Extensor Tendinitis: What Causes Pain on the Back of Your Hand and Top of Your Foot
Updated: 2 days ago
Medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026
Quick Answer
Extensor tendinitis is a type of tendinitis that affects the tendons on the back of your hands and the top of your feet [4]. Extensor tendons help you straighten your fingers, lift your toes, extend your wrists, and bring your ankle up [4]. It's usually caused by repetitive motions and overuse [4], and it typically heals with rest, ice, and at-home care [4].
What the research says
Steroid injections relieve tendon pain in the short term, but the benefit may not last. A systematic review of 41 randomized trials (2,672 participants) of injections for tendinopathy found consistent evidence that corticosteroid injections reduced pain in the short term compared with other interventions, but this effect was reversed at intermediate and long terms; among 991 participants who received corticosteroid injections in studies that reported adverse events, only one (0.1%) had a serious adverse event (tendon rupture) (PubMed: Coombes et al., Lancet, 2010 [1]).
Smoking and manual labor raise the risk of a related overuse tendon injury. In a meta-analysis of 22 studies of lateral epicondylitis (tennis elbow), smoking history (odds ratio 1.46), manual labor (odds ratio 2.39), female sex (odds ratio 1.33), and hypercholesterolemia (odds ratio 1.67) were significant risk factors (PubMed: Chen et al., J Hand Ther, 2024 [2]).
Hand-therapy protocols can guide toe-extensor rehabilitation. A case report describes how a hand extensor tendon repair protocol was applied by a hand therapy service to toe extensors after toe extensor lacerations were repaired — an example of how the same tendon-care principles carry over from the hand to the foot (PubMed: Coady-Fariborzian & Mueller, Fed Pract, 2020 [3]).
What Is Extensor Tendinitis? An Overview
Extensor tendinitis (sometimes spelled tendonitis) is a type of tendinitis that affects the tendons on the back of your hands and the top of your feet.
Tendinitis is a condition that refers to any inflammation or irritation that affects your tendons [4]. Extensor tendinitis is inflammation in your extensor tendons — the tendons that help you straighten your fingers, lift your toes, extend your wrists back and bring your ankle up [4].
Extensor tendinitis is usually caused by repetitive motions that build up irritation in your tendons over time and overload your tendons with increased weight or tension [4]. The most common causes are using your hands or feet for work, as part of a sport you play, or an activity you do often [4].
Key points about extensor tendinitis
Key Point | What It Means |
Definition | Inflammation of the extensor tendons on the back of the hands and top of the feet [4] |
What extensor tendons do | Straighten fingers, lift toes, extend wrists back, bring ankle up [4] |
Main cause | Repetitive motions and overuse (work, sport, hobby) [4] |
Affected areas | Back of hand; top of foot [4] |
First-line treatment | RICE method + NSAIDs [4] |
Surgery needed? | Rare |
Recovery time | A few weeks to a few months [4] |
Long-term outlook | Full recovery expected; no long-term impacts [4] |
Extensor tendinitis is inflammation of the tendons that straighten your fingers and lift your toes, located on the back of the hand and the top of the foot [4]. It's caused by repetitive overuse and is a temporary injury with full recovery expected [4].
How does this condition affect your body?
Your tendons link your muscles to your bones [4]. They're like strong, flexible ropes [4]. Extensor tendons are a specific type of tendon in your hands and feet. In your hands, they help you extend and straighten your fingers [4]. The extensor tendons in your feet help you lift your toes up and lift the front of your foot off the ground [4].
If you have extensor tendinitis, it can be painful or difficult to move your hands or feet, especially during the activity that caused the tendinitis [4].
How common is extensor tendinitis?
Tendinitis is very common [4]. Extensor tendinitis is common among people who use their hands and feet for work or as part of a sport or hobby [4].
Extensor Tendinitis vs. Stress Fractures
Both extensor tendinitis and stress fractures can cause similar symptoms in your hand or foot, and both can be caused by repetitive use (overuse) [4]. The difference is what's damaged inside your body.
If you have extensor tendinitis, one of the extensor tendons that run along the top of your foot or back of your hand just below your skin is irritated or inflamed [4]. A stress fracture is a type of bone fracture. Your metacarpals are the bones in your hand that give it its shape [4]. In your foot, your metatarsals are the five bones that form the arch of your foot [4] and join the back of your foot to your toes. A stress fracture can start as inflammation deep in the bone and lead to a tiny crack in these bones that forms over time after repeated motions or intense activity [4].
Condition | What's Damaged | How It Starts |
Extensor tendinitis | An extensor tendon on the top of the foot or back of the hand, just below the skin [4] | Irritation/inflammation from repetitive use [4] |
Stress fracture | Bone (metacarpals in the hand, metatarsals in the foot) [4] | Inflammation deep in the bone leading to a tiny crack over time [4] |
Shared features | Both cause similar symptoms in the hand or foot; both can be caused by repetitive use/overuse [4] | — |
Visit your provider as soon as you notice any symptoms in your hands or feet, no matter what's causing them.
Extensor tendon zones
Your provider might refer to a zone — or compartment — of your hand or foot that's affected by extensor tendinitis. These zones are sections of your hands and feet that help providers explain or classify where you're having issues. They're like the borders on a map. Some follow natural lines of your hand or foot, but in general they're boundaries that help divide your hand or foot into smaller pieces to explain where you're experiencing symptoms. Providers usually divide hands into nine zones and feet into four zones [4].
Body Part | Number of Zones |
Hands | 9 zones [4] |
Feet | 4 zones |
Extensor tendinitis is a soft-tissue (tendon) injury, while a stress fracture is a bone injury [4]. Hands are divided into 9 tendon zones and feet into 4 zones [4], which helps providers pinpoint exactly where the inflammation is.
Symptoms of Extensor Tendinitis
Symptoms of extensor tendinitis include pain (either along the length of a tendon or in an area around it), pain that gets worse when you use your hand or foot, stiffness, swelling, and discoloration or warmth around a tendon [4].
Extensor tendinitis symptoms include pain along or around a tendon, pain that worsens with use, stiffness, swelling, and discoloration or warmth around the affected tendon [4].
What Causes Extensor Tendinitis?
Extensor tendinitis can be caused by anything that makes you use your hands or feet in a repetitive motion [4]. Over time, the normal wear and strain builds up on your extensor tendons and causes irritation. That irritation makes your tendons swell (become inflamed). That inflammation is what causes pain and makes it hard for your tendons to move as smoothly as they usually can [4].
Some of the activities that can lead to extensor tendinitis include any job that requires you to be on your feet all day, gardening or landscaping, scrubbing, woodworking, painting, sports injuries, repeated typing motions on a keyboard (hands), and wearing shoes that fit poorly or are too tight (feet) [4]. Certain tendons in the wrist are more prone to tendinitis in new mothers who are repetitively lifting their baby and breastfeeding [4]. It's less common, but anything that suddenly twists your hand or foot — like catching yourself after tripping or slipping and twisting your foot — can also cause extensor tendinitis [4].
Activity or Factor | Body Part Most Affected |
Jobs on your feet all day [4] | Feet |
Gardening or landscaping [4] | Hands and feet |
Scrubbing [4] | Hands |
Woodworking [4] | Hands |
Painting [4] | Hands |
Sports injuries [4] | Hands or feet |
Typing on a keyboard [4] | Hands |
Poorly fitting or tight shoes [4] | Feet |
Repetitive baby lifting/breastfeeding [4] | Wrists |
Sudden twisting (tripping/slipping) | Hands or feet (less common) [4] |
Who does extensor tendinitis affect?
Extensor tendinitis can affect anyone. However, you're more likely to develop extensor tendinitis if your job or a hobby causes you to use your hands and feet in repetitive motions [4].
People with certain health conditions are more likely to develop extensor tendinitis, including autoimmune diseases (like rheumatoid arthritis), certain types of arthritis (like gout), people with foot issues like osteoarthritis, and people with flat feet or high arches [4]. People older than 40 or anyone with naturally tight (inflexible) tendons are more likely to develop tendinitis too [4]. You're more likely to develop tendinitis if you smoke or use tobacco products [4].
Risk Factor | Why It Matters |
Repetitive hand/foot motions (job or hobby) [4] | Builds wear and irritation over time |
Autoimmune diseases (e.g., rheumatoid arthritis) [4] | Raises tendinitis risk |
Certain arthritis (e.g., gout) [4] | Raises tendinitis risk |
Foot issues like osteoarthritis [4] | Raises tendinitis risk |
Flat feet or high arches [4] | Raises tendinitis risk |
Age over 40 [4] | Natural tendon changes |
Naturally tight (inflexible) tendons [4] | Less able to absorb strain |
Smoking or tobacco use [4] | Raises tendinitis risk |
Extensor tendinitis is most often caused by repetitive motions — jobs on your feet all day, gardening, scrubbing, woodworking, painting, sports injuries, typing, and tight shoes [4]. Risk factors include age over 40, smoking, arthritis, flat feet or high arches, and inflexible tendons [4].
How Is Extensor Tendinitis Diagnosed?
Your healthcare provider will diagnose extensor tendinitis with a physical exam. They'll talk to you about your symptoms and look at your hand or foot [4].
They may palpate (press) on your hand or foot to check for areas of swelling and tenderness. Your provider may also ask you to perform certain movements to assess your range of motion, strength, and the severity of your pain [4].
You might also need imaging tests if your provider suspects that your tendon is torn or that you have other damage inside your hand or foot [4]. The most common tests include X-rays, musculoskeletal ultrasound (MSK-US), and CT (computed tomography) scan or MRI (magnetic resonance imaging) [4].
Test | What It Does |
Physical exam | Discuss symptoms; look at hand or foot [4] |
Palpation | Press to check for swelling and tenderness [4] |
Movement assessment | Assess range of motion, strength, and pain severity [4] |
X-rays | Rule out bone damage if a tear or other damage is suspected |
Musculoskeletal ultrasound (MSK-US) | Image the tendon and surrounding tissue |
CT scan or MRI | Detailed imaging for suspected tears or deeper damage |
Providers diagnose extensor tendinitis with a physical exam — including palpation and movement tests for range of motion and strength [4]. X-rays, musculoskeletal ultrasound, CT, or MRI are used only if a torn tendon or other damage is suspected [4].
Treatment for Extensor Tendinitis
How is extensor tendinitis treated?
Extensor tendinitis is usually treated with at-home remedies and over-the-counter medications [4].
You should be able to treat extensor tendinitis at home by following the RICE method: Rest (avoid the activity that irritated your tendons; don't overuse your hand or foot while it heals) [4], Ice (apply a cold compress to your hand or foot for 15 minutes at a time, four times a day) [4], Compression (wrap the painful area in an elastic bandage to help reduce swelling) [4], and Elevation (prop your hand or foot above the level of your heart as often as you can) [4].
RICE Step | How to Do It |
Rest | Avoid the activity that irritated your tendons; don't overuse while healing [4] |
Ice | Cold compress for 15 minutes at a time, four times a day [4] |
Compression | Wrap the painful area in an elastic bandage to reduce swelling [4] |
Elevation | Prop your hand or foot above the level of your heart as often as you can [4] |
Over-the-counter NSAIDs like aspirin or ibuprofen can reduce pain and inflammation [4]. Talk to your provider before taking NSAIDs for longer than 10 days [4].
If your symptoms don't improve in a few weeks, your provider might use additional treatments, including corticosteroid injections (which decrease inflammation and reduce pain) [4] and physical therapy (which includes range-of-motion exercises and stretches that can relieve your symptoms and strengthen the area around your irritated tendons) [4].
It's rare to need surgery to treat extensor tendinitis [4]. If your symptoms don't improve after trying other treatments, talk to your provider.
Treatment Step | For Whom | Key Notes |
RICE method | Everyone | First-line at-home care [4] |
OTC NSAIDs (aspirin, ibuprofen) | Everyone | Check with provider before use longer than 10 days [4] |
Corticosteroid injections | Symptoms not improving in a few weeks | Decrease inflammation, reduce pain [4] |
Physical therapy | Symptoms not improving in a few weeks | Range-of-motion exercises and stretches [4] |
Surgery | Rare | Talk to provider if other treatments fail |
Extensor tendinitis is usually treated at home with the RICE method (rest, ice 15 minutes four times a day, compression, elevation) plus OTC NSAIDs [4]. If symptoms persist beyond a few weeks, corticosteroid injections and physical therapy help; surgery is rare [4].
How long does it take to recover from extensor tendinitis?
How long it takes you to feel better depends on how irritated your tendons are. Most people start to feel better as soon as they rest their hand or foot and take a break from any activities that irritate their extensor tendons [4].
It can take anywhere from a few weeks to a few months for your tendons to return to normal [4]. Talk to your provider about a recovery timeline for your specific case of extensor tendinitis.
Outlook: What to Expect
What can you expect if you have extensor tendinitis?
You should expect to make a full recovery from extensor tendinitis [4]. It's a temporary injury that shouldn't have long-term impacts on your health or your ability to work or do the activities you love [4].
Do you need to miss work or school?
If you can do your job or schoolwork without putting additional stress on your injured hand or foot, you shouldn't need to miss work or school while your tendons heal [4]. If the work you do or one of your hobbies caused extensor tendinitis, you might need to take time away from them while you recover.
Can you walk or run with extensor tendinitis?
Most people can still walk and move with extensor tendinitis in their foot [4]. Just make sure to give your body time to recover after moving or walking.
Talk to your healthcare provider before resuming any physical activities like running or working out [4]. If you resume any activity that puts stress on your injured tendon — especially if that activity caused your tendinitis — you can make your symptoms worse. You might also cause more damage to your tendon, which can lead to more serious issues like a torn or ruptured tendon [4].
Prevention
How can you prevent extensor tendinitis?
During sports or other physical activities, wear the right protective equipment, don't "play through the pain" if your hand or foot hurts during or after physical activity, give your body time to rest and recover after intense activity, stretch and warm up before playing sports or working out, cool down and stretch after physical activity, and consider wearing wrist sleeves or ankle sleeves at work or during physical activity if you notice your tendons are sore at the end of the day [4].
Follow these general safety tips to reduce your risk of an injury: make sure your home and workspace are free from clutter that could trip you or others, always use the proper tools or equipment at home to reach things (never stand on chairs, tables or countertops), and use your cane or walker if you have difficulty walking or have an increased risk for falls [4].
Prevention Strategy | When It Helps |
Wear protective equipment | Sports and physical activities |
Don't play through the pain [4] | During or after activity |
Rest and recover after intense activity [4] | Recovery window |
Warm up and stretch before activity [4] | Pre-workout |
Cool down and stretch after activity [4] | Post-workout |
Wrist/ankle sleeves when sore [4] | Work or physical activity |
Clutter-free home and workspace [4] | Fall prevention |
Proper tools (never stand on chairs/counters) [4] | Safe reaching |
Cane or walker if needed [4] | Fall risk |
Living With Extensor Tendinitis
When should you see your healthcare provider?
Talk to your provider if you're experiencing symptoms like pain or swelling that get worse after a few days or if you can't move your hand or foot like you usually can [4].
When should you go to the ER?
Go to the emergency room if you notice any of the following: extreme pain, swelling that's getting worse, discoloration, or the inability to move your hand or foot at all [4].
What questions should you ask your doctor?
Question | Why It Matters |
Do I have extensor tendinitis or another injury? | Correct diagnosis |
Which tendons are injured? | Determines treatment approach |
How long will it take to heal? | Recovery timeline expectations |
Which activities should I avoid, and for how long? | Safe return-to-activity plan |
A note about healing
Extensor tendinitis can be painful and make it hard to move throughout the day the way you're used to. Giving your body the time it needs to heal will make sure you don't develop a more serious issue. Talk to your provider about any accommodations you might qualify for while you heal if your injury was caused at work [4].
Conclusion: Don't Rush Your Recovery
Extensor tendinitis — inflammation of the tendons on the back of your hands and the top of your feet — is a temporary overuse injury that usually responds well to rest, ice, compression, elevation, and over-the-counter pain relief [4]. Full recovery is expected within a few weeks to a few months, and surgery is rarely needed [4]. The one rule to remember: don't rush your recovery. Returning to the activity that caused the problem too soon can worsen your symptoms or tear the tendon [4].
Important: See a healthcare provider if your pain or swelling gets worse after a few days or you can't move your hand or foot normally [4]. Go to the ER for extreme pain, worsening swelling, discoloration, or a complete inability to move your hand or foot [4]. Early treatment prevents a temporary injury from becoming a torn tendon.
Related on Rinnit: Understanding NSAIDs: A Comprehensive Guide to Nonsteroidal Anti-Inflammatory Drugs · Physical Therapy: Enhancing Mobility, Strength, and Recovery
Further reading: Cleveland Clinic — Extensor Tendinitis
Frequently Asked Questions
1. What is extensor tendinitis?
Extensor tendinitis (sometimes spelled tendonitis) is a type of tendinitis that affects the tendons on the back of your hands and the top of your feet. Extensor tendons help you straighten your fingers, lift your toes, extend your wrists back, and bring your ankle up.
2. What causes extensor tendinitis?
Anything that makes you use your hands or feet in repetitive motion — jobs on your feet all day, gardening, scrubbing, woodworking, painting, sports injuries, typing, or tight-fitting shoes. The wear builds up over time, causing irritation and inflammation. Sudden twists (like catching yourself after tripping) can also cause it.
3. What are the symptoms of extensor tendinitis?
Symptoms include pain along the length of a tendon or around it, pain that worsens when you use your hand or foot, stiffness, swelling, and discoloration or warmth around a tendon.
4. What's the difference between extensor tendinitis and a stress fracture?
Extensor tendinitis is inflammation of a tendon just below the skin on the top of the foot or back of the hand, while a stress fracture is a tiny crack that forms over time in the bones (metacarpals or metatarsals). Both cause similar symptoms and can result from repetitive use.
5. How is extensor tendinitis treated?
Most cases respond to the RICE method — rest, ice (15 minutes at a time, four times a day), compression with an elastic bandage, and elevation above the heart — plus over-the-counter NSAIDs like aspirin or ibuprofen. If symptoms persist for weeks, corticosteroid injections and physical therapy can help. Surgery is rare.
6. How long does it take to recover?
It depends on how irritated your tendons are, but most people feel better as soon as they rest. Full recovery typically takes anywhere from a few weeks to a few months.
7. Can I work with extensor tendinitis?
If you can do your job or schoolwork without putting additional stress on your injured hand or foot, you usually don't need to miss work or school. If your job or hobby caused the tendinitis, you may need time away from it while you recover.
8. Can I walk or run with extensor tendinitis?
Most people can still walk and move with extensor tendinitis in their foot — just give your body time to recover after moving. Always talk to your provider before resuming running or workouts, since re-stressing the tendon can lead to a torn or ruptured tendon.
9. Can extensor tendinitis be prevented?
Wear protective equipment during sports, don't play through the pain, warm up and stretch before activity, cool down afterward, rest after intense activity, consider wrist or ankle sleeves if your tendons get sore, and keep your workspace trip-free.
10. When should I go to the ER?
Go to the emergency room for extreme pain, swelling that's getting worse, discoloration, or if you can't move your hand or foot at all.
References
Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet. 2010;376(9754):1751-1767. doi:10.1016/S0140-6736(10)61160-9. PMID: 20970844.
Chen Q, Shen P, Zhang B, Chen Y, Zheng C. A meta-analysis of the risk factors for lateral epicondylitis. J Hand Ther. 2024;37(1):44-52. doi:10.1016/j.jht.2023.05.013. PMID: 37580201.
Coady-Fariborzian L, Mueller B. Application of hand therapy extensor tendon protocol to toe extensor tendon rehabilitation. Fed Pract. 2020;37(1):33-37. PubMed. PMID: 32047353.
Cleveland Clinic. Extensor tendinitis. Cleveland Clinic Health Library. Medically reviewed; last updated May 7, 2022. https://my.clevelandclinic.org/health/diseases/23126-extensor-tendinitis
Medical Disclaimer
This article is for informational purposes only and does not constitute medical advice. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read here.
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