Tendon sheath injection, also known as a tendon sheath corticosteroid injection, is a medical procedure used to alleviate pain and inflammation in tendons and their surrounding sheaths. Tendon sheaths are protective coverings that encase tendons, and inflammation within these sheaths can lead to conditions such as tenosynovitis or tendinitis. Common sites for these injections include the wrists, hands, elbows, and ankles. The procedure involves injecting a corticosteroid medication, often combined with an anesthetic, directly into the tendon sheath to reduce inflammation and provide pain relief. The primary causes for tendon sheath injections include chronic inflammatory conditions such as rheumatoid arthritis, repetitive strain injuries, overuse injuries, or acute injuries leading to inflammation of the tendon's surrounding sheath. Conditions like de Quervain's tenosynovitis, carpal tunnel syndrome, and trigger finger are examples where tendon sheath injections may be beneficial. Tendon sheath injections are typically considered when conservative treatments, such as rest, physical therapy, or non-steroidal anti-inflammatory drugs (NSAIDs), have failed to provide sufficient relief. Symptoms that might indicate the need for a tendon sheath injection include persistent pain, swelling, and tenderness around the affected tendon. Patients may experience difficulty with movement or gripping due to pain or stiffness in the affected area. In cases of de Quervain's tenosynovitis, for example, patients might have pain at the base of the thumb that worsens with certain hand movements. Complications of tendon sheath injections are relatively rare but can include infection, bleeding, allergic reactions to the medication, and damage to the tendon or surrounding tissues. Some patients may experience temporary worsening of symptoms, increased pain, or skin thinning at the injection site. Additionally, there is a risk of the injection failing to provide long-term relief, which may require additional treatments or interventions. Injections should be administered by a trained healthcare professional to minimize risks and ensure the correct placement of the medication. Following the procedure, patients are generally advised to avoid strenuous activities and movements that might irritate the injected area. Ice application and elevation may help reduce discomfort and swelling. Proper follow-up and monitoring are essential to assess the effectiveness of the injection and to determine whether additional treatments are necessary. Tendon sheath injections can be an effective means of managing pain and inflammation, improving function, and enhancing the overall quality of life for individuals with inflammatory tendon conditions.
