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Intersection syndrome

Intersection syndrome is painful condition that effects the tendons of the wrist and forearm. Those who suffer from this condition are often those whose daily activity involves repeated movements that involve wrist action. The muscle of the hand and wrist originate further up the arm and their tendons come together to pass through small spaces created for this purpose. The issues arise when the tendon/muscle become overused and inflamed, this restricts the space for the tendons to pass through and can cause irritation.

Symptoms

Symptoms of intersection syndrome are dependent on severity in most cases your symptoms will be:

  • Crepitus (squeaking and creaking) as the tendon causes friction during movement
  • Pain that is made worse by repetitive activities
  • Swelling over the intersection area (3-4cm along the forearm from the wrist)
  • Pain that may spread down to the thumb or along the forearm

The main challenge with this injury is differentiating between intersection syndrome and De Quervains. They are both similar as they are injuries to the tendons and the sheath that around them although the difference comes in the positioning of pain, this is because of the specific tendon/muscle that is being overused.

Causes

Each tendon is surrounded by a lubricant called tenosynovium, this fluid like substance is responsible for assisting with the smooth gliding motion needed when doing activities. When this injury occurs the tensoynovial lining may become inflamed from constant friction against other tendons and muscles. As this process continues the tendon becomes even more swollen causing more irritation and begins to thicken. This process is what causes the space for the tendon to decrease in size causing pain when you move your wrist.

Treatment

Typically, the injury will be treated with conservative management. Initially the most important step is to modify your day to day routines with activities that will not aggravate your symptoms. This will allow the initial healing phases to take place in the affected area. Avoide any gripping twisting or turning movements of the wrist/hand. 

In addition to this, occasionally you will be supplied with a brace or a taping technique that will aim to keep your wrist and hand in alignment with your forearm, this will reduce stress placed on already damaged structures and protect from further injury. Anti-inflammatory medications can be taken to reduce your pain and swelling in the wrist and allow healing to begin. If these measures are not successful in reducing your pain you may be advised to have cortisone injection that will aim to reduce swelling and pain. Cortisone effects are generally temporary.

Surgical approach:

If conservative management fails you may require a small operation that will involve a small procedure where the surgeon will remove the thickened tenosynovium, this procedure is called a tendon release. After your operation you will require a period of rehabilitation where you will be prescribed a series of exercises and activities to do in relation to your injury to get the best possible recovery.

Strand House, 169 Richmond Rd, Kingston upon Thames KT2 5DA 020 8546 6464