In short
Extensor tendonitis is irritation of the tendons that lift the toes or straighten the fingers. In the foot it causes pain across the top, usually after a jump in walking or running or from shoes that press on the area. In the hand it causes pain on the back of the wrist. It usually settles with a short rest, a change of footwear or activity, and a gradual return. Pain in one spot on a foot bone needs checking for a stress fracture.
On this page
What is extensor tendonitis?
The extensor tendons run across the top of the foot to lift the toes, and across the back of the hand and wrist to straighten the fingers and pull the wrist back. They sit close under the skin, with little padding over them.
Extensor tendonitis is pain and irritation in those tendons. Like other tendon problems, it is an overuse injury, caused by repeated movements or by a sudden increase in load.1
Extensor tendonitis in the foot
Symptoms
- Pain across the top of the foot, worse with walking or running
- Swelling over the top of the foot1
- Soreness when you lift your toes against resistance
- Discomfort from the pressure of a shoe on the area
Causes
The usual triggers are the general ones for tendon injuries: increasing the intensity of exercise over a short period, and unsuitable footwear.1 Incorrect footwear is a recognised cause of foot pain.2
Shoe fit deserves a close look. A review of studies that measured feet and shoes found that between 63 and 72 per cent of people were wearing shoes that did not match the length or width of their feet, and that poor fit was linked to foot pain.3
Could it be a stress fracture?
Pain on the top of the foot after a jump in training has another important cause: a stress fracture in one of the long bones of the foot. Stress fractures are common overuse injuries that develop during periods of increased training without enough rest.4
The two can be hard to tell apart on your own. As a rough guide, tendon pain tends to run along the line of the tendon and change when you move your toes. Bone pain tends to sit in one spot and hurt when you press on it. If you are unsure, or the pain is not settling, see a doctor. The diagnosis of a stress fracture is mainly made by examination, with scans when needed.4
Pain that keeps coming back?
Talk it through with an Australian doctor online. No referral needed.
Extensor tendonitis in the hand and wrist
Tendon problems in the hand and wrist are common. The extensor tendons pass over the back of the wrist in six tunnels, and inflammation of the tendon lining can develop in any of them.5 They are common in athletes.6
- Pain on the back of the wrist or hand that is worse with use
- Swelling over the back of the wrist
- Pain at the thumb side of the wrist is usually de Quervain's tenosynovitis, the most familiar of these conditions
Our guide to wrist pain covers the other causes.
Treatment
- Ease off for a couple of days. Rest the area, use ice, and avoid the activity that set it off.1
- Do not rest completely for long. More than 48 hours of complete rest can slow recovery. Use the area as normally as you can as it settles.1,7
- Take the pressure off. For the foot, check that your shoes are long and wide enough and are not pressing on the sore area. For the wrist, a splint can rest the tendons.5
- Build back gradually. Return to running, walking or the aggravating task in steps.
- Get advice if it lingers. A physiotherapist can guide strengthening, and a podiatrist can assess your feet and footwear.2
For hand and wrist tendons that do not settle, the options include splinting, hand therapy, an injection and, uncommonly, an operation to release the tendon.5
How long does it take to heal?
Most tendon problems recover completely, and many do so without medical treatment.7 If yours has not improved after one or two weeks of looking after it, have it checked.7
When to see a doctor
- Pain that has not improved after one or two weeks7
- Pain in one spot on a bone, or pain at night or at rest
- Swelling, redness or heat over the area, or a fever1
- Numbness or tingling in the foot or hand
- You cannot move your toes or fingers normally
See also tendonitis, foot pain and peroneal tendonitis.
Next step: talk to a doctor
Answer a few quick questions and you’ll get an email about your eligibility. A consultation doesn’t guarantee any particular treatment.
References
- healthdirect. Tendinopathy.
- Better Health Channel. Feet: problems and treatments.
- Buldt AK, Menz HB. Incorrectly fitted footwear, foot pain and foot disorders: a systematic search and narrative review of the literature. J Foot Ankle Res. 2018;11:43.
- McInnis KC, Ramey LN. High-Risk Stress Fractures: Diagnosis and Management. PM R. 2016;8(3 Suppl):S113-24.
- Adams JE, Habbu R. Tendinopathies of the Hand and Wrist. J Am Acad Orthop Surg. 2015;23(12):741-50.
- Patrick NC, Hammert WC. Hand and Wrist Tendinopathies. Clin Sports Med. 2020;39(2):247-258.
- Better Health Channel (Victorian Government). Tendonitis.
This guide is general information, not medical advice. It doesn’t replace a consultation with a doctor who knows your history. In an emergency, call 000.