How to treat tenosynovitis?

Written by Na Hong Wei
Orthopedics
Updated on September 20, 2024
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In clinical practice, the treatment of stenosing tenosynovitis is divided into three stages. The first stage involves general treatments, including early immobilization, followed by localized heat therapy, microwave therapy, and shock wave therapy, as well as the topical application of anti-inflammatory and pain-relieving medications. If there is no improvement after one week of conservative treatment, the second stage is initiated. The second stage involves an injection treatment, which is quite effective for this type of tenosynovitis in clinical practice. Generally, one or two injections can significantly alleviate symptoms, and some people may even fully recover. However, if after three injections the symptoms do not improve or worsen, further injections should be avoided, as this method is not beneficial for you, and you would then proceed to the third stage. The third stage involves surgical treatment. There are two types of surgical treatments: one involves a minor procedure using a small needle knife in traditional Chinese medicine, and the other involves conventional surgery. However, for radial styloid stenosing tenosynovitis, surgery is generally recommended due to the proximity of the radial nerve, which could be at risk of damage.

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Written by Lv Yao
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Is tenosynovitis easy to treat?

Tendon sheath inflammation refers to the sterile inflammation of the tendon sheath surrounding a tendon, caused by repetitive activity and friction. This condition can impact tendon movement. In cases of early symptoms, conservative treatment such as rest and the topical application of non-steroidal anti-inflammatory drugs can be used to alleviate symptoms. However, if the symptoms are severe and lead to constrictive tendonitis, where the movement of the tendon sheath is obstructed and there is a snapping sensation during movement, surgery may be necessary to remove the constricted tendon sheath and relieve symptoms.

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The difference between tendinitis and tendon sheath cyst.

Tendinitis refers to the inflammation of a sheath surrounding the tendon, known as the tendon sheath, caused by chronic strain. This results in a sterile inflammatory response between the tendon and its sheath, leading to symptoms such as pain and limited mobility. Meanwhile, a tendon sheath cyst is a cystic change occurring within the tendon sheath due to various reasons, characterized by a small amount of fluid or gel-like tissue within the cyst. When tendinitis occurs, it can be managed with conservative treatment, rest, and physical therapy to alleviate symptoms. On the other hand, a tendon sheath cyst might not show evident symptoms initially, but as the condition progresses and the cyst grows, it may compress local blood vessels or nerves causing symptoms, necessitating surgical intervention at this stage.

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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.

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Orthopedics
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Is electrothermal therapy effective for tendinitis?

Regarding the question of whether electrothermal therapy is effective for tenosynovitis. First, it needs to be affirmed that electrothermal therapy is beneficial for patients with tenosynovitis. The primary purpose of electrothermal therapy is to promote local blood circulation and facilitate the absorption of inflammatory exudates, which can effectively alleviate the clinical symptoms of the patient's tenosynovitis, and the results are quite good. Therefore, patients with tenosynovitis can undergo electrothermal therapy. In addition, for patients with tenosynovitis, local injections, topical plasters that activate blood circulation and remove blood stasis, and daily local hot washing can also be performed. Hot washing with Sichuan pepper and salt in hot water is usually sufficient. For patients with severe tenosynovitis, it is necessary to actively pursue surgical treatment.

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Written by Guan Jing Tao
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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.