Tendonitis in the hand is inflammation of the tendons or the thin tissue sheaths surrounding them, causing pain, stiffness, and difficulty gripping or moving your fingers and thumb. It develops when repetitive motion, overuse, or an underlying health condition irritates the tendons that connect your forearm muscles to the bones in your hand and fingers. Most cases heal within a few weeks with rest and simple treatments, though chronic cases can take up to two months or longer.
How Hand Tendons Work and What Goes Wrong
Your hand and wrist contain a dense network of tendons, each running through a protective sheath lined with a fluid-filled membrane. This membrane keeps the tendons lubricated so they glide smoothly every time you bend a finger, grip an object, or rotate your wrist. When something irritates or damages that membrane, it swells. The swollen tissue creates friction inside the sheath, and the tendon can no longer move freely. That friction is what produces the pain, catching, and stiffness you feel.
In some cases the problem is purely inflammatory (tendinitis), meaning the tissue is actively swollen and irritated. In longer-lasting cases, the tendon itself can develop tiny areas of degeneration rather than active inflammation, a condition more accurately called tendinosis. The distinction matters because tendinosis typically takes longer to resolve, often two to six months compared to a few days or weeks for straightforward tendinitis.
Common Types of Hand Tendonitis
De Quervain’s Tenosynovitis
This is the most well-known form of hand and wrist tendonitis. It affects two tendons on the thumb side of your wrist that help you move your thumb away from your hand and straighten it. When the tendons swell or the sheath around them thickens, they no longer fit well inside their tunnel, and you feel a sharp or aching pain at the base of your thumb that can travel up the forearm.
Pain is usually worst when you’re gripping something, turning your wrist, making a fist, or lifting with your thumbs pointed upward (like picking up a child). You may also notice visible swelling or a small fluid-filled bump on the thumb side of the wrist. The pain can come on gradually over weeks or appear suddenly.
Trigger Finger
Trigger finger is a form of stenosing tenosynovitis, where inflammation narrows the space inside the tendon sheath so much that the tendon catches or locks as it tries to slide through. You’ll typically feel a clicking or snapping sensation when bending or straightening the affected finger, and in more advanced cases the finger can get stuck in a bent position. It most commonly affects the ring finger or thumb, though any finger can be involved.
Causes and Risk Factors
Repetitive hand movements are the most common trigger. Any activity that requires sustained gripping, pinching, wringing, or typing can gradually irritate the tendon sheaths. This includes work at a computer, assembly-line tasks, playing musical instruments, racket sports, and gardening. A sudden increase in hand activity, like a weekend of heavy yard work when you’re not used to it, can also set things off.
Several underlying health conditions raise your risk independently of how you use your hands. Diabetes, rheumatoid arthritis, gout, and osteoarthritis all increase the likelihood of developing tendonitis. Infections can occasionally cause it as well. Women are more commonly affected by de Quervain’s, particularly during pregnancy and the postpartum period, likely due to hormonal changes and the repetitive motions of caring for a newborn.
What It Feels Like
The hallmark symptom is pain that worsens with use. You might notice it first thing in the morning as stiffness, or it might build throughout the day as you use your hands. Common symptoms include:
- Aching or sharp pain along the tendon, often near the wrist or at the base of a finger
- Swelling or warmth over the affected area
- Stiffness that makes it hard to fully open or close your hand
- Catching or clicking when moving a finger (in trigger finger)
- Weakness in your grip, especially when grasping or twisting
Pain from de Quervain’s tends to radiate from the wrist up into the forearm. Trigger finger pain is usually concentrated at the base of the finger on the palm side of the hand, and you’ll often feel a tender nodule there.
How It’s Diagnosed
Most hand tendonitis is diagnosed through a physical exam without imaging. Your doctor will press along the affected tendons, ask you to move your hand in specific ways, and note where the pain occurs. For suspected de Quervain’s, a test called the Finkelstein maneuver is commonly used: you tuck your thumb across your palm, wrap your fingers over it, and bend your wrist toward your little finger. If this reproduces sharp pain on the thumb side of the wrist, the diagnosis is essentially confirmed. X-rays and MRIs generally aren’t needed unless your doctor suspects a fracture, arthritis, or another condition that could mimic tendonitis.
Treatment Without Surgery
The first line of treatment is reducing the irritation that’s causing the inflammation. That starts with rest, meaning you avoid or modify the specific motions that trigger your pain. A splint or brace can help by keeping the affected tendon in a neutral position, which is especially useful at night or during activities you can’t avoid.
Ice applied for 15 to 20 minutes several times a day helps control swelling in the early stages. Over-the-counter anti-inflammatory medications can reduce both pain and inflammation. If these measures aren’t enough, a corticosteroid injection into the tendon sheath delivers a concentrated dose of anti-inflammatory medication directly to the problem area. Research comparing injection approaches found that higher-dose injections led to lower rates of needing a repeat injection (18% versus 35%) and lower rates of eventually needing surgery (12% versus 21%) compared to lower-dose injections.
Exercises and Rehabilitation
Once the acute pain settles, gentle exercises help restore flexibility and prevent the tendon from stiffening. The goal is to gradually increase how much the tendon can tolerate without re-triggering inflammation. Start small: two to three repetitions of each movement, repeated every hour or so throughout the day. As your tolerance builds, you can shift to doing sets of eight repetitions with a brief rest between sets, two to three times a day. The maximum to work toward is two sets of 15 repetitions.
Stretching is equally important. Hold each stretch for 20 to 30 seconds, and aim for two to three sets done two to three times daily. Common exercises include making a gentle fist and slowly opening your hand, spreading your fingers wide, and bending your wrist up and down with a straight arm. The key is consistency over intensity. Pushing through pain during rehabilitation usually backfires.
When Surgery Is Needed
Surgery becomes an option when several months of conservative treatment haven’t resolved the problem. The procedure typically involves releasing or widening the tendon sheath so the tendon can move freely again. It’s usually done as an outpatient procedure, and you go home the same day. Recovery after surgery varies, but most people regain functional use of their hand within a few weeks, with full strength returning over the following months.
Preventing Flare-Ups
If your tendonitis is linked to computer work or desk tasks, a few adjustments to your setup can make a real difference. Position your keyboard so your wrists stay straight and your forearms are level, with your hands at or slightly below elbow height. Keep your mouse close and set its sensitivity high enough that you can use a light touch rather than pressing hard. If your desk has a hard edge, pad it or use a wrist rest to avoid constant pressure on your wrist tendons.
Beyond ergonomics, the most effective prevention strategy is breaking up repetitive tasks. Take short pauses to stretch your hands, fingers, and wrists throughout the day. If your work involves sustained gripping or pinching, alternating hands or switching to tools with larger, cushioned grips reduces the load on any single tendon. Paying attention to early warning signs, like mild aching after a long day, gives you a chance to back off before a full flare-up develops.