Managing Hand Synovitis: Balancing Traditional and Western Treatments

Periosteitis of the hand

In early May, I developed hand tendonitis due to using a mouse.
I then sought traditional Chinese medicine treatment, and the swelling subsided in about three days.
However, after having a small hot pot that evening, my hand began to swell again.
The Chinese medicine practitioner applied heat therapy, but it worsened the condition.
Later, I went to the emergency department at Chung Hsing Hospital, where I received anti-inflammatory injections and took anti-inflammatory medication for two days, but there was no improvement.
I sought traditional Chinese medicine again, and although I received acupuncture, the progress has been very slow.
Especially on rainy days recently, my hand has been in more pain.
I later went to a pharmacy to buy anti-inflammatory medication, which noticeably reduced the swelling.
My questions are as follows: 1.
Should I continue with acupuncture? 2.
I've heard that anti-inflammatory medications can be harmful to the kidneys, which makes me very anxious.

Hou Liqing, 20~29 year old female. Ask Date: 2005/06/02

Dr. Chen Xingyuan reply Orthopedics

Dear Miss Hou,
Based on your letter, you may be experiencing tendonitis or ligament inflammation due to overuse or improper use of your wrist.
In the acute phase, anti-inflammatory and analgesic medications can be used for treatment.
For patients with severe symptoms, local corticosteroid injections may be administered when necessary, which can significantly help alleviate symptoms.
All medications have some side effects, but as long as they are used under a physician's guidance and with a proper understanding of medication use, they are generally quite safe.
The most important thing is for you to understand the cause of your pain and to make improvements accordingly.
Therefore, it is essential to reduce wrist usage and provide appropriate protection.
The effectiveness of acupuncture may vary from person to person; if you feel it is beneficial, it is worth trying.
However, this should only be considered a part of adjunctive therapy.
If wrist usage is not reduced and careful use is not practiced, the pain may not heal easily.
Wishing you health and safety!
Sincerely,
Dr.
Chen

Reply Date: 2005/06/02

More Info

Managing hand synovitis can be a complex issue, especially when balancing traditional and Western treatments. Synovitis, which is inflammation of the synovial membrane in the joints, can lead to pain, swelling, and reduced mobility. In your case, it seems that the condition was exacerbated by repetitive strain from using a mouse, and the subsequent treatments have had mixed results.

Understanding Synovitis
Synovitis can occur due to various reasons, including repetitive use, trauma, or underlying conditions such as rheumatoid arthritis. Symptoms typically include swelling, pain, and stiffness in the affected joint. The management of synovitis often involves a combination of rest, physical therapy, medication, and sometimes injections or surgery, depending on the severity.

Treatment Approaches
1. Traditional Chinese Medicine (TCM): Acupuncture and herbal remedies are commonly used in TCM to treat inflammation and pain. Acupuncture can help improve blood flow and reduce inflammation, but its effectiveness can vary from person to person. If you find that acupuncture is not providing significant relief, it may be worth discussing with your practitioner whether to continue or adjust the treatment plan.

2. Western Medicine: Non-steroidal anti-inflammatory drugs (NSAIDs) are often prescribed to manage pain and inflammation. While there are concerns about the long-term use of NSAIDs, particularly regarding kidney health, they can be effective for short-term relief. It’s essential to use them as directed and monitor for any side effects. If you have pre-existing kidney issues or other health concerns, it’s crucial to consult with your healthcare provider about the safest options for you.

3. Rest and Activity Modification: One of the most effective ways to manage synovitis is to reduce the activities that exacerbate the condition. This may involve taking breaks from repetitive tasks, using ergonomic tools, or modifying how you perform certain activities.
4. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around the joint, improve flexibility, and reduce the risk of further injury. A physical therapist can design a personalized exercise program that takes into account your specific needs and limitations.

5. Heat and Cold Therapy: Applying heat can help relax and loosen tissues and stimulate blood flow, while cold therapy can reduce swelling and numb sharp pain. Alternating between heat and cold can be beneficial, especially during flare-ups.

Addressing Your Concerns
1. Should You Continue Acupuncture?: If you feel that acupuncture is not providing the relief you hoped for, it may be worth discussing with your acupuncturist. They might suggest adjusting the treatment frequency or techniques. Alternatively, you could explore other modalities such as physical therapy or massage therapy.

2. Concerns About NSAIDs and Kidney Health: It’s understandable to be concerned about the side effects of medications. While NSAIDs can have adverse effects on the kidneys, especially with long-term use or in individuals with pre-existing kidney conditions, they can be used safely for short periods. Always communicate your concerns with your healthcare provider, who can help you weigh the risks and benefits and monitor your kidney function if necessary.

Conclusion
Managing hand synovitis effectively requires a comprehensive approach that considers both traditional and Western medicine. It’s essential to listen to your body and adjust your treatment plan based on what works best for you. Regular follow-ups with your healthcare providers, whether they are Western or traditional practitioners, will help ensure that you are on the right track to recovery. Remember, the goal is to reduce inflammation, manage pain, and restore function to your hand while minimizing any potential side effects from treatments.

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