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Tendinitis
How to reduce swelling from tendon sheath inflammation.
Suggest local physical treatments, often involving electrical therapy and physiotherapy, along with the use of non-steroidal gels applied topically, all of which can effectively reduce local swelling. It is advised to apply for 10-20 minutes per session, two to three times per day, typically improving swelling and pain effectively within one to two weeks. For recurrent, stubborn tenosynovitis, local injection treatments are recommended when necessary, and if there is no significant improvement, local surgical treatment may be considered. (Medication should be used under the guidance of a doctor.)
Causes of recurrence of wrist tenosynovitis
Tendinitis is most commonly seen in the wrist or metacarpophalangeal joints. Typically, patients will experience redness, swelling, heat, and tenderness in the wrist, along with limited joint mobility. It is usually recommended that patients rest and avoid overexertion. Due to repeated friction caused by overexertion, swelling of the annular ligament or tendon sheath can occur. This leads to insufficient circulation of synovial fluid within the joints, and excessive friction can cause damage to the tendons and tendon sheaths, resulting in chronic inflammation and swelling. This is how tendinitis develops. Repetitive tasks, such as flipping a spoon at the wrist or cooking, can cause pain, with the most common being de Quervain's tenosynovitis, which can be confirmed by physical examination. Activities like wringing a towel or cooking can lead to pain. When necessary, treatments such as injections or small needle knife therapy may be required. Rest can relieve most symptoms, but there is a high chance of recurrence. Attention should be paid to wearing wrist braces and applying local heat can help.
Symptoms of tenosynovitis
The symptoms of tenosynovitis mainly manifest as pain, swelling, and limited mobility in the affected area. Tenosynovitis is primarily a condition caused by long-term engagement in certain activities, leading to frequent movement of the tendon within the tendon sheath, which results in inflammatory damage to the sheath. When a patient with tenosynovitis is asymptomatic, treatment may not be necessary, and rest is typically sufficient. However, when symptoms do appear, treatment becomes necessary. Initial measures include rest and the symptomatic use of anti-inflammatory and analgesic medications, as well as medications that invigorate the blood and dispel stasis. Treatment can also be supplemented with methods such as heat application, physical therapy, and local injections to help improve symptoms and achieve favorable outcomes. When mobility impairments occur, surgical treatment may also be needed.
Tendon sheath inflammation X-ray manifestations
Tendon sheath inflammation typically shows no noticeable abnormalities in the early stages on X-rays. However, in cases of recurrent constrictive tendon sheath inflammation, it may lead to abnormal changes in the local ligaments and joints, such as ectopic ossification, calcification, and bone proliferation. Generally, an X-ray examination of tendon sheath inflammation shows no significant local abnormalities. In stubborn cases, which relapse after multiple treatments, X-rays may reveal changes such as bony proliferation or ectopic ossification with high-density shadows.
Tendinitis, cold compress or hot compress?
First of all, it must be affirmed that patients with tenosynovitis need to actively apply heat. The condition known as tenosynovitis is mainly caused by local excessive irritation and friction, leading to the proliferation of connective tissue and resulting in aseptic inflammation. Therefore, active heat application is necessary. The main purpose of heat application is to promote local blood circulation and the absorption of inflammatory exudates, which can effectively alleviate the clinical symptoms of the patient's tenosynovitis. Additionally, patients with tenosynovitis need to actively rest and protect the affected area. For those with severe pain, local injection treatment can also be considered.
How to reduce inflammation in tendinitis
To reduce inflammation in tendinitis, non-steroidal anti-inflammatory drugs (NSAIDs) should be used rather than antibacterial drugs such as cephalosporins, as the two are entirely different. In addition to using NSAIDs, it is also recommended to combine this with local physical therapy, such as electrotherapy, physiotherapy, acupuncture, etc. Topical NSAIDs can be applied locally and used in conjunction with physical therapy. For initial occurrences of tendinitis, these treatments can also provide good relief and improve symptoms of pain. However, for recurrent, stubborn tendinitis, the effectiveness of oral and topical medications in improving symptoms is limited. If necessary, local pain point block treatments can be performed, which can also result in good therapeutic effects. (The use of medications should be under the guidance of a doctor.)
Consequences of the deterioration of tenosynovitis
If tenosynovitis recurs repeatedly and is not given enough attention, it can become quite persistent and may not significantly improve with appropriate treatment. In such cases, surgery may be necessary. When tenosynovitis worsens, it leads to local pain, limited movement, and even noticeable swelling. Generally, there is no malignant transformation in the local tissues of tenosynovitis. The underlying mechanism of tenosynovitis involves aseptic inflammation due to the tendons' load-bearing activities. Long-term recurrence can lead to local scar hyperplasia. Post-surgical treatment should avoid repeated load-bearing activities to reduce recurrence.
Causes of tenosynovitis
The causes of tenosynovitis, simply put, the tendon sheath is a double-layered dense synovial tube that encases the tendons. It acts as a protective fluid sheath for the tendons, consisting of two layers enveloping the tendon. Between these two layers is a cavity filled with synovial fluid. The inner layer is closely attached to the tendon, while the outer layer lines the inside of the tendon fibrous sheath, jointly attaching to the bone. It primarily functions to stabilize, protect, and lubricate the tendons, preventing them from friction-induced damage and compression. Long periods of excessive friction can lead to damage in both the tendon and its sheath, leading to swelling and pain, which are the symptoms of tenosynovitis. For example, certain occupations such as bricklayers, carpenters, those who work extensively with computers, and chefs who frequently stir with spoons, as well as seamstresses in textile factories, are prone to developing tenosynovitis. There might be a link between this condition and occupational diseases. In such cases, applying heat can be helpful, and if the pain is particularly severe, enclosed treatments might be conducted. Additionally, taking drugs that promote blood circulation and relieve pain might be advisable. In severe cases, surgical treatment may be necessary. (The use of medications should be under the guidance of a doctor.)
How to diagnose tenosynovitis?
Tendinitis refers to the condition where the tendons and their sheaths, due to excessive flexing and extending activities, develop adhesion and exudation between each other, leading to a painful aseptic inflammatory response. Generally, when tendinitis occurs, there is restricted movement in flexing and extending, as well as localized pain symptoms. Moreover, tenderness is also pronounced in areas where tendinitis symptoms are evident. Therefore, the diagnosis of tendinitis can be made through symptoms and examination, and when necessary, ultrasound and MRI can be used to reflect local swelling and inflammatory responses.
How to treat tendon sheathitis?
This mainly depends on the severity of the patient's tendinitis, which determines the proactive treatment plan. For instance, if the tendinitis is very severe, with local snapping and limited flexion and extension movements, it is necessary to actively carry out treatments such as small-needle-knife surgery, tenosynovectomy, or partial excision surgery. However, for tendinitis that merely presents as pain symptoms, conservative treatment can still be chosen. For example, local injection, reducing physical activity, and insisting on daily local hot washing. Using some topical ointments that promote blood circulation and remove blood stasis, many patients will gradually recover through these active treatment methods.