What is Extensor Tendonitis? The Symptoms & Treatment Options

Written by Leah Bell-Steele
Physiotherapist, University of Queensland
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on May 31, 2022

Woman with extensor tendonitis pain

What is Extensor Tendonitis?

Extensor tendonitis is a term that describes irritation or overload in the tendons of extensor muscles. Tendons are fibrous tissue extending from the muscle that attach to bone.

The extensor muscles in the hand are located on the back of the hand, and pull the fingers, hand, and wrist back towards the face. The extensor muscles in the feet are located in the shin and top of the foot, and help lift the foot upwards. The tendons of these muscles can become irritated or overloaded over time, causing extensor tendonitis.

Extensor tendonitis in the feet is often caused by spending a lot of time standing or wearing poorly fitted shoes. Extensor tendonitis in the hands is often caused by overuse, particularly during repetitive tasks or sports.

Tendonitis often requires a combination of treatments to relieve the pain and resolve the cause of the symptoms.

What are the symptoms of extensor tendonitis?

The main symptoms of extensor tendinitis may include:

  • Aching or sharp pain

  • Stiffness

  • Loss of strength

  • Difficulty with everyday activities

  • Pain during repetitive tasks

  • Pain can be worse at the end of the day

  • Usually only one side is affected, however this is not always the case.

What are the causes of extensor tendonitis?

There are many different causes of extensor tendonitis.

Extensor tendonitis may be caused by:

  • Muscle weakness

  • Bone spurs

  • Previous injury

More specifically, extensor tendonitis in the feet may be caused by:

  • Overuse, such as jumping, dancing, or running

  • Standing for long periods of time

  • Tight or poorly fitted shoes

While extensor tendonitis in the hands may be caused by:

  • Overuse, during repetitive tasks such as manual labour or typing

  • Overuse, from sports that require throwing or twisting movements.

Other causes of pain may include muscle aches and pain, infection, fracture, arthritis, and more. It is important to consult a doctor to rule out any more serious underlying causes of the pain. A diagnosis is also important before any treatment commences, as it could otherwise make the pain worse.

Diagnosing extensor tendonitis

A health practitioner, such as a doctor or physiotherapist, can assess extensor tendonitis. It is usually diagnosed by eliminating other conditions. The health practitioner will ask about the history of symptoms and any risk factors, and complete a physical examination to check the range, strength, and various other structures in the area.

A doctor may request further imaging to assess the soft tissue in the hand or feet. This may include an ultrasound or X-ray, and can also help rule out other underlying medical conditions.

In some cases, a doctor may get a referral to a hand specialist or podiatrist for more specialised testing and investigations.

When to see a doctor

In some cases, extensor muscle pain may resolve on its own. However, extensor tendonitis is often a chronic condition that, when left untreated, can persist and worsen over time.[1]

If the pain is severe, persistent, is caused by an injury, or if there are any unexplained symptoms, it is important to see a doctor immediately.

How is extensor tendonitis treated?

Extensor tendonitis can be complex to treat, and usually requires a combination of treatments.

This may include:

  • Rest - Rest and recovery is important for the tendons to heal.

  • Ice therapy - When appropriately used, ice therapy can be used for short-term pain relief.

  • Pain relief - A doctor may recommend pain relief such as non-steroidal anti-inflammatory drugs (NSAIDs) to relieve pain and inflammation.

  • Corticosteroid injections - In rare cases, a doctor may use a corticosteroid injection locally to reduce pain and inflammation. It is usually a short-term solution only, used to help restore movement and enable participation in exercises, as there are long-term health consequences.

  • Activity modification - Avoiding aggravating movements or sports can settle the symptoms and help the healing process.


Physiotherapists can address musculoskeletal pain. They may prescribe stretching or strengthening exercises to condition the muscles and tendons, and restore movement and function. Other treatments may include technique assessment and retraining for sport, taping, or passive modalities.


In very rare cases, a doctor may recommend a review with a surgeon to discuss other options. This is usually a last line of treatment reserved for severe cases, or when there are other medical conditions presenting with the pain.

Surgery is not always effective, and carries the risk of infection, excessive bleeding, and other complications.[2] Healing times can also be prolonged, and a brace or splint may be required for a period after the surgery.

Recovery from extensor tendonitis

Extensor tendonitis is an overuse injury. It can be complex to treat, and requires a strong commitment to rehabilitation.[3] If the pain and symptoms are not addressed, there is a risk the pain may re-develop or worsen over time. There is a risk of re-injury, so it is important to complete the appropriate treatments to avoid future injuries.

Preventing extensor tendonitis

A few simple strategies can help reduce the risk of developing pain in the extensor muscles of the hands and feet.

This may include:

  • Wearing properly fitted and supportive shoes

  • Increasing any new activity gradually

  • Completing regular exercise, including resistance weight training

  • Taking breaks when needed

  • Allowing adequate recovery times between exercise or activity.

Things to consider about extensor tendonitis

Extensor tendonitis is a common injury.[1] It can occur when the extensor muscles in the hands or feet become overloaded or irritated over time. It often requires a combination of treatments to alleviate symptoms and resolve the cause of the pain. If the pain is persistent or if there are any concerns, it is important to consult a doctor.

Written by Leah Bell-Steele
Physiotherapist, University of Queensland
Published on May 31, 2022
Medically reviewed by Dr Gina Arena
Research Fellow, University of Western Australia
Reviewed on May 31, 2022
Medical reviewers
Last medically reviewed on May 31, 2022
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