Tendonitis is a process of inflammation that occurs where a muscle connects to a bone. This disease belongs to fatigue diseases of the musculoskeletal system of the body, since its development occurs against the background of deteriorating tissue condition. Standard medications that relieve pain and inflammation are ineffective for this problem. They help relieve discomfort and eliminate symptoms, but cannot cure the disease.
Knee tendonitis is an inflammatory process that occurs in the tendon above the knee. It connects the thigh muscle to the tibia. Hip tendonitis is an inflammation of the tissues and ligaments that surround the joint. There is also tendinitis of the tendons that are located in the area of the ischial tuberosity. This process is considered the most dangerous to human health, so its treatment must be started immediately after the diagnosis has been made. If this is not done, the tendonitis will develop into a pinched sciatic nerve.
Elbow joints may also suffer from a similar condition, but it may have different names depending on the specific location of the problem. It is popularly called “baseball elbow.”
Many people confuse tendinosis with stretched or torn tendons. But they have a significant difference. When tendons are mechanically injured, some fibers are torn and soon begin to grow together and heal. The affected area brings discomfort and acute pain to the person, so he is forced to reduce the load on it. With tendonitis, tissue rupture occurs constantly, and their healing is always at different stages. The load on the affected area is not reduced. It is for this reason that treatment may be delayed, and the disease becomes chronic.
Stages of tendinitis
Modern medicine distinguishes several stages of this disease. These include:
- Acute phase. The damaged area of the body causes severe pain. If a person feels discomfort in a calm state, then with physical activity it develops into unbearable acute pain;
- Subacute phase. The pain persists and is accompanied by swelling. Movements become difficult and limited;
- Chronic phase. Tissue degeneration occurs. Pain becomes a constant “guest”, as does stiffness.
Modern classification of the disease
Tendonitis can be different. There is a certain classification, which is based on the characteristics of inflammation and methods of its treatment. Today, doctors distinguish between serous, purulent, and fibrous inflammatory processes.
Tendinosis is also divided according to the place of its occurrence. There are such tendinitis:
- Temporal.
It causes difficulty chewing food. When the jaw opens, a clicking sound may occur. Often the process is accompanied by discomfort or pain;
- Tendonitis of the shoulder joint.
The disease affects the capsule, which serves as the connection of the tendon with the supraspinatus and biceps muscles. Only an experienced specialist can help solve this problem. With tendinosis of the shoulder joint, the patient cannot fully raise his arm up or move it behind his head;
- Biceps tendonitis
leads to impairment and stiffness of hand movements;
- The disease that affected elbow joint
, does not allow full flexion and extension of the limb in this place. Accompanied by severe pain during physical activity and movement;
- Wrists.
It makes itself felt after physical activity. The patient feels stiffness in his hands, and is also unable to bend and straighten his fingers;
- Hip joint.
It is difficult for a person with this disease to move, let alone run or perform other more intense physical activities. After some time, the joint becomes permanently dysfunctional;
- Knee joint.
With this disease, the tendon in this area is affected. Damage can lead to partial or complete degeneration. The reason is the constant wearing of uncomfortable high-heeled shoes, as well as physical training to the limit. If adequate treatment is not provided, the patient may remain crippled for life;
- Achilles tendon
. Most often, professional athletes and heavy physical labor workers suffer from this problem. The disease is characterized by the presence of painful sensations even at rest. The pain intensifies when walking up stairs, and there is a feeling of stiffness in the joint;
- Feet.
In this case, the pain extends not only to the lesion, but also “radiates” to the lower leg. If you do not undergo treatment, then over time nodules appear in the foot, which make it difficult to move the leg;
Whatever type of tendonitis bothers you, it is important to consult a doctor in time so that he can conduct an examination and prescribe the necessary medications. Self-medication is not only ineffective, but also unsafe for health.
Symptoms
Symptoms of the disease appear gradually. In the early stages, the patient experiences pain at the time of maximum physical exertion. The rest of the time, the injured tendon does not cause any discomfort to the child or adult. Over time, the pain syndrome becomes more intense: discomfort occurs with minimal physical activity. If left untreated, the patient may be unable to perform everyday activities such as washing dishes, putting on clothes, fastening buttons, tying shoelaces.
The skin next to the source of inflammation turns red and swelling forms. Local temperatures may rise. Palpation of the tendon increases the pain. With sudden movements of the injured limb, the patient may hear a crunching or crackling sound.
Causes of joint tendonitis
Many people are interested in the question, where does this disease come from? Most often it occurs in two categories of people. The first is professional athletes who train often, for a long time and for wear and tear. This excessive stress on the body leads to damage to tendons and joints. The second is the age category of people who have “passed” forty. In this case, the cause of tendonitis is age-related disorders in the body.
Damage due to excessive physical activity can be caused by a variety of factors:
- If you start doing exercises without the necessary warm-up and warm-up, and also if you systematically violate the technique of performing them;
- Problems in the hip joint appear when running technique is violated. The foot does not land on the ground correctly, the joint suffers from an impact on a hard surface, since the foot is at the wrong angle;
- Exercises that involve sudden jumps, bends, and turns can also provoke the appearance of a similar problem;
- Using incorrect and uncomfortable shoes when we are talking about outdoor activities and not in the gym;
- Problems with the elbow joint are caused by sudden movements of the hands, accompanied by a violation of the technique of performing exercises. As well as constantly performing the same movement with frequent intervals;
- If you apply too much weight during exercise, tendinitis of the shoulder joint may occur.
The anatomical features of the human skeleton can also cause this disease. For example, problems in the hip joint may be caused by unequal leg lengths. Custom-made shoes with soles of different heights can help the situation. Problems in the knee joints often cause bowed legs or dislocated joints.
The older a person gets, the less elastin fibers he contains in his body. They are responsible for the mobility and elasticity of tendons. At the same time, the number of collagen fibers increases. They are responsible for the strength of fabrics. Therefore, this leads to the development of tendinosis.
In rare cases it may be caused by:
- infectious diseases that are sexually transmitted;
- metabolic disorders;
- mechanical injuries in the place where the tendons are located;
- autoimmune diseases.
Diagnostics
The doctor makes a diagnosis based on a history of sports or other injuries and a characteristic clinical picture. Additional examination methods (ultrasound, CT and MRI of the knee joint) are usually not required.
An x-ray of the knee sometimes shows slight thickening of the soft tissue. With ossifying tendonitis, there are foci of calcification.
Reference! CT, MRI and ultrasound are indicative of advanced stages of the disease. Ultrasound of the knee joint reveals a violation of the tendon structure. MRI and CT scans reveal ligament damage.
Laboratory tests are relevant for secondary symptomatic tendonitis. Rheumatoid diseases are indicated by anticiruline antibodies and rheumatoid factor, accelerated ESR, and metabolic pathologies are indicated by increased levels of creatinine and uric acid.
Most often, tendinitis is differentiated from injuries to the bone structures of the knee joint and rheumatoid diseases. The decisive method in this situation is the x-ray diagnostic method.
Symptoms of tendinitis
This disease comes with several different symptoms. But the most obvious of them is pain. At the initial stage, discomfort may be noticeable only after physical exertion or hard work. Over time, they visit a person with enviable regularity. The sensation can be described as a dull pain, which is concentrated at the site of tissue inflammation. At the same time, it appears only during the movement. When the joint is at rest, the discomfort disappears. If you press on the area of the body where the disease has begun to develop, the pain becomes stronger.
If the inflammation is in an advanced state, then a symptom of tendonitis is redness of the skin around the affected tendon, as well as a local increase in temperature. The joint loses mobility, in some cases a characteristic crunch appears when the body moves.
Elastic nodules in the tissue that can be palpated are also a symptom of tendinitis. They occur after prolonged treatment. There may be one or several nodules. They are an accumulation of fibrous tissue that appears in place of inflammation.
A symptom of shoulder tendonitis may be the appearance of calcifications. These are denser nodules that represent an accumulation of salt deposits. Very often, tendinosis ends in tissue rupture, which leads to longer treatment and rehabilitation.
Pathogenesis
Tendons are formed in the form of dense, inelastic cords consisting of bundles of collagen fibers. Thanks to them, muscle tissue connects to bones. Tendons provide the transmission of movement from muscles to the skeleton and maintain stable joint function. Intense and monotonous movements interfere with the process of natural restoration of collagen fibers - the first signs of tendinitis appear.
The tendon structures swell and individual strands of collagen begin to break down. If the load remains high, foci of fatty degeneration, necrosis and deposition of calcium salts form in the tissues. Hardened calcifications lead to re-injury of the previously damaged area. The inflammatory process gradually spreads to the entire tendon.
Tendonitis in pregnant women and its features
This disease is a frequent “guest” of women who are expecting a child. If there are suspicions, then it is preferable not to do an x-ray or computed tomography during the examination. Any medications that a pregnant woman will take must be prescribed by the attending physician and also agreed with the gynecologist. In this case, self-medication will be dangerous not only for the patient, but also for her unborn child.
When the first symptoms of tendinitis appear, doctors advise limiting yourself to physical therapy, rest, and applying cold compresses to the affected area. If you need to relieve inflammation and reduce pain, ointments based on painkillers are prescribed.
If the problem enters an acute phase, the doctor may resort to immobilization of the joint. Antibiotics may be prescribed, but only if a bacterial infection is found and other treatments have been ineffective. In the most extreme cases, surgery is performed on the joint.
Knee tendonitis: ICD 10 code
In the International Classification of Diseases, 10th revision, tendinitis of the knee joint is associated with a variety of diseases that give rise to the pathological process. Pathologies characterized by inflammatory and degenerative-dystrophic processes, with the exception of foot pathologies, have code M76. This category includes tendinitis of the patellar region, which is assigned the code M76.5.
The use of the International Classification of Diseases is a prerequisite for making a diagnosis. Knee tendinitis, symptoms and treatment, photos of which are described and demonstrated by rheumatologists at the Yusupov Hospital Therapy Clinic, can be treated conservatively and surgically.
Features of the development of tendinitis in children
This disease does not occur as often in children as in adults. The most “popular” place where tendinosis occurs is the knee joint. At the first symptoms of tendonitis in a child, you need to contact a pediatric traumatologist. He will conduct an examination and make an accurate diagnosis. After this, the little patient will be prescribed the necessary medications. Most often, the list includes muscle relaxants and non-steroidal anti-inflammatory drugs, both for oral administration and in the form of ointments.
For a certain period of time, you will have to limit your mobility and remove all physical activity. If the pain is very severe, the joint is immobilized. Treatment includes a variety of physical therapy, including electrophoresis. As soon as the acute phase of the disease has passed, a course of massages is carried out and physical therapy is added.
Forecasts, prevention
With timely treatment and strict adherence to the doctor’s recommendations, the prognosis for the patient is favorable - the inflammatory process is stopped, and relapses, as a rule, occur extremely rarely.
Preventive actions:
- wear comfortable shoes;
- Do some physical exercise throughout the day;
- avoid putting excessive pressure on the knee joints;
- Carry out intensive training under the supervision of a trainer;
- Strengthen your immune system and treat infectious diseases in a timely manner.
You can find out which doctor specializes in hip tendinitis on our website Dobrobut.com.
Related services: Orthopedics and traumatology Arthroscopy
Complications after tendinitis
Like any other disease, tendon tendinitis can have complications. It is not difficult to avoid them if you start the right treatment on time. However, it may happen:
- tissue ruptures;
- chronic course of the disease, which is accompanied by constant pain;
- processes of bone tissue proliferation, which lead to inflammation of various types.
Timely examination by a doctor and compliance with all his instructions will minimize the likelihood of complications.
Tenosynovitis
Tenosynovitis is an inflammation of the tendon and its surrounding membranes, also known as synovial membranes.
Some tendons are covered with synovial membranes, but some tendons are not covered. The synovium produces a small amount of oily fluid that is secreted into the space between the tendon and its synovium. This oily fluid helps the tendon move easily and without resistance when the bone to which the tendon is attached moves. Common signs of tenosynovitis are pain, swelling and tenderness in the joint area. In most cases, it is necessary to sharply reduce movement in the inflamed joint to allow for faster recovery. Often, the pain lasts for several days and disappears without any treatment. But in other cases, pain and swelling persist for many months, especially if no treatment is given.
Any tendon in the human body can be susceptible to tenosynovitis, but there are certain areas that are most susceptible to this pathology. For example, the hand and wrist, since they are often used to perform the same type of repetitive movements.
While there is no actual evidence to suggest what exactly can prevent tenosynovitis from occurring, it is still recommended to avoid repetitive movements as much as possible. Nowadays, there are certain exercises to strengthen the muscles surrounding the damaged tendons.
Treatment of tendinitis
It is important that treatment for this disease is prescribed by a doctor. The first step is to remove excess stress on the joint whose tendons are inflamed. It is not necessary to completely immobilize an arm or leg. You can simply “take care” of your limbs and not put unnecessary strain on them physically. In order to reduce mobility, elastic bandages, bandages, and bandages are useful. Exercise therapy may be prescribed, which should be carried out by an experienced rehabilitation therapist. Properly selected exercises will not only relieve muscle tension, but also strengthen them.
To relieve the pain that always accompanies tendonitis, doctors prescribe non-steroidal anti-inflammatory drugs. They are available in the form of ointments and creams, as well as tablets for oral administration.
In some cases, treatment with glucocorticoid injections will be effective, but it should be remembered that such injections can provoke tendon rupture. Physiotherapy, which is used in combination with drug treatment, will also be useful. If a large amount of calcifications and salt deposits were found in the inflamed area, then shock wave therapy will help break them up.
If the sciatic nerve is pinched due to inflammation of the hip joint, the doctor may prescribe surgery to eliminate the underlying problem. In this case, drug treatment will be ineffective, since it can only eliminate the symptoms, but not cure the disease.
One of the most popular drugs today that helps heal inflamed joints and tendons is Artracam. It has a positive effect on the metabolism in cartilage tissues and also stimulates biosynthesis.
The main active ingredient of Artracam is glucosamine sulfate. It has a pronounced analgesic and anti-inflammatory effect, and also increases the amount of hyaluronic acid in the synovial fluid. Degenerative processes in the joints are slowed down, and joint function is restored. The pain becomes less pronounced even in the acute period.