Synovial tendonitis?

[akomom]

On June 21 my right (dominant) hand was shut in the car door. It was extremely painful, but I had full movement of my hand so assumed it was simply going to be bruised and didn't go to the doctor immediately. My hand became slightly swollen, no bruising, with significant pain that seemed disproportionate to the visible injury. My right hand would be a different color and temperature than my other hand, and pain extended into my wrist, and was variable in my fingers and joints, with occasional tingling. I went to urgent care on June 23, and an X-ray was done and was normal. I was put in a wrist brace for 10 days, and this was very painful unless I kept my thumb tucked in next to the pointer finger. I had the most relief dumping the hand brace. The difference in temperature and color slowly resolved over two weeks, but the swelling continued with significant pain and occasional finger tingling. Only July 18th saw an orthopedic specialist who did a throrough physical exam of my hand and found no deficiencies in strength or movement, and at the time of the exam did not note any difference in hand color or temperature. Swelling was still present and a diagnosis of synovial tendonitis given based on how the doctor observed the motion of excess fluid on the top of my hand, and a rx for piroxicam and using the hand as little as possible was given. I took a car trip to the mountains over the weekend of July 26th, with others doing all the "manual stuff" so I could rest my hand, yet during the trip, the occasional difference in color and temperature has inexplicably returned, the swelling is worse, and the pain has gone from a tolerable 4-5 to an average of a 7. I thought perhaps I didn't rest my hand enough on the trip, but the situation continues several days later. I get no relief from the piroxicam and don't what else I could take with it to reduce the pain. Do I need a return trip to the doctor, or is this up and down typical of synovial tendonitis? Do I need to worry about progression to something more serious, like nerve damage from chronic swelling?
Thanks

[dr_simran]

Hello Dear,
The conservative treatment of wrist tendonitis includes use of -splints. anti-inflammatory medication NSAIDs.,avoiding activities that cause pain and swelling,Injection of corticosteroids into the tendon sheath which help reduce swelling and pain.
You should follow up your orthopedic physician and discuss regarding surgery.
It may be recommended if symptoms are severe or do not improve. The goal of surgery is to open the compartment covering to make more room for the irritated tendons. You should go in for further investigations to evaluate the present condition ,so that appropriate treatment can be done.
Refer http://orthoinfo.aaos.org/topic.cfm?topic=A00007#Treatment for more details.
Best