Types of Tenosynovitis

The Different Types / Stages of Tenosynovitis

Tenosynovitis is not one single injury. It is an umbrella term for inflammation of a tendon’s synovial sheath, and it presents in several patterns depending on where the sheath sits and how badly it has been irritated. Understanding those patterns will help you recognise your own symptoms quickly and – if work has contributed – build a stronger legal claim.

Diffuse vs. nodular inflammation

Clinicians first distinguish between two broad forms:

• Diffuse tenosynovitis – the sheath is inflamed along most or all of the tendon’s length, so pain follows every movement through the full range.
• Nodular tenosynovitis – swelling is concentrated in one tight spot, creating a palpable lump that can catch under surrounding pulleys and make the tendon jerk or lock.

Both forms respond to rest, splintage and early physiotherapy, but a nodular lesion is more likely to need corticosteroid injection or, in stubborn cases, surgical release.

The most well-known clinical sub-types;

De Quervain’s Tenosynovitis (thumb side of the wrist);

Named after Swiss surgeon Fritz de Quervain, this is still the most common site-specific tenosynovitis diagnosed in UK hand clinics. It affects the abductor pollicis longus and extensor pollicis brevis tendons as they run through a narrow fibrous tunnel at the base of the thumb. Key signs include sharp pain when lifting a kettle, trouble wringing out a cloth and a positive Finkelstein’s test. Left untreated, grip strength can drop by up to 50 percent.

Trigger Finger and Trigger Thumb;

Here the nodule forms on the flexor tendon itself. You may feel a painless click at first, then progressive locking that needs the other hand to prise the finger straight. In children a trigger thumb can fix in the bent position; in adults it is often linked to repeated gripping of tools with a small handle diameter

Related tendon disorders;

Lateral Epicondylitis (Tennis Elbow) hurts on the outer side of the elbow and down the back of the forearm. The problem starts where the tendons that lift the wrist away from the palm attach to the bone, so gripping a kettle or using a screwdriver can feel sharp and burning.

Medial Epicondylitis (Golfer’s Elbow) is the mirror image, producing pain on the inner side of the elbow and forearm. It flares when the tendons that bend the wrist toward the palm are strained – think carrying shopping bags or swinging a golf club.

Rotator Cuff Tendonitis involves the small tendons that steady the shoulder joint; when the long head of the biceps is irritated it may also be called Biceps Tendonitis. Reaching overhead, fastening a seat belt or lying on the affected shoulder can be difficult.

These disorders inflame the tendon itself rather than the sheath, but in everyday conversation – and in many workplace injury claims – they are grouped with tenosynovitis because the symptoms, causes and treatment overlap.

How severe is it? – The ASSiST grading scale

Hand surgeons grade tenosynovitis (trigger digits) using the Amsterdam Severity Scale in Stenosing Tenosynovitis (ASSiST). Knowing your grade helps predict recovery time and claim value.

Although ASSiST was designed for trigger digits it mirrors the escalation seen in De Quervain’s and the longer inflammation persists, the higher the grade climbs and the more intensive (and expensive) the treatment becomes. The condition’s impact varies according to how it arose. Repetitive work with poor ergonomics often produces diffuse Grade 1–2 disease that responds well to task rotation and steroid injection. By contrast, tenosynovitis secondary to rheumatoid arthritis or gout can flare unpredictably and may progress to Grade 3 despite optimal workplace adjustments.

Ready to talk?

If you believe your symptoms began – or were made worse – because of your job, our specialist solicitors can advise whether you have a viable claim.

Contact us today for free, no obligation advice regarding your Tenosynovitis claim – either by calling us free on 0800 028 2060, or by requesting a free call back, whereby one of our team will contact you at a time of your choice, to discuss your situation.

We’re here to help – contact us today.