Tendonitis, or tendonitis, is a degenerative and degenerative process that affects the tendons at the site of their attachment to the bones, although a secondary inflammatory process can reach even the muscles of the corresponding tendons. The name of the disease comes from tendo - tendon. Theoretically, such a pathology can develop in any part of the body, where there are tendons, but most often tendinitis affects tendon formation in the ankle, knee, wrist and elbow joints. Also can occur tendonosis of the hip and shoulder.
The main cause of tendon tendon is their functional overload. As a result of increased and constant motor activity in a certain part of the body, which may be related to the type of occupational training of a person or with enthusiasm for sports, microtraumas develop in the tendon. If at this moment to stop the load on the limb, then such injuries quickly and without a trace heal, without causing a person pain and discomfort.
But, if the trauma is repeated constantly, then the body does not have time to repair the damage, as a result of which aseptic inflammation develops in this place. Over time, the normal structure of tendons is broken, their degeneration begins, which leads to the loss of basic qualities - elasticity and strength. As a result, any movement of a patient with a hand causes pain to a person. At the same time, the function of the affected joint suffers.
Tendonitis can occur in different joints of
. The increased risk of tendonitis has:
- professional athletes( there are even separate nosological forms of tendonosis, for example, "elbow tennis player" or "knee jumper");
- people who are engaged in heavy physical work( loaders, builders);
- persons who, due to their professional duties, constantly overload certain joints( computer typing operators, seamstresses, turners, people working with a wrench, different levers and mechanisms).
In other cases, the primary link in the pathogenesis of the disease can be inflammation. It is then recommended to use the term "tendonitis", which indicates the root cause of the pathology - inflammatory changes in the tendons.
Tendonitis can develop as a result of:
- autoimmune inflammatory diseases( rheumatoid arthritis, systemic connective tissue diseases);
- infectious soft tissue lesions near the joint;
- reactive arthritis( Reiter's syndrome);
- allergic reactions;
- secondary changes in other diseases of the musculoskeletal system( osteoarthritis, postural disorders, flatfoot, etc.).
As a rule, in order to effectively treat tendonosis, you need to know exactly what it originated from. Since the methods of treatment will be different. For example, in the case of a bacterial infection, antibiotics are prescribed, with autoimmune disorders - cytostatic and anti-inflammatory drugs, and in the case of occupational hazards, it is first necessary to get rid of provoking factors. Therefore, the definition of the cause is important in each case.
Epicondylitis - tendonosis of the forearm of the forearm
Clinical signs of the disease are not specific, but give the possibility to suspect the problem.
The most common complaints of patients are as follows:
- pain in the area of the damaged joint that occurs with certain active movements( it is important to remember that passive movements do not cause painfulness, unlike the pathology of the structures of the joint itself);
- soreness with palpation of an inflamed tendon;
- in case the patient has ossifying tendinosis, then during movement and palpation there may be a specific sound of crepitations( crackling);
- externally, as a rule, there are no pathological changes, only in the case of an acute infectious process can there be redness of the skin, its swelling and an increase in local temperature;
- amplitude of movements in the joint is preserved, but with pain the patient can spare the affected limb and not allow himself sweeping movements.
It's important to remember! Constant, and sometimes the only symptom of tendonitis is pain in active movements involving the affected tendon. In addition, the patient can not complain about anything. But often this pain becomes the reason of impossibility to be engaged in the work or favorite business.
Specific types of tendonosis
Consider the most common types of tendinitis for localization.
Tendonitis of the elbow joint
This disease most often develops among tennis players( tennis player's elbow) and golfers( the "elbow of the golfer").In this case, pathological changes tend to tendons, which are attached to the lateral and medial epicondyle of the humerus. Painful sensations arise at the moment of physical activity and are felt from the inner or outer side of the elbow, radiating to the muscles of the forearm. Over time, patients begin to feel weak in the sore arm and can not hold even the cup.
Tendonosis of wrist joint
Characteristic for people who perform many movements with fingers of the hand, for example, pianists, people working with computers. In this case, the pain occurs in the area of the affected finger( usually the first and the index finger), it delivers into the muscles of the forearm. With the development of complications( compression of the nerves in the tunnel syndrome), the sensitive and motor function of the upper limb may be impaired.
Tendonosis of the knee joint
The patellar ligament most often suffers, by means of which the quadriceps femoris is attached to the bones of the lower limb. This disease is also called the "knee of the jumper", which indicates its most common etiology( mostly athlete athletes are ill).The pain is localized below the patella, is absent at rest, strengthened by physical exertion.
Tendonosis of the hip joint
Such a diagnosis is established in the case of a lesion of tendons that are attached to the structures of the hip joint. Most often the tendon of the long adductor muscle of the hip, ilio-lumbar and deflecting muscles suffers. Patients complain of pain in the projection of the hip joints during movements, the reduction and withdrawal in the joints is slightly limited.
Diagnosis and complications
Tendency is a clinical diagnosis that is established by characteristic complaints, objective examination and anamnesis( identification of risk factors).To exclude similar diseases, X-rays, MRI, ultrasound of damaged limbs are performed.
Among the complications of pathology is ossifying tendonosis, which develops when salts are deposited in damaged connective tissue, and tunnel syndrome. The latter develops, as a rule, with damage to the wrist joint, when the nerves are squeezed due to sclerotic changes near the located tendons.
Shockwave therapy is an effective method for combating tendon diseases
Treatment of tendonosis and prevention
If the process has become chronic, then the treatment of tendonosis is long and complex. Its duration is from 4 to 6 weeks. Begin therapy with conservative methods:
- complete unloading of a sick arm and immobilization( plaster bandage, elastic bandage, bandage, orthosis), the discharge time is set by the doctor in each case individually;
- medicamental anti-inflammatory therapy - injections, tablets and ointments from the group of NSAIDs, glucocorticoids;
- for infectious diseases prescribe antibacterial drugs;
- physiotherapeutic procedures( shock wave therapy, laser therapy, magnetotherapy, ultrasound with hydrocortisone, UHF, electrophoresis, paraffin and ozocerite applications, etc.);
- therapeutic restorative physical training;
- in some cases is useful treatment of folk remedies, but for each recipe you need to consult a doctor.
In the case of ineffectiveness of conservative treatment or development of complications resort to surgical operations, during which plasticity is performed by autografts of tendons. An important point of recovery from surgery and prevention of repeated cases of disease is the elimination of risk factors for the disease. If this can not be achieved, then it is necessary to take care of the rationalization of the regime of work and training, the use of special orthopedic structures to protect joints.
- Reasons for
- Symptoms of
- Specific types of
- Diagnosis and complications
- Treatment of tendonosis and prevention