Extensor Carpi Ulnaris (ECU) Tenosynovitis

Extensor Carpi Ulnaris Tenosynovitis is a common cause of wrist pain and swelling on the top of the wrist. The Extensor Carpi Ulnaris (ECU) tendon is located on the pinky side of the wrist and can become stressed and inflamed with certain activities or injuries.

Symptoms of ECU Tenosynovitis:

  • Inflammation
  • Pain and Swelling, usually with certain movement such as lifting

Causes of ECU Tenosynovitis:

  • Repetitive motion of the wrist
  • Overuse
  • Direct Trauma
  • Inflammatory Diseases such as Rheumatoid Arthritis


ECU tenosynovitis can generally be diagnosed upon examination. Inflamed tendons will be evident upon examination of the wrist and hand.

Treatment Options:

  • Rest (taking a break from activities that cause pain).
  • Oral anti-inflammatory medications such as Ibuprofen to decrease inflammation.
  • A resting splint to rest the wrist and decrease inflammation.
  • A small injection of cortisone in the wrist to decrease inflammation.
  • Hand therapy to help decrease inflammation and strengthen the tendon.

Pain and swelling is generally resolved with nonoperative treatment. 

If these conservative treatments do not relieve pain, surgery may be recommended, followed by hand therapy. Hand therapy will help strengthen the wrist and restore range of motion. The recovery period is short with minimal limitation in hand use.


© Copyright 2015 Dr. Allan Rosen MD