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Advice: Intersection Syndrome and Treatment

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Intersection syndrome refers to a painful condition of the wrist and forearm. It commonly presents as radial or thumb sided wrist pain at the back of the forearm just above the wrist, but pain can travel down into the wrist if the condition is severe. Other conditions that give similar symptoms (such as osteoarthritis of the thumb joints or De Quervain’s) should be fully excluded with a comprehensive assessment at diagnosis, as some of the symptoms can be very similar. Intersection syndrome is much less common than De Quervain’s syndrome and this is why fewer people have heard of it. Subtle swelling may be noticed over the area and an assessment will be made for a feeling of ‘wet leather’ or crepitus (a grating or crackling sensation) under the area.

Intersection Syndrome

What Causes Intersection Syndrome?

The cause of this painful condition is tenosynovitis of the wrist extensor tendon. This is when irritation occurs to the tendon covering known as the sheath. It is often brought on by repetitive movements in flexion and extension of the wrist such as rowing or weight lifting. These activities cause overload to the area where the tendons cross over one another and this can cause irritation if the load is progressed too quickly or too intensively. This might occur within a period of increased training frequency in preparation for a race, or when a break in training has occurred due to a holiday or illness and then training is picked up again too quickly afterwards. Sometimes intersection syndrome can be due to a direct blow to the forearm but this is rare.


This condition rarely if ever requires surgery to treat it. Ultrasound can sometimes provide a useful confirmation of the diagnosis but this can mostly be made clinically with testing by a specialist musculoskeletal physiotherapist or doctor. Treatment will usually require a period of activity modification. You will need to reduce the amount of load going through the area for a period and then be guided to build back up slowly to ensure the tendons recover effectively. There are specialist exercises that can start to gradually increase load through the area again and ensure you are strong for your activity. Sometimes soft tissue massage techniques can be useful to release any scarring or areas that might be stiff and stuck. This will allow tissues to move better around and against each other reducing the irritation. These techniques are easily learned and applied and can be highly effective at treating this painful condition.


Rarely does intersection syndrome last more than 6 months after onset. If you think you have this condition, seek assessment and advice and try to start identifying those activities that might be overloading the area. Contact us today to arrange an initial assessment with one of our specialist physios on 020 7884 0374 or email