Intersection Syndrome

Intersection Syndrome leads to pain, swelling and occasionally ‘squeaking’ on the back of the wrist.  The pain of Intersection Syndrome is usually worse with gripping or lifting, especially with the ‘palm down’.  Intersection syndrome is usually due to overuse from activities that require repetitive wrist extension, such as raking leaves, shoveling, rowing, weight lifting or skiing.

Similar to DeQuervain’s Tendinitis, Intersection Syndrome is due to a space problem, caused by too much stuff in too little space.  The tendons of the wrist travel through tight tunnels (sheaths).  When overused, swelling occurs within the tunnels.  In cases of Intersection Syndrome, the wrist’s tendons become compressed in the tunnel adjacent to the tunnel that causes DeQuervain’s tendinitis.

Treatment of Intersection Syndrome starts with avoiding the painful activities.  Specifically, avoid lifting with the palm down, which stresses the involved tendons; lifting with the palm up causes less pain.  A splint and a steroid injection are also used to decrease swelling and inflammation within the affected tunnel.

If non-operative treatments fail to provide relief, or if they work but the Intersection Syndrome recurs, a surgical release is very effective.  A surgical release decompresses the tendons and allows them to heal.  How long it takes to feel better is often dependent on how damaged the tendon was by the tunnel’s constriction before surgery.  Intersection Release is a quick, minimally-invasive outpatient procedure.  The adjacent tunnel, the one involved with DeQuervain’s tendinitis, is often released at the same time, as these conditions may coexist.

Please keep the wound clean and dry for 24 hours.  Bathing is safer than showering.  Wrap a towel around the dressing in case any water gets in, then place a plastic bag over the hand and secure it tightly with rubber bands.  After 24 hours the dressings can be removed and the incision can get wet in the shower.  Blot it dry.  There are no stitches to remove (they’re buried and absorbable).  There’s a piece of tape over the wound.  The tape will fall off when it’s ready.  The longer it stays on, the nicer the final wound may look.  Please don’t submerge the incision under water (like swimming, or putting your hand under water) for 10 days after surgery.

It’s best to avoid heavy lifting and gripping for a few weeks while the tendon is trying to heal.  Otherwise, computer use and typing are fine immediately after surgery.

Intersection Syndrome is a very treatable overuse syndrome that causes pain, swelling and occasionally ‘squeaking’ on the back of the wrist.  As for most conditions, the best results are obtained with early treatment.