Orthopedic surgeon and hand expert, Dr. Jeffrey E. Budoff, MD

Arthroscopic and open surgery of the hand, wrist, elbow and shoulder

Flexor Carpi Radialis (FCR) Tendinitis

Hand Surgery Houston

Hand

Wrist

Elbow

Shoulder

The Flexor Carpi Radialis (FCR) is one of the tendons that helps flex the wrist. It is located on the palmar surface of the wrist, near the base of the thumb muscles. Overuse, usually from repetitive lifting with the palm up, may lead to FCR Tendinitis. Computer use may also cause FCR Tendinitis because the FCR is often used maintain pressure on the keyboard by flexing the wrist. FCR Tendinitis is similar to DeQuervain’s Tendinitis in that it’s caused by a space problem.

Like the tendons involved in DeQuervain’s syndrome, the FCR tendon runs in a sheath. Overuse can lead to swelling within that sheath, leading to compression/pinching of the FCR tendon. This leads to pain and tenderness, usually located about an inch above the wrist. This pain is often increased by gripping and by lifting with the palm up, both of which stress the tendon.

Treatment starts with avoiding painful activities. Try to limit lifting. If lifting is necessary, then lift with the palm down. A splint can be worn during periods of heavy activity or when typing.  A steroid injection can effectively decrease inflammation and swelling, and reduce pain. If non-operative measures fail, then the FCR’s tunnel (sheath) can be surgically released. This is a simple, quick, minimally-invasive, outpatient procedure. Like the DeQuervain’s Release, it is highly effective.

After 3 days the dressings can be removed and the incision can get wet in the shower. After showering, blot it dry. There is a piece of special tape over the wound. The longer it stays, the nicer the wound will do. It’ll fall off when it’s ready. Don’t submerge the incision under water (i.e. no swimming or putting the hand under water to do dishes) for 10 days after surgery. The stitches are absorbable: There are no stitches to remove.

After surgery, avoid heavy activities for a week or two. Once released, the FCR tendon starts to heal. How long it takes to feel better depends on how much damage it had before it was released and how much the FCR tendon gets to rest following surgery. Like the DeQuervain’s Release and Intersection Release, FCR Release is usually very effective.