Tendinitis
(Tendonitis)
In this condition factsheet:
Diagnosing Tendinitis
Doctors have a wide range of tests to check for damage to different tendons. De Quervain's syndrome, for example, is detected by the test known as Finkelstein's sign. With the affected hand, you make a fist with the thumb closed onto the palm by the fingers, then flex your wrist in all directions. If there's pain at the top of the wrist just behind the thumb, then it's a clear indication of De Quervain's syndrome. Similar tests exist for all types of tendinitis.
Your doctor will also want to know if the problem is strain- or injury-related, or if some other disease is the cause. Most other diseases can be ruled out using simple blood tests. After reviewing your medical history and conducting a careful physical exam, your doctor may also recommend imaging tests such as an ultrasound or a magnetic resonance imaging (MRI) scan.
Treating and Preventing Tendinitis
Most cases of tendinitis and tenosynovitis clear up with adequate rest, application of warm or cold compresses, and use of nonsteroidal anti-inflammatory medications (NSAIDs; e.g., ibuprofen, naproxen). For people who can’t take NSAIDS, acetaminophen may be used. For some people, corticosteroid (e.g., triamcinolone, methylprednisolone) injections with or without an anesthetic (e.g., lidocaine) are used to help with inflammation and pain. A splint or cast may be needed to hold the joint in place and rest the irritated tendon, but not for long because it can cause contractures, muscle wasting, and adhesions.
Physical therapy can be used to address tendon problems that do not resolve despite standard treatment. Your doctor or therapist can help you move better and safely to maintain strength and reduce pain or swelling. There is some evidence that certain chiropractor treatments, such as manual and manipulative therapy, can be used to help with shoulder disorders, such as rotator cuff injuries.
Surgery is rarely used for tendinitis, but it's sometimes necessary in cases of separated shoulder or ruptured tendons. Seriously torn shoulder cuffs often have to be sutured back in place in a procedure called rotator cuff repair.
Tenosynovectomy relieves inflammation over the long-term by removing the synovium from the tendon sheaths. Synovium is a membrane that lines the sheaths that secretes synovial fluid. Normally, this fluid lubricates the joint, but too much of it can cause the sheath to swell.
Ruptured tendons in the hand may not be repairable, but a number of surgical procedures try using other tendons to perform double duty. Sometimes, the surgeon switches tendon attachment points (tendon transfer), giving the most important tasks to the healthiest tendons. If the tendon has been cut or cleanly torn, it may be repaired by primary tendon repair.
Hand tendon repair and tendon transfer are unlikely to restore full freedom of movement when symptoms are longstanding. These procedures are used only for cases of severe injury, often involving multiple tendons. Surgery is rarely used for people with rheumatoid arthritis or lupus, as the disease process will continue, undoing the surgeon's work. The answer to these problems is to treat the underlying disease.
Most cases of irreversibly damaged tendons occur in people who keep exercising the joint after the initial strain. Many forms of tendinitis are less painful after a few minutes of exercise. If exercise is continued day after day, the inflammation will progress, and the tendon will start to deteriorate. It's then replaced by weaker fibrous tissue that may cause pain every time the joint and muscle is used. The correct way to deal with a tendon injury is to stop exercising and consult with your doctor as soon as possible.
To help prevent tendinitis, be sure to warm up and stretch prior to exercise. Move around periodically and do your best to avoid repetitive movements at work. Keeping physically fit and building muscle tone may also help prevent tendinitis.
All material copyright MediResource Inc. 1996 – 2024. Terms and conditions of use. The contents herein are for informational purposes only. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Source: www.medbroadcast.com/condition/getcondition/Tendinitis
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