how to treat this rheumatic disease?
A tendinitis is an inflammation of a tendon. It is responsible for pain and stiffness in the joints and can affect the way the affected tendon moves.
It is a problem usually associated with overuse or injury of this fibrous cord, such as during sports activities or work involving repetitive strain, poor body posture, or excessive loading on a particular area of the body. It most often affects the elbow, wrist, fingers and thighs and can even become extremely disabling.
What is tendonitis: everything you need to know
Tendons are strands of fibrous, flexible tissue that connect muscles and bones. Their function is to transmit the force of muscular contraction necessary to move a bone.
All the flexible parts of our body have tendons. Mechanical or chemical reasons can lead to inflammation, causing tendonitis.
The mechanical cause is associated with prolonged and repetitive efforts, as well as overload. Tendonitis of chemical origin, on the other hand, is due to poor nutrition and toxins present in the body.
Tendonitis can also result from:
- Certain diseases (e.g. diabetes or rheumatoid arthritis);
- Certain antibiotics.
Most common joints
A number of joints are more prone to the development of tendonitis.
Generally due to overuse, practitioners of sports that require repetitive lifting of the arms (swimmers or tennis players, for example) are most at risk. It also affects professionals such as carpenters, painters and welders, among others.
There are two types of elbow tendonitis: lateral epicondylitis (called “tennis elbow”) and medial epicondylitis (called “golfer’s elbow”).
The most common form of tendonitis is known as “jumper’s knee” and involves the patellar tendon at the lower edge of the patella or the quadriceps tendon at the upper edge of the patella. It is a common overuse injury, particularly affecting basketball players and distance runners.
It usually takes the form of de Quervain’s disease, a condition that causes pain in the back of the wrist at the base of the thumb. Although it is most common in people who repeatedly grip or pinch their thumb, it sometimes develops during pregnancy or for no known reason.
It affects the Achilles tendon, located at the back of the heel. It is usually caused by overuse, especially in sports that require repeated running or jumping. It can also be associated with improper footwear or poor running technique.
In some cases, Achilles tendonitis is caused by an inflammatory disease such as ankylosing spondylitis, reactive arthritis, gout or rheumatoid arthritis.
Symptoms occur where the tendon attaches to the bone. They usually include:
- Pain and stiffness, which worsens with movement;
- Pain, especially at night;
- Tendon snapping sensation on movement;
- If ruptured, the person may feel a crack in the tendon line and movement of the joint will be difficult.
In some cases, tendonitis may cause the joint to feel weak and the area may be red, swollen and warm to the touch.
Symptoms may last only a few days, or they may last for several weeks or months.
If you have symptoms of tendonitis, you can start with conservative treatment for two to three days to manage the pain and protect the tendon.
- Rest: avoid moving the tendon for two or three days;
- Ice: place ice cubes in a towel-protected bag, then place it on the affected tendon area for 15 to 20 minutes, two hours apart;
- Support: Wrap an elastic bandage or soft strap around the affected area and tighten loosely (it is important to remove the bandage or strap before going to bed).
When you are able to move the injured area without pain, try to continue to do so so that the joint does not stiffen.
Until the tendon has recovered, avoid heavy lifting or other activities that worsen symptoms. Do not resume sports until you no longer feel pain in the affected tendon.
In some cases, medication may be needed to reduce pain, including paracetamol and ibuprofen. A non-steroidal anti-inflammatory cream or gel applied to the skin of the affected area may also be indicated.
If the pain is very severe, persists for a long time, or the tendonitis causes limitation of movement, it may be necessary to consult a specialized orthopedic physician and possibly undergo physiotherapy.
In more severe cases, treatment may include corticosteroid infiltration, shock wave or ultrasound therapy, platelet-rich plasma injections, or even surgery to remove damaged tissue or repair a ruptured tendon.
Acupuncture may also help control acute pain, but its long-term benefits are not scientifically proven.
Tendonitis cannot be prevented, but there are ways to reduce the risk of tendon injury.
Here are some suggestions of what can be done:
- Warm up before exercise and stretch at the end;
- Wear proper shoes or insoles;
- Take regular breaks from repetitive exercises or movements;
- Do muscle strengthening exercises around the tendons, with the help of a professional (physical therapist or physical education teacher) ;
- Maintain a balanced diet.
People who work long hours at the computer and perform repetitive motions should take several breaks throughout the day, use a height-adjustable chair, and adjust the screen to eye level.
You should also keep your shoulders relaxed and your elbows and knees at 90 degrees, with your feet always supported.