Flexor Carpi Radialis (FCR) Tendinitis
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.
Because I inject Marcaine (numbing medicine) into the wound, the hand will often be numb for the entire day of surgery. Starting the day after surgery, you can type and use computers. While there are no formal activity restrictions, if you want to minimize pain and swelling, you should probably avoid heavy lifting and gripping for 4 weeks. These activities won’t cause damage, but these stresses often cause extra pain, discomfort and swelling that most people would rather avoid. However, if you need to perform work or other activities and don’t mind pain and swelling, that’s fine.
The wound is sealed with a superglue-like material. You can shower immediately. Afterwards, gently blot the wound dry. The glue will fall off when it’s ready. The longer it stays on, the better the wound will do. So don’t wipe the glue off or put ointment on it. Please don’t get the wound dirty or submerge it under water (like swimming, or putting your hand under water) for 10 days after surgery. There are no stitches to remove (they’re buried and absorbable).
Computer use and typing are fine immediately after surgery. After the splint is removed, the wrist can be moved normally and used within the limits of pain. Avoid heavy lifting and gripping that can stress the tendon while it is trying to heal. If it is necessary to lift something, try to keep the palm down while lifting. In other words, try not to lift with the palm up while the tendon is healing. Non-painful activities can be performed. The vast majority of people do extremely well following FCR tendon Release.