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Tendonitis: recognizing and treating symptoms | > – Guide

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Tendonitis: recognizing and treating symptoms |  > – Guide

As of: February 21, 2024 11:52 p.m

Tendonitis usually occurs as a result of monotonous or unusual movements, often in the hand, but also in the arm or foot. Causes, symptoms and treatment as well as home remedies at a glance.

by Elena Zelle-Möhlmann

Tendons connect bones and muscles throughout the body. Where the tendons are exposed to particular stress, they are surrounded by a protective sheath – the tendon sheath. This sheath is filled with a fluid (synovia) so that the tendon can literally slide smoothly through the protective sheath.

Tendonitis – acute and chronic

When overloaded, the fine tissue of the tendon sheath can swell. Then there is more friction on the surrounding tissue. Tendons often lead through narrow tunnels and so-called compartments, anatomical gaps that are limited, for example, by strong ligaments.

The friction between these structures on the swollen tendon sheath becomes stronger and sliding becomes increasingly difficult. Tendonitis develops. Doctors also speak of tendovaginitis. In principle, this can occur anywhere where the tendons are surrounded by a protective covering. It is particularly common on the wrists. Acute symptoms can often improve after a few days with immobilization. However, tendonitis can also become chronic and last for weeks, even months, especially if not treated adequately.

The inflammation maintains itself: the constant friction leads to permanent nodules and scars in the connective tissue. These thickenings increase friction and thus inflammation. This can create a stubborn vicious circle.

VIDEO: What helps with tendonitis? (5 mins)

Symptoms: Pain when moving

Tendonitis is primarily noticeable through pulling and stabbing pain. At first the symptoms only occur when you move, but if the tendonitis lasts longer, they also occur at rest or at night. The affected area may also be swollen, warm or red. The area is usually sensitive to pressure. Sometimes the affected area rubs or grinds audibly when you move. Tendonitis can also be associated with restricted movement.

Causes: Overload and one-sided movement as typical triggers

The cause of tendonitis is usually overload – due to unusual strain or monotonous movements. Less commonly, diseases such as rheumatoid arthritis or infections can also lead to tendonitis. A few examples at a glance:

Tendonitis of the wrist and forearm: The wrist hurts especially when it is moved upwards towards the forearm. Sports such as tennis or golf can be triggers, but so can unusual stress such as renovation or gardening work. However, it doesn’t always have to involve special physical exertion – on the contrary: typing on a cell phone or working on a PC are common triggers for tendonitis or other painful problems in the wrists, fingers or forearm. People who knit a lot or play music are also at risk. Tendonitis in the foot: Anyone who walks or runs long distances in unsuitable shoes or with a misaligned foot without adequate training risks developing tendonitis in the foot or lower leg. Joggers are particularly at risk. The tendon plate of the sole of the foot or the Achilles tendon is often affected here. Tendonitis of the thumb or other fingers: Many people are particularly familiar with two special cases: The first is Quervain’s disease (tendovaginitis de Quervain). The tendons of the thumb muscles are affected. The cause is usually overload caused by frequent movement of the thumb away from the palm of the hand – like you do when typing on your cell phone. In this case the term cell phone thumb was also used. The second special form is the trigger finger or snapping finger: The flexor tendon of a finger is thickened, so that painful snapping occurs when bending or stretching because the tendon can no longer slide properly. Elbow or arm tendonitis: In this area, too, there is a special form that should be mentioned: tennis arm or tennis elbow. The tendon attachment that connects the muscles to the elbow bone is inflamed. In addition to tennis players, craftsmen, construction workers and people who work a lot on computers are particularly affected.

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Diagnosis: If in doubt, see a hand surgeon

The family doctor is usually the first point of contact. You can often guess from the conversation (anamnesis) whether the symptoms are tendonitis. Special movement tests usually provide information. Like the so-called Finkelstein test, for example: you close your fist around your thumb and tilt it down towards your little finger. If it hurts, the person affected usually has tendonitis on the thumb (Quervain).

Sometimes there is also a swelling – a so-called ganglion, also known colloquially as the overleg. If you are unsure, you should consult a specialist in hand surgery who specializes in the diagnosis and treatment of pain in the hand, even independently of an operation. Confusion with osteoarthritis pain, which also often affects the thumb, fingers and hand, should be avoided at all costs. Ultrasound and MRI may only be necessary in exceptional cases, when anamnesis and tests from a specialist cannot make a clear diagnosis.

Avoid chronic inflammation

The earlier tendonitis is consistently treated, the gentler the therapy. If not treated adequately, tendonitis easily becomes chronic as the vicious circle of inflammation, scarring and further narrowing becomes self-reinforcing. Protracted disease progression with persistent pain and restricted mobility in everyday life and hobbies as well as long periods of absence from work and rehabilitation are feared consequences that can often be avoided with early, targeted treatment.

Treatment and home remedies: splint, cooling or warming, physiotherapy, painkillers

As a rule, initial treatment is conservative – i.e. without surgery. That means:

Avoid cause: Adjust the cause of the problem. If this is not possible because you have tendonitis from working on the computer but still sit at the computer a lot at work, it can also help to adapt your workstation – for example, resting your palms in front of the keyboard when writing or using an ergonomically shaped mouse . Spare: Keep the affected area still. Splints, tapes or bandages can help with this. Cool or warm: Anything that helps is allowed. So try out whether heat or cold alleviates the symptoms. Cold usually helps with acute inflammation when the painful area is warm, swollen and red. With chronic irritation, many people find warmth rather than soothing. Physical therapy: Manual treatments, stretching exercises and exercises for muscular balance in the physiotherapy practice can bring relief and are crucial for successful rehabilitation. Specialized hand therapists have additional training for the particularly targeted treatment of painful diseases of the hand and arm. Pain relievers and anti-inflammatory agents: To relieve the symptoms, those affected can take anti-inflammatory painkillers such as ibuprofen or diclofenac. Cooling ointments with anti-inflammatory agents also help some people. But be careful: even over-the-counter products can have side effects and should only be taken for a limited time. Cortisone injections: The decongestant and anti-inflammatory effects of cortisone can reduce the acute inflammation of a tendon sheath. However, repeated injections can cause long-term damage to the tendon tissue, so this treatment should not be repeated at will.

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When does surgery make sense?

If conservative treatment does not bring any improvement, surgery is an option. Depending on where the tendonitis is, excess connective tissue is removed or constricting ligaments are cut to create more space: for example, a ring ligament on the trigger finger or a ligament on the wrist that constricts the thumb tendons in the so-called first tendon extensor compartment. The aim of the operation is to ensure that the tendon can slide smoothly again. The procedure can often be carried out on an outpatient and minimally invasive basis, i.e. without large incisions. The operation is usually possible with local anesthesia.

How can you prevent tendonitis?

The best way to prevent it is to avoid monotonous movements or excessive strain – this is of course often easier said than done. But even small breaks in which the stressed areas are relaxed and stretched can prevent tendonitis. If you write a lot on your PC, you should rest your palms on it. Instead of typing on your smartphone with your thumbs, it’s best to place the device on the table and use other fingers to operate it instead. When jogging or walking, you should make sure you wear well-fitting shoes and increase your training slowly so that your body can adapt to the strain.

Experts on the topic

Specialist in plastic and aesthetic medicine and hand surgery
At Kurpark 1
23611 Bad Schwartau

Occupational therapist and certified hand therapist
Eutin Ring 8a
23611 Bad Schwartau

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Visit | 02/27/2024 | 8:15 p.m

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