Ulnar sided wrist pain caused by abnormal ECU tendon
The ECU tendon, or extensor carpi ulnaris, is one of the major wrist tendons. It is on the ulnar side of the wrist, the same side as the small finger. There are a number of causes of ulnar sided wrist pain, and one of those are problems with the ECU tendon. The two most common ECU tendon problems are tendonitis and tendon subluxation.
ECU tendonitis is the result of inflammation of the ECU tendon.
Signs of ECU tendonitis include:
- Tenderness directly over the ECU tendon
- Swelling or fullness of the tendon sheath
- Crepitus with movement of the wrist
- Pain with resisted ulnar deviation (pointing the wrist to the pinky side)
Tests are generally performed to evaluate for other sources of ulnar sided wrist pain. X-rays would be normal for most patients with tendonitis, and an MRI might show some fluid around the tendon. Sometimes your doctor will perform a test by injecting a numbing medications (lidocaine) around the tendon to see if the ulnar sided wrist pain resolves.
- Ice application
- Anti-inflammatory medications
- Wrist splint
- If symptoms persist, an injection of cortisone can be helpful.
Seldom is a surgical procedure needed for treatment of ECU tendonitis, but if symptoms persist despite appropriate management, a surgical debridement of the tendon can be considered.
ECU Snapping or Subluxation
Snapping ECU syndrome is a condition due to the ECU tendon sliding in and out of its groove on the side of the wrist.
Signs of ECU subluxation include:
- Painful snapping of the wrist with twisting movements
- Tendon snapping out of its groove with turning the hand to a palm-up position
- Tendon snaps back into place when the hand is turned palm down
Normally, the ECU tendon runs within a smooth sheath along a groove on the side of the wrist joint. It is held in this position by a ligament. Sometimes after an injury such as a wrist fracture, this tendon sheath can become unstable. If the ECU tendon is not held in place, it may ‘snap' over the bone as the wrist is rotated.
- Immobilizing the wrist with the tendon in proper position.
- Surgical reconstruction of the tendon sheath.
How to reduce post-surgery pain without opioids
Here are non-opioid options to reduce pain after surgery:
1. Elevate the injured area so it is higher than your heart.
2. Keep moving by frequently, gently and slowly moving the parts of the body that are outside of the splint or cast (i.e. fingers, wrist, elbow, shoulder). This improves blood flow, which limits swelling.
3. Ice the painful area to reduce swelling, inflammation and pain.
4. Heat the area to increase blood flow and reduce muscle spasms, soreness and joint pain. Only use heat if you are in the phase of recovery where you can remove your dressing or splint.
5. Avoid smoking both before and after surgery, as chemicals present in cigarettes can increase pain.
6. Consume vitamin C daily for 6 weeks to potentially reduce pain.
It is important to note that every patient, surgery and surgeon is unique, so the suggestions above may not apply to your situation. Discuss your strategy for managing pain with your surgical team before and after your surgery.
Do you have a ganglion cyst?
Ganglion cysts are very common lumps within the hand and wrist that occur adjacent to joints or tendons. The most common locations are the top of the wrist, the palm side of the wrist, the base of the finger on the palm side, and the top of the end joint of the finger. The ganglion cyst often resembles a water balloon on a stalk, and is filled with clear fluid or gel.
Treatment can often be non-surgical. In many cases, these cysts can simply be observed, especially if they are painless, as they frequently disappear spontaneously. If the cyst becomes painful, limits activity, or is otherwise unacceptable, several treatment options are available.
Why diagnosing the cause of hand pain is complicated
Diagnosing hand pain’s cause is complicated. Symptoms may come and go or get worse at different times or movements. In some cases, pain may even travel from one part of the arm or hand to another.
“The problem is, hand and arm pain may originate from more than one area of the body,” explains orthopedic surgeon David Geier, M.D., director of sports medicine at the Medical University of South Carolina in Charleston.
“Tendon problems in the wrist typically cause pain in the wrist and thumb but also the forearm,” Dr. Geier adds.
Age, lifestyle, occupation and genetics determine your risk of hand and arm disorders.
For example, mothers-to-be are at a higher risk of carpal tunnel syndrome because the increased fluid caused by pregnancy compresses wrist nerves.
“Plus, new moms may be prone to tendonitis in the elbow from picking up and holding the baby throughout the day,” Dr. Geier says.
5 herbs to fight arthritis and joint pain
Here are some herbs that help to reduce inflammation and join pain from arthritis:
1. Burdock Root (Arctium lappa or Arcticum minus) – Burdock contains fatty oils which (along with its sterols and tannins) contribute to burdock’s reputation as an anti-inflammatory.
2. Flax ( Linum usitatissimum) – Flaxseed is one of the best vegan sources of Omega-3 (ALA), which is so important to a strong immune system and for fighting inflammation.
3 Turmeric (Curcuma longa) – It contains at least two chemicals (curcumin and curcuminoids) which decrease inflammation.
4. Nettles (Urtica dioica) – These contain, calcium, phosphorus, iron, magnesium, beta-carotene, along with vitamins A,C, D, and B complex, all in a form that is easy for the body to use.
5. Licorice (Glycyrrhiza glabra) – It decreases free radicals at the site of inflammation and inhibits the enzyme production that's involved in the inflammatory process.