Tendonitis: what to do?

Tendonitis (tenovaginitis) can have various causes, with prolonged, monotonous movement usually being the cause of the symptoms. A typical symptom is severe pain, which can occur with movement but also at rest. If tendonitis is treated correctly, it usually heals independently after a few days. The affected joint must be protected. Otherwise, a chronic course of inflammation is also possible.

Tendonitis in the hand and elbow

In areas subject to heavy wear, tendons are protected from excessive wear and tear by a tendon sheath. Inside the sheath is synovial fluid, allowing the tendon to slide back and forth easily.

If the tendons are heavily used, the surrounding tendon sheath is also affected, and inflammation can develop. Such tendonitis occurs particularly frequently on the thumb, hand, elbow or shoulder. In principle, however, any tendon can become inflamed, for example, in the knees or feet.

 

Computer work and sport as a cause

Constantly repetitive, monotonous movements usually cause tendonitis. This is often the case with computer work – for example, when operating the mouse or the keyboard. But musicians or artisans who continuously perform the same movements (especially with their hands and arms) are also often affected.

Overloading during sports can also be a trigger. Typical sports that can result in inflammation of the tendon sheath are:

• floor exercise
• Golf
• Climb
• Tennis

In these sports, the complaints usually occur in the hand, elbow or shoulder area.

Finally, various household activities can also trigger tendonitis. The overload can be triggered by unfamiliar activities such as renovation work, working in the garden or moving house.

Infections and diseases as triggers

In rare cases, tendonitis is not caused by an overload, but by an infection with pathogens such as chlamydia, gonococci or mycoplasma.

In addition, diseases such as rheumatoid arthritis can also trigger tendonitis.

 

Symptoms of tendonitis

Typical tendonitis is severe pulling or stabbing pain in the affected tendon area. It is often the case that the hand or shoulder hurts with every movement. Sometimes, the pain also occurs at rest.

Redness and swelling can also indicate tendonitis. A slight bulge appears under the skin if there is a strong thickening of the tendon sheath. Crunching noises can also sometimes occur when the tendon is moved. This is called snowball crunching.

carpal tunnel syndrome and tendonitis

The symptoms associated with tendonitis are often similar to those of carpal tunnel syndrome. In carpal tunnel syndrome, however, there is damage to the median nerve, which runs in the wrist area. This nerve damage is caused by increased pressure within the carpal tunnel.

Tendonitis is a possible cause of the increased pressure in the carpal tunnel. In addition to the median nerve, various tendons run through the tunnel. If the affected tendon swells due to tendonitis, the space in the carpal tunnel is reduced, and the nerve can be damaged. Typical symptoms are pain and numbness in the fingers.

to make a diagnosis

In the case of tendonitis, the diagnosis can often be made based on the typical symptoms. In addition, the doctor can feel the relevant area and carry out some movement tests.

If no diagnosis can be made in this way, an ultrasound examination or an MRI can be carried out. If there is a suspicion of a rheumatic disease, a blood test is usually carried out.

 

treat tendonitis

In the case of tendonitis, it is essential to immobilize the affected joint – whether hand, elbow or knee – as much as possible. Bandages or splints can help prevent continued undue stress on the joint. It is also essential to avoid the activity that leads to the inflammation.

Pain, redness, and swelling can be relieved with cold packs. However, do not place the cold compress directly on the skin; otherwise, frostbite may occur. If the pain is very severe, you may be able to take painkillers. These often also have an anti-inflammatory effect and can thus ensure faster healing. In addition to tablets, anti-inflammatory ointments are also well suited.

If the symptoms are severe, the doctor treating you can inject a mixture of cortisone and a local anaesthetic into the inflamed area. Cortisone usually accelerates the healing process significantly. However, you should be informed about possible side effects beforehand. If the inflammation still does not heal, surgery is the last option. The constricted area can be split and thereby relieved.

Duration of tendonitis

If the tendon sheath is inflamed, the symptoms usually take a few days to subside. The healing process often depends mainly on how much the affected joint is spared. In rare cases, a chronic course is also possible. It then takes a few weeks to a few months for the symptoms to subside.

Once the tendonitis has subsided, intensive follow-up treatment is recommended. Regular physiotherapy can prevent the symptoms from reoccurring and the inflammation possibly taking a chronic course. Likewise, it would help if you tried to avoid the triggering movement.

preventive measures

You can ensure that you don’t develop tendonitis with a few simple tips and tricks. If you work a lot on the PC, you must protect your hands and fingers:

• Use a keyboard that is as flat as possible so that you do not have to bend your wrists too much when working.
• Place a pad in front of the keyboard and support the palms of your hands when typing – this relieves the wrists.
• Use an ergonomically designed mouse or operate the mouse with your left hand instead of your right hand for a change.
• Take breaks from time to time and move and stretch your wrists a bit.

Regular breaks are also recommended for other monotonous movements, in which you move and thus offer the body a change from the repetitive movement sequences.

To prevent exercise-induced tendonitis, it is essential to thoroughly warm up and stretch before exercising.