Flexor Carpi Radialis Tendinitis
Pain and swelling on the thumb side of the wrist often comes from irritation of the flexor carpi radialis (FCR) tendon. Early rest, simple exercises and splints usually ease symptoms.
What Is FCR Tendinitis?
The FCR tendon runs from your forearm muscle, through a tight tunnel by the wrist bone called the trapezium and attaches near the base of your index finger. Tendinitis means the tendon and its lining become irritated or inflamed, causing pain where it rubs against the bone.
Why Does It Happen?
• Overuse – repeated wrist bending in sports (golf, tennis) or manual jobs
• Change in activity – sudden increase in gripping tasks or new hobbies
• Tight tunnel – the FCR fills most of its canal, so minor swelling leads to pinching
• Nearby arthritis or bone bumps can also rub on the tendon
Typical Symptoms
• Sharp or aching pain on the palm-side, thumb-side of the wrist
• Tenderness when you press over the tendon just below the wrist crease
• Worsening pain when you bend your wrist towards the palm and thumb-side, or grip tightly
• A crackling or “snapping” sensation as the tendon moves
• Swelling or a warm feeling over the tendon tunnel
Getting the Right Diagnosis
Prof Imam will:
- Ask about your activities and symptom history
- Press on the tendon to check for tenderness
- Ask you to move against gentle resistance to reproduce pain
- Use an ultrasound or MRI only if the diagnosis is unclear or surgery is considered
Non-Surgical Treatments (First Line)
• Rest and modify activities that make pain worse
• Wear a wrist splint or soft strap in neutral or slight bend for 2–4 weeks
• Take paracetamol or ibuprofen for short-term pain relief
• Apply cold packs for 10–15 minutes after activity
• Gentle hand therapy exercises:
– Tendon-gliding movements to help the tendon slide smoothly
– Controlled wrist bending and stretching under therapist guidance
– Gradual strengthening with light resistance
When to Consider Surgery
If symptoms persist after 3–6 months of careful non-surgical care, or imaging shows a significant tendon tear, your specialist may recommend:
• Tunnel Release – widening the tendon canal by cutting the tight sheath
• Tendon Repair or Transfer – for large tears, the surgeon may trim the damaged tendon and re-route or re-attach it to restore strength
Rehabilitation and Recovery
• Early finger and wrist movement to prevent stiffness after rest or surgery
• Progressive strength exercises over 8–12 weeks
• Return to full activities by 3–4 months, guided by your therapist
Preventing Recurrence
• Use ergonomic tools and maintain good wrist posture
• Take frequent breaks from repetitive tasks
• Continue gentle stretching and strengthening exercises
• Manage any arthritis or wrist stiffness promptly
Clinical Pearls
• FCR tendinitis pain is always localised to the thumb-side of the wrist
• Early rest and splinting often prevent the need for surgery
• Avoid high-dose steroid injections into the tendon tunnel—they may weaken the tendon
Patient FAQs
Will I fully recover?
Yes—most people regain full wrist function with rest, splints and guided exercises.
How long before I can resume sports or work?
Mild cases improve in weeks; more severe or surgical cases take 3–4 months of gradual return.
Can I keep using my wrist if it hurts?
You may do light tasks, but modify or avoid movements that flare pain until guided by your therapist.
Call-to-Action
For exercise videos and a printable rehab plan, visit www.TheArmDoc.co.uk/hand-therapy. To book a specialist review, phone 020 3384 5588 or email Info@TheArmDoc.co.uk.
Evidence & Guidelines
Based on UK best practice for tendon disorders and current NICE recommendations.
Disclaimer
This leaflet offers general guidance and does not replace personalised medical advice. Always discuss your symptoms and treatment plan with your healthcare team.