Tendonitis is the inflammation and swelling of the enclosed or sheathed tendons.
Tendons are the strong fibrous structures that attach muscles to bones.
When these tendons become swollen or inflamed, it is termed tendonitis.
In many patients, tendinosis (tendon degeneration) is also present.
It can happen together with synovitis (inflammation of the tendons sheaths or synovium).
It can also produce stenosing tendonitis (tightened inflammation of the tendon sheaths).
The most frequent cause is excess use of the involved tendon.
These disorders are more frequent in middle-aged adults and mostly in people who are play sports.
They may be more frequent if the work requires repetitive movements such as writing, typing or use of a computer mouse.
Some risk factors are:
1. Injury or damage to the tendon
2. Repetitive movements of finger and wrist joints
3. Arthritis of the joints may be prone to tendonitis
4. Systemic disorders such as multiple sclerosis, amyloidosis, rheumatoid arthritis
5. Tendonitis happens in families, and is normally appear more often in males than in females
6. Tendonitis can happen as a result of injury or excess use.
7. Playing sports is a frequent cause.
8. Tendonitis also can happen with aging as the tendon’s elasticity becomes loosen.
Body-wide (systemic) diseases, such as rheumatoid arthritis or diabetes, can also result in tendonitis
The main symptoms are pain, tenderness and occasionally swelling of the affected part of the tendon.
1. Pain on movement of the tendon
a. Pain and tenderness along a tendon, normally near a joint
b. Pain at night
c. Pain that becomes worse with movement or action
2. Swelling of part of the tendon affected
3. Stenosis of the tendon sheath may be present
4. Stiffness in the morning
5. Stiffness of the tendon - inability to stretch
1. Swelling over the affected tendon
2. Passive stretching of the tendon is painful.
3. There may be local tenderness of the inflamed tendon.
4. The tendons sheaths are normally swollen and thickened
5. The tendons may become stuck in the narrowed tendon sheaths (Trigger Finger)
6. There may be crepitations over the tendon as it travels across the sheaths
There are definite tests for specific tendons.
The tendon may be inflamed, and the skin over it may be warm and red.
If an infection is the suspected cause (rare) then blood tests and other tests may be performed to find the cause of the infection.
Occasionally, if the diagnosis is not certain, the doctor may suggest:
1. Ultrasound scan
Treatment may be conservative:
1. Rest of the tendon
2. Splints or brace
3. Cold or ice
4. Pain killers such as NSAID
5. Muscle relaxant
A physiotherapist will give the patient a program of exercises to slowly make the muscles of the involved tendon stronger.
This will require doing exercises that raise the load that the muscle can carry.
7. Injection of local anesthetic and long acting steroid into the affected sheath or tendon nodule may help to reduce inflammation
Surgical opening of the synovial sheath may be necessary for tendon release.
In rare cases, surgery is needed to remove the inflamed tissue from around the tendon.
Other treatments are also being given to treat tendonitis:
1. Shock-wave therapy
2. Autologous blood injection
Blood is taken from the patient and then injected into the region around the injured tendons.
TABLE OF CONTENT
Chapter 1 Inflamed Tendons (Tendonitis)
Chapter 2 Causes
Chapter 3 Symptoms
Chapter 4 Diagnosis
Chapter 5 Treatment
Chapter 6 Prognosis
Chapter 7 Trigger Finger
Chapter 8 De Quarvian’s Disease