Tendinitis and tenosynovitis: Treatment, symptoms, advice and help

About tendinitis and tenosynovitis

Tendinitis is an irritation and inflammation of the tendon which are fibrous cords of tough tissue that connect muscles to bones. Some tendons are surrounded by tendon sheaths. Tenosynovitis is tendinitis accompanied by inflammation of the protective covering around the tendon (tendon sheath).

Tendinitis and tenosynovitis: Incidence, age and sex

Tendinitis usually occurs during middle or older age, as the tendons weaken and become more susceptible to injury and inflammation. Tendinitis also occurs in younger people who exercise vigorously.

Signs and symptoms of tendinitis and tenosynovitis: Diagnosis

Tendinitis and tenosynovitis cause pain in the area of the involved tendon which may radiate down the limb. Tenderness with touching, palpating or bumping the affected tendon and pain with movement or use of the attached muscles may also be seen. Occasionally, the tendons or their sheaths swell and feel warm. Weak grip might occur, with difficulty or pain holding onto, pinching, or gripping objects. The diagnosis is usually based on symptoms and results of a physical examination.

Causes and prevention of tendinitis and tenosynovitis

Tenosynovitis and tendinitis occur as a result of injury or overuse or is secondary to inflammatory joint conditions. Certain joint diseases, such as rheumatoid arthritis, systemic sclerosis, gout, diabetes, and reactive arthritis (previously called Reiter's syndrome), can cause tenosynovitis. In people with gonorrhea, especially women, gonococcal bacteria can cause tenosynovitis. Doctors can usually diagnose tendinitis based on the symptoms and results of a physical examination. Sometimes magnetic resonance imaging (MRI) or ultrasonography is helpful. Prevention is by avoiding action that places prolonged repetitive strain on the muscles.

Tendinitis and tenosynovitis: Complications

If tendinitis lasts a long time, calcium may become deposited. The area around the joint is often affected. In addition to being painful, the joint may feel stiff and weak.

Tendinitis and tenosynovitis: Treatment

Rest, immobilization with a splint or cast, and application of heat or cold—whichever works—are often helpful. Taking non-steroidal anti-inflammatory drugs (NSAIDs) for 7 to 10 days can reduce the pain and inflammation. Sometimes corticosteroids (such as betamethasone, methylprednisolone, or triamcinolone) and local anesthetics (such as lidocaine) are injected into the tendon sheath. Rarely, the injection causes pain hours later because the corticosteroid temporarily forms crystals inside the joint or sheath. This pain lasts less than 24 hours and can be treated with cold compresses and pain relievers.

Other drugs may be used, depending on the cause. After inflammation is controlled, exercises to increase the range of motion should be done several times a day.

Chronic, persistent tendinitis, as can occur in rheumatoid arthritis, may have to be treated surgically to remove inflamed tissues, and physical therapy may be needed after surgery.