Extensor Tendinitis

Overview

What is extensor tendinitis?

Extensor tendinitis (sometimes spelled tendonitis) is a type of tendinitis that affects the tendons on the back of your hands and the top of your feet.

Tendinitis is a condition that refers to any inflammation or irritation that affects your tendons. Extensor tendinitis is inflammation in your extensor tendons — the tendons that help you straighten your fingers, lift your toes, extend your wrists back and bring your ankle up.

Extensor tendinitis is usually caused by repetitive motions that build up irritation in your tendons over time and overload your tendons with increased weight or tension. The most common causes are using your hands or feet for work, as a part of a sport you play or activity you do often.

Like other types of tendinitis, the best way to treat extensor tendinitis is to avoid activities that make you overuse your tendons and give your body time to rest and recover. You can also reduce your symptoms with at-home treatments, physical and occupational therapy and over-the-counter medications.

Talk to your provider if your symptoms are getting worse or don’t go away after a few days. Visit your provider right away if you can’t use your hands or feet like you usually do.

Who does extensor tendinitis affect?

Extensor tendinitis can affect anyone. However, you’re more likely to develop extensor tendinitis if your job or a hobby causes you to use your hands and feet in repetitive motions.

People with certain health conditions are more likely to develop extensor tendinitis, including:

People older than 40 or anyone with naturally tight (inflexible) tendons are more likely to develop tendinitis too. You’re more likely to develop tendinitis if you smoke or use tobacco products.

How common is extensor tendinitis?

Tendinitis is very common. Extensor tendinitis is common among people who use their hands and feet for work or as part of a sport or hobby.

How does this condition affect my body?

Using your tendons while they’re irritated and inflamed can make it painful or difficult to do the activities that are a part of your daily routine.

Your tendons link your muscles to your bones. They’re like strong, flexible ropes. Extensor tendons are a specific type of tendon in your hands and feet. In your hands, they help you extend and straighten your fingers. The extensor tendons in your feet help you lift your toes up and lift the front of your foot off the ground.

If you have extensor tendinitis it can be painful or difficult to move your hands or feet, especially during the activity that caused the tendinitis.

Extensor tendinitis vs. stress fractures

Both extensor tendinitis and stress fractures can cause similar symptoms in your hand or foot. They can both also be caused by repetitive use — or overuse. The difference between extensor tendinitis and a stress fracture is what’s damaged inside your body.

If you have extensor tendinitis, one of the extensor tendons that run along the top of your foot or back of your hand just below your skin is irritated or inflamed.

A stress fracture is a type of bone fracture. Your metacarpals are the bones in your hand that give it its shape. In your foot, your metatarsals are the five bones that form the arch of your foot and join the back of your foot to your toes. A stress fracture can start as inflammation deep in the bone and lead to a tiny crack in these bones that forms over time after repeated motions or intense activity.

Visit your provider as soon as you notice any symptoms in your hands or feet, no matter what’s causing them.

Symptoms and Causes

What are the symptoms of extensor tendinitis?

Symptoms of extensor tendinitis include:

  • Pain (either along the length of a tendon or in an area around it).
  • Pain that gets worse when you use your hand or foot.
  • Stiffness.
  • Swelling.
  • Discoloration or warmth around a tendon.

Extensor tendon zones

Your provider might refer to a zone — or compartment — of your hand or foot that’s affected by extensor tendinitis. These zones are sections of your hands and feet that help providers explain or classify where you’re having issues.

They’re like the borders on a map. Some of them follow natural lines of your hand or foot, but in general they’re boundaries that help divide your hand or foot into smaller pieces to explain where you’re experiencing symptoms.

Providers usually divide people’s hands into nine zones. Feet have four zones.

What causes extensor tendinitis?

Extensor tendinitis can be caused by anything that makes you use your hands or feet in a repetitive motion. Over time, the normal wear and strain builds up on your extensor tendons and causes irritation. That irritation makes your tendons swell (become inflamed). That inflammation is what causes pain and makes it hard for your tendons to move as smoothly as they usually can.

Some of the activities that can lead to extensor tendinitis include:

  • Any job that requires you to be on your feet all day.
  • Gardening or landscaping.
  • Scrubbing.
  • Woodworking.
  • Painting.
  • Sports injuries.
  • Your hands can develop extensor tendinitis from repeated motions like typing on a keyboard.
  • Wearing shoes that fit poorly or are too tight can irritate the tendons in your feet.

Certain tendons in the wrist are more prone to tendinitis for new mothers who are repetitively lifting their baby and breastfeeding.

It’s less common, but anything that suddenly twists your hand or foot — like a catching yourself after tripping or slipping and twisting your foot — can cause extensor tendonitis.

Diagnosis and Tests

How is extensor tendinitis diagnosed?

Your healthcare provider will diagnose extensor tendinitis with a physical exam. They’ll talk to you about your symptoms and look at your hand or foot.

They may palpate (press) on your hand or foot to check for areas of swelling and tenderness. Your provider may also ask you to perform certain movements to assess your range of motion, strength and the severity of your pain.

You might also need imaging tests if your provider suspects that your tendon is torn or that you have other damage inside your hand or foot. The most common tests include:

Management and Treatment

How is extensor tendinitis treated?

Extensor tendinitis is usually treated with at-home remedies and over-the-counter medications.

You should be able to treat extensor tendinitis at home by following the RICE method:

  • Rest: Avoid the activity that irritated your tendons. Don’t overuse your hand or foot while it heals.
  • Ice: Apply a cold compress to your hand or foot for 15 minutes at a time, four times a day.
  • Compression: You can wrap the painful area in an elastic bandage to help reduce swelling.
  • Elevation: Prop your hand or foot above the level of your heart as often as you can.

Over-the-counter NSAIDs like aspirin or ibuprofen can reduce pain and inflammation. Talk to your provider before taking NSAIDs for longer than 10 days.

If your symptoms don’t improve in a few weeks your provider might use additional treatments, including:

  • Corticosteroid injections: Corticosteroids decrease inflammation and reduce pain.
  • Physical therapy: Physical therapy includes range-of-motion exercises and stretches that can relieve your symptoms and strengthen the area around your irritated tendons.

It’s rare to need surgery to treat extensor tendinitis. If your symptoms don’t improve after trying other treatments, talk to your provider.

How long does it take to recover from extensor tendinitis?

How long it takes you to feel better depends on how irritated your tendons are. Most people start to feel better as soon as they rest their hand or foot and take a break from any activities that irritate their extensor tendons.

It can take anywhere from a few weeks to a few months for your tendons to return to normal. Talk to your provider about a recovery timeline for your specific case of extensor tendinitis.

Prevention

How can I prevent extensor tendinitis?

During sports or other physical activities:

  • Wear the right protective equipment.
  • Don’t “play through the pain” if your hand or foot hurts during or after physical activity.
  • Give your body time to rest and recover after intense activity.
  • Stretch and warm up before playing sports or working out.
  • Cool down and stretch after physical activity.
  • Consider wearing wrist sleeves or ankle sleeves at work or during physical activity if you notice your tendons are sore at the end of the day.

Follow these general safety tips to reduce your risk of an injury:

  • Make sure your home and workspace are free from clutter that could trip you or others.
  • Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
  • Use your cane or walker if you have difficulty walking or have an increased risk for falls.

Outlook / Prognosis

What can I expect if I have extensor tendinitis?

You should expect to make a full recovery from extensor tendinitis. It’s a temporary injury that shouldn’t have long-term impacts on your health or your ability to work or do the activities you love.

Do I need to miss work or school with extensor tendinitis?

If you can do your job or schoolwork without putting additional stress on your injured hand or foot, you shouldn’t need to miss work or school while your tendons heal.

If the work you do or one of your hobbies caused extensor tendinitis, you might need to take time away from them while you recover.

Can I walk or run with extensor tendinitis?

Most people can still walk and move with extensor tendinitis in their foot. Just make sure to give your body time to recover after moving or walking.

Talk to your healthcare provider before resuming any physical activities like running or working out. If you resume any activity that puts stress on your injured tendon — especially if that activity caused your tendinitis — you can make your symptoms worse. You might also cause more damage to your tendon, which can lead to more serious issues like a torn or ruptured tendon.

Living With

When should I see my healthcare provider?

Talk to your provider if you’re experiencing symptoms like pain or swelling that get worse after a few days or if you can’t move your hand or foot like you usually can.

When should I go to the ER?

Go to the emergency room if you notice any of the following:

  • Extreme pain.
  • Swelling that’s getting worse.
  • Discoloration.
  • You can’t move your hand or foot at all.

What questions should I ask my doctor?

  • Do I have extensor tendinitis or another injury?
  • Which tendons are injured?
  • How long will it take to heal?
  • Which activities should I avoid, and for how long?

A note from Cleveland Clinic

Extensor tendinitis can be painful and make it hard to move throughout the day the way you’re used to. Giving your body the time it needs to heal will make sure you don’t develop a more serious issue.

Talk to your provider about any accommodations you might qualify for while you heal if your injury was caused at work.

Last reviewed by a Cleveland Clinic medical professional on 05/07/2022.

References

  • American Podiatric Medical Association. Tendinitis. (https://www.apma.org/tendinitis) Accessed 5/6/2022.
  • American Society for Surgery of the Hand. Extensor Tendon Injury. (https://www.assh.org/handcare/condition/extensor-tendon-injury) Accessed 5/6/2022.
  • Coady-Fariborzian L, Mueller B. Application of Hand Therapy Extensor Tendon Protocol to Toe Extensor Tendon Rehabilitation. (https://pubmed.ncbi.nlm.nih.gov/32047353/) Fed Pract. 2020 Jan;37(1):33-37. Accessed 5/6/2022.
  • MedlinePlus. Tendinitis. (https://medlineplus.gov/tendinitis.html) Accessed 5/6/2022.

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