresses to arthritis over years. Physical examination tests can distinguish between these conditions, but providers must know to perform and interpret them correctly.
Triangular fibrocartilage complex (TFCC) tears affect structures on the pinky side of the wrist. These injuries also mimic tendonitis, causing pain with wrist rotation and gripping. The TFCC includes ligaments, cartilage, and other structures stabilizing the wrist joint. Tears require specific treatments ranging from immobilization to surgical repair, none of which resemble tendonitis management. Board certified hand surgeon Dr. Uzma Rehman in the Warren, MI area emphasizes that providers must consider ligament injuries when patients present with wrist pain, not automatically assume tendonitis without thorough evaluation.
Nerve Compression Syndromes Mimicking Tendonitis
Nerve compression creates pain patterns that overlap significantly with tendonitis symptoms, leading to frequent misdiagnosis. Carpal tunnel syndrome compressing the median nerve causes aching pain in the wrist and hand that many patients and providers attribute to tendonitis. The pain typically worsens with repetitive hand use, exactly like tendonitis would. However, carpal tunnel syndrome also causes numbness and tingling that tendonitis doesn’t produce. Unfortunately, early carpal tunnel syndrome sometimes presents with pain before obvious numbness develops, creating diagnostic confusion.
Wartenberg’s syndrome involves compression of the superficial radial nerve at the wrist, causing pain along the thumb side that mimics de Quervain’s tendonitis almost perfectly. Both conditions hurt with thumb and wrist movement, both cause tenderness in similar locations, and both may improve temporarily with anti-inflammatory treatment. However, Wartenberg’s syndrome requires different long-term management than tendonitis, and accurate diagnosis matters for effective treatment. Careful physical examination can distinguish these conditions, but only when providers consider nerve compression as a diagnostic possibility.
Pronator syndrome compressing the median nerve in the forearm creates pain and weakness that spread to the wrist and hand, sometimes getting diagnosed as forearm tendonitis. The condition affects people who perform repetitive pronation movements – turning the palm downward – making it common in certain occupations. Like other nerve compressions, pronator syndrome may improve temporarily with rest and anti-inflammatory measures, delaying accurate diagnosis. Hand specialist Dr. Uzma Rehman conducts comprehensive neurological examinations distinguishing nerve compression from true tendonitis, ensuring patients receive appropriate treatment for their actual condition.
Arthritis Presenting as Tendonitis
Early arthritis often gets misdiagnosed as tendonitis since both cause joint pain and stiffness. Thumb carpometacarpal (CMC) arthritis affecting the base of the thumb creates pain remarkably similar to de Quervain’s tendonitis. Both conditions hurt with gripping, pinching, and thumb movement. Both cause tenderness around the thumb base. However, arthritis involves cartilage degeneration in the joint while tendonitis involves tendon sheath inflammation – completely different problems requiring different treatments.
Radiocarpal arthritis affecting the wrist joint similarly mimics wrist tendonitis. The pain, stiffness, and weakness resemble what tendon inflammation would cause. X-rays reveal the joint space narrowing and bone changes characteristic of arthritis, but these studies aren’t always obtained for presumed tendonitis cases. Months may pass with ineffective tendonitis treatment before someone finally orders imaging revealing the true diagnosis.
Trigger finger, while technically involving tendons, differs from simple tendonitis. The condition involves nodule formation on flexor tendons combined with tendon sheath narrowing, creating catching or locking of fingers. It often gets labeled “tendonitis” and treated with anti-inflammatory measures that rarely help. Trigger finger typically requires injection or surgical release for definitive treatment. Board certified hand doctor Dr. Uzma Rehman in the Warren, MI area performs thorough clinical and imaging evaluations when hand injuries don’t respond as expected to tendonitis treatment, identifying the arthritis or other conditions actually causing symptoms.
Ganglion Cysts Causing Tendonitis-like Symptoms
Ganglion cysts are fluid-filled sacs arising from joints or tendon sheaths. These benign growths can cause pain and discomfort easily confused with tendonitis, particularly when they’re small and not obviously visible. Ganglion cysts commonly develop on the wrist, either on the back (dorsal) or palm side (volar). They may fluctuate in size, sometimes disappearing then recurring, creating symptom patterns that confuse patients and providers.
The pain from ganglion cysts occurs through multiple mechanisms. Large cysts create pressure on surrounding structures including tendons and nerves. Small cysts may cause pain by irritating joint capsules or ligaments. The pain typically worsens with wrist movement, exactly like tendonitis. However, ganglion cysts require different treatment than tendonitis – they may need aspiration or surgical excision rather than anti-inflammatory measures and rest.
Occult ganglion cysts that don’t show obvious swelling prove particularly prone to misdiagnosis as tendonitis. Ultrasound or MRI imaging reveals these hidden cysts, but only when providers order these studies. Patients with “tendonitis” that doesn’t improve with standard treatment deserve imaging to rule out ganglion cysts and other structural abnormalities. Hand specialist Dr. Uzma Rehman uses ultrasound and MRI judiciously to identify these hidden causes of hand pain that standard examination might miss.
Partial Tendon Tears vs Inflammation
Actual tendon pathology itself sometimes gets mischaracterized. Tendonitis implies inflammation without structural tendon damage, but many cases labeled “tendonitis” actually involve partial tendon tears – entirely different conditions. Partial tears create pain similar to inflammation but require different management. While pure inflammation may respond to rest, anti-inflammatory medication, and activity modification, partial tears often need immobilization or even surgical repair depending on severity.
Chronic tendon problems often involve tendinosis rather than tendonitis. Tendinosis means tendon degeneration with abnormal collagen structure rather than inflammatory changes. This distinction matters because anti-inflammatory treatments that help tendonitis don’t address the structural problems of tendinosis. Tendinosis requires rehabilitation focusing on gradual loading to stimulate healthy collagen formation, not just reducing inflammation.
Distinguishing between tendonitis, tendinosis, and partial tears usually requires imaging. Ultrasound reveals structural tendon changes, tears, and thickening that indicate problems beyond simple inflammation. MRI provides even more detail about tendon quality and integrity. These studies help hand specialists plan appropriate treatment based on actual tendon pathology rather than assumed inflammation. Board certified hand surgeon Dr. Uzma Rehman in the Warren, MI area emphasizes that persistent tendon pain warrants imaging to assess actual structural condition rather than assuming simple inflammation that should respond to basic treatment.
When to Seek Hand Specialist Evaluation
Several red flags suggest your “tendonitis” might actually be different hand injuries requiring specialist attention. Symptoms persisting despite appropriate rest, splinting, and anti-inflammatory treatment for 6-8 weeks deserve reevaluation. True tendonitis usually improves significantly with these conservative measures. Failure to improve suggests alternative diagnoses that hand specialists can investigate.
Numbness or tingling accompanying pain indicates possible nerve involvement rather than pure tendonitis. Catching, locking, or giving way sensations suggest mechanical problems like trigger finger, ligament tears, or loose bodies in joints. Visible swelling or deformity obviously requires more than tendonitis treatment. Any of these features warrant hand specialist consultation.
Progressive weakness despite treatment also signals problems beyond simple inflammation. While tendonitis can cause weakness from pain inhibition, persistent or worsening weakness suggests structural damage – tendon tears, nerve compression, or other conditions requiring specific interventions. Hand doctor Dr. Uzma Rehman in the Warren, MI area provides comprehensive evaluation for patients whose “tendonitis” doesn’t follow expected patterns, identifying the actual hand injuries causing symptoms and providing appropriate treatment rather than continuing ineffective approaches based on incorrect diagnoses.
Hand Injuries | Tendonitis Doctor | Warren, MI Area
If you’ve been diagnosed with “tendonitis” that isn’t improving with standard treatment, you may actually have different hand injuries requiring specialist evaluation and targeted treatment. At the practice of board certified hand specialist Dr. Uzma Rehman in the Warren, MI area, patients receive comprehensive diagnostic assessment identifying the actual conditions causing their pain rather than assuming inflammation without proper investigation.
Don’t continue suffering with misdiagnosed hand pain that isn’t getting better. Schedule an appointment with Dr. Rehman to discover what’s really causing your symptoms and what treatments can provide the relief you’ve been seeking. Accurate diagnosis is the foundation of effective treatment – getting the diagnosis right matters for getting your hands better.
