Extensor Pollicis Longus Tendinitis

Reviewed by Dr Shiva

What is Extensor Pollicis Longus Tendinitis

Tendons attach muscles to bones. They also help with joint movements. When tendons become irritated or swollen, it is called tendinitis.

The extensor pollicis longus (EPL) tendon connects the EPL muscle to a bone that is near the end of the thumb. The EPL muscle helps to straighten and extend the thumb.

EPL tendinitis is a condition in which the EPL tendon lining (sheath) becomes irritated and swollen. This causes pain on the thumb side of the back of the wrist.

What are the causes?

Causes of this condition include:

  • Activities that repeatedly cause your thumb and wrist to extend.
  • Sudden increase in activity or change in activity.

What increases the risk?

This condition is more likely to develop in:

  • People who play sports and activities that involve repeated hand and wrist motions, such as tennis, golf, bowling, and gardening.
  • People who do heavy labor.
  • People who have had a previous wrist injury.
  • People who have poor wrist strength and flexibility.
  • People who do not warm up properly before activities.

Does Radial Fracture cause Extensor Pollicis Longus Tendinitis?

A study conducted on seven patients (out of 7, 6 were women and 1 man) who has sustained a nondisplaced distal radius fracture an year back.

Among these 7 patients, 3 had developed Extensor Pollicis Longus Tendinitis without rupture, 4 had eventually developed EPL tendon rupture.

What are the symptoms of Extensor Pollicis Longus Tendinitis?

Symptoms of this condition include:

  • Pain or tenderness over the thumb side of the back of the wrist when your thumb and wrist are not moving.
  • Pain that gets worse when you straighten your thumb or extend your wrist.
  • Pain when the injured area is touched.
  • Locking or catching of the thumb joint while you bend and straighten your thumb.
  • Decreased thumb motion due to pain.
  • Swelling over the affected area.

Extensor Pollicis Longus Tendinitis is a rare disease.

Two cases were reported in the English literature by Mogensen and Mattsson, who referenced several additional case reports in the Scandinavian and German literature.

Both of their patients had diffuse wrist pain for several months before the pain and tenderness became localized to the third compartment.

How is Extensor Pollicis Longus Tendinitis diagnosed?

This condition is diagnosed with a medical history and physical exam. Your health care provider will ask for details about your injury and ask about your symptoms.

How is Extensor Pollicis Longus Tendinitis treated?

Treatment may include the use of icing and medicines to reduce pain and swelling. You may also be advised to wear a splint or brace to limit your thumb and wrist motion. In less severe cases, treatment may also include working with a physical therapist to strengthen your wrist and calm the irritation around your EPL tendon sheath. In severe cases, surgery may be needed.

Follow these instructions at home:

If you have a splint or brace:

  • Wear it as told by your health care provider. Remove it only as told by your health care provider.
  • Loosen the splint or brace if your fingers become numb and tingle, or if they turn cold and blue.
  • Keep the splint or brace clean and dry.

Managing pain, stiffness, and swelling

  • If directed, apply ice to the injured area.
    • Put ice in a plastic bag.
    • Place a towel between your skin and the bag.
    • Leave the ice on for 20 minutes, 2–3 times per day.
  • Move your fingers often to avoid stiffness and to lessen swelling.
  • Raise (elevate) the injured area above the level of your heart while you are sitting or lying down.

General instructions

  • Return to your normal activities as told by your health care provider. Ask your health care provider what activities are safe for you.
  • Take over-the-counter and prescription medicines only as told by your health care provider.
  • Keep all follow-up visits as told by your health care provider. This is important.
  • Do not drive or operate heavy machinery while taking prescription pain medicine.

Contact a health care provider if:

  • Your pain, tenderness, or swelling gets worse, even if you have had treatment.
  • You have numbness or tingling in your wrist, hand, or fingers on the injured side.
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