I am a 23 years male and I go to gym regularly. Around 2 weeks back my right wrist started hurting and now if I close my wrist some tendons are moving near carpel bone and causing pain. Sometimes I can not even close my hand. Previously doctor gave pain killer and some vitamins but it didn't work. I got and xray, mri and ultrasound and bellow are the reports. there is abnormal synovial thickening with edema and inflammatory changes seen in the proximal palmar aspect of hand at the level of metacarpal bone deep to flexor digitorum superficialis tendon of middle finger. The synovial thickening is mobile and extends proximally up to the wrist joint at the level of flexor retinaculum. (dynamic ultrasound of the hand was performed: during flexion of hand the abnormal synovial thickening extends proximally into the wrist joint in the subcutaneous plane). There is mild to moderate edema seen in the adjacent soft tissue plane. Is there any serious issue, what are all the available treatments. Thanks in advance.

Dr. Sirish PhysiotherapistPhysiotherapist17yrs exp

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Based on the imaging findings you provided, it appears that you have inflammation and thickening of the synovial lining in your wrist, specifically in the proximal palmar aspect of your hand near the metacarpal bone. This inflammation is causing pain and restricted movement, especially when flexing your hand. This condition is often referred to as tenosynovitis, which is inflammation of the tendon sheath and synovial lining surrounding a tendon. In your case, it seems to be affecting the flexor digitorum superficialis tendon of the middle finger. The treatment options for tenosynovitis typically involve a combination of conservative measures and, in some cases, more aggressive interventions. Here are some possible treatments: rest and immobilization: resting the affected wrist and avoiding activities that aggravate the symptoms can help reduce inflammation and allow the tissues to heal. Immobilizing the wrist with a splint or brace may also be beneficial in some cases. Ice therapy: applying ice packs to the affected area for 15-20 minutes several times a day can help reduce pain and inflammation. Anti-inflammatory medications: nonsteroidal anti-inflammatory drugs (nsaids) like ibuprofen or naproxen can help reduce pain and inflammation. However, it's essential to consult with your healthcare provider before taking any medication. Physical therapy: a physical therapist can provide exercises and modalities to improve wrist strength, flexibility, and range of motion. They may also perform manual techniques to reduce inflammation and improve tissue healing. Corticosteroid injections: in some cases, corticosteroid injections may be recommended to reduce inflammation and provide temporary pain relief. However, these injections are typically used judiciously due to potential side effects and should be administered by a qualified healthcare professional. Occupational therapy: an occupational therapist can assist with ergonomic modifications and provide advice on proper wrist positioning and techniques to reduce strain during daily activities. Surgical intervention: in severe cases of tenosynovitis that do not respond to conservative treatments, surgical intervention may be necessary to remove inflamed tissue or release constricting structures.  

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