Since the causes for the development of tendovaginitis can be infectious as well as non-infectious, a comprehensive diagnosis must precede the choice of the appropriate therapy. Furthermore, the appropriate therapy for tendovaginitis depends on the extent as well as on the frequency with which the symptoms occur. In most cases a drug therapy is completely sufficient.
Various painkillers (analgesics), which belong to the class of non-steroidal anti-inflammatory drugs, for example, can help to relieve the stabbing pain in the area of the affected joint. In addition, many analgesics have an additional anti-inflammatory effect and are thus able to contain the course of the disease and bring about a rapid recovery of the tendon sheaths. Paracetamol is less suitable for the therapy of tendovaginitis, as it has an analgesic effect but no anti-inflammatory effect.
Furthermore, a temporary immobilization of the affected joint can be useful. In many cases the attending physician tends to apply a supporting bandage and anti-inflammatory ointments or creams. For patients who frequently suffer from tendovaginitis, the fitting of a so-called warp splint can be useful.
The splints, which are specially adapted to mechanical stress symptoms, alleviate the symptoms of external compression of the affected area. In addition, in case of frequent tendovaginitis, an adjustment of the working conditions must be considered, for example by purchasing joint-gentle computer equipment. Only by reducing the incorrect and excessive strain on the inflamed tendon sheaths can long-term relief be achieved.
For the therapy of chronic tendovaginitis, local anesthetics (narcotics) or cortisone preparations can still be used. If the symptoms do not improve despite pain therapy and application of local anesthetics, surgical correction of the irritated tendon apparatus should be considered. In most cases, the simple splitting of the affected tendon sheath is sufficient to ensure a permanent elimination of symptoms.
Tendovaginitis is also in urgent need of treatment in patients who only suffer from a mildly pronounced symptomatology. The omission of a prompt therapy can hold the danger of a chronification of the complaints. In medical terminology, the clinical picture resulting from this phenomenon is called “Repetive Strain Injury” (short: RSI).
The tendon sheaths of the finger flexors can also be damaged by a long-lasting inflammation in the area of the wrist. Some patients suffer from inflammatory processes and thickening of the finger flexor tendons after several years of untreated tendovaginitis. In pronounced cases this can even lead to an increasing loss of function (technical term: tendovaginitis stenosans).