Diagnosis tendovaginitis

The diagnosis of a tendosynovitis is usually made by the clinical picture based on the typical symptoms. For example, pain in the area of certain muscles, to which the inflamed tendon belongs, is indicated for certain movements. In addition, the history of the illness with an occupational history provides important information on the presence of a tendon sheath inflammation.

In some cases, an infiltration of the muscles and tendons or deposits can be seen in the X-ray image. However, since it is very difficult and difficult to detect, this method is rarely used, as radiation exposure should be avoided. It can also lead to a thickening of these tendons. An ultrasound image of the affected tendon can show a tear or tear through the tendon. This would have to be treated differently than inflammation of the tendon alone.

Therapy

Treatment for tendosynovitis involves immobilising the affected area. Cooling pads can also be helpful and alleviate the pain of movement. In addition, local pain relief and anti-inflammatory measures can be taken, including ointments or injections of corticosteroids (“cortisone“).

Alternatively, pain and anti-inflammatory drugs – so-called non-steroidal anti-inflammatory drugs (e.g. diclofenac, ibuprofen) – can be used systemically in tablet form.

Bandages
Rails
Or in severe cases a plaster

Chronic tenosynovitis usually requires surgery, as the conservative treatments described above do not usually bring about any improvement. In this case the tendon sheath is split. In the case of an underlying bacterial infection, the therapy of the tendon sheath inflammation is supplemented by an antibiotic and, if necessary, surgical relief.

Inflammatory rheumatic diseases as the cause of tendon sheath inflammation are also primarily treated with non-steroidal anti-inflammatory drugs. In addition, an immunosuppressive therapy to modify the body’s own defensive reactions must usually be initiated. The treatment of tendovaginitis stenosans consists of surgical splitting of the tendon sheath, since conservative measures show no success in this case.

The situation is different in case of tendovaginitis stenosans de Quervain: In this case, treatment is initially carried out by immobilization or injection of painkillers. Only if these therapeutic measures fail to improve, is surgical splitting of the tendon sheath attempted. Bandages for the treatment of tendosynovitis are mainly used on the wrist to stabilize and immobilize it.

Above all, the bandages can prevent overloading of the joint, which usually leads to the tendon sheath inflammation. They have the advantage that the functions of the affected joint are not restricted, so that everyday tasks can be continued. In addition, depending on their strength, these bandages can protect against injuries.

They are mainly used in sports. In addition to immobilization and protection against permanent overloading of the affected tendon, the supports can also be used as a preventive measure after previous tendosynovitis. For example, if activities are to be performed which led to inflammation of the tendon sheath the previous time.

The support reduces the strain on the wrist, which means that the inflammation is less likely to occur or subsides if the tendon sheath is already inflamed. There are many different bandage manufacturers who offer all kinds of materials and strengths. The different models are designed to ensure an optimal fit for the patient and to adapt to individual needs.

For example, the bandages can be very stable and thus prevent injuries or effectively stabilize the wrist. These are particularly recommended for unstable wrists, for example after a fracture, or to prevent repeated injuries. Elastic bandages, on the other hand, allow the wrist to move more, and therefore do not stabilize it as effectively.

They are more suitable for immobilization in case of inflammation or overstrain. The bandages also differ according to the materials used. Bandages made of neoprene are very durable, tear-resistant and deformable, but also airtight, so that these bandages are usually not worn permanently.

Some people are allergic to neoprene and should not use these bandages. If the support effect of the bandage may be less, knitted wrist bandages are recommended. These warm the wrist, but are also breathable and can therefore be worn permanently.

Which bandage is the right one should always be decided by a physician in order to select the correct fit and the right materials. In addition, the function of the bandage should be adapted to the current needs of the complaints in order to achieve an optimal therapeutic result. Taping the body parts affected by tendosynovitis is an alternative or complementary treatment method, usually performed by orthopedic surgeons, but sometimes also by trained physiotherapists.

In contrast to a plaster cast or splint, the area to be treated is not completely immobilized, but rather restricted in its range of motion or undesired movements. In the area of tendosynovitis, the so-called kinesio-taping has become widely accepted. This involves the use of elastic, water- and air-permeable adhesive plasters of different colors, which are applied using a specific technique.

Since the painful inflammation of the tendon sheaths is usually caused by overloading certain muscles or muscle groups, this is exactly where the effect of the taping comes into play: The muscles are relieved by lowering the muscle tension at rest, swelling and pain are reduced by lifting the skin and joint functions are improved by stimulating deep sensitivity.If the application of a plaster or a plaster splint is selected as a therapy method for tendosynovitis, it should achieve absolute immobilization and immobilization of movement – usually for 14 days – in the affected body part. Regular checks of the plaster in terms of fit and firmness are necessary to prevent complications such as circulatory disorders or nerve or skin damage caused by pressure points. Depending on which part of the body (e.g. wrist, arm, foot, etc.)

is affected by tendosynovitis and in which area of the respective body part the inflamed tendon sheaths are located, different plaster variants are preferred. For example, inflammations in the wrist area usually result in the application of a forearm cast that surrounds the wrist but leaves the fingers free to move. However, it is different in the case of tendovaginitis de Quervain, where the thumb is the only finger that is included in the plaster (roe deer leg plaster).

If the tendons at the elbow are affected, an upper arm plaster cast is used (forearm plaster cast with additional inclusion of the elbow and upper arm), if there are tendosynovitis in the foot area, a lower leg plaster cast is applied (inclusion of foot and lower leg, knee and toes are free). In addition to the general medical measures, which usually already allow a successful treatment of tendonitis, there are also some homeopathic approaches to treat this type of inflammation. Here, homeopathic medicines called Rhus tox as well as Arnica in different dilutions (potentiation) are used.

As a rule of thumb one should stick to a dosage of “5 globules three times a day”. An improvement of the tendon inflammation should already occur after a few days. Often the symptoms of tendonitis can be significantly reduced and the inflammation process contained by simple home remedies.

Thus, consciously keeping the affected part of the body calm in everyday life and wearing simple support cuffs or bandages from the pharmacy can be a first start. For acute inflammations, cooling with ice packs or quark wraps (spread cold quark on a cloth and wrap it around the affected area) as well as anointments with horse, moor and marigold balm usually help. In addition, compresses with diluted arnica tincture or an alcohol-healing earth mixture, but also cabbage or rescuer’s spittle compresses can help against inflammation.

The application and rubbing in of over-the-counter, pharmacy-only Voltaren® gel (active ingredient: diclofenac) can also reduce the symptoms by providing local pain relief and a decongestant and cooling effect. In addition, care can be taken to ensure that during the inflammatory phase, food and drink intake is as low in meat and alcohol as possible, but that sufficient vitamin E (soy products, nuts, vegetable oil, whole grains, etc.) is consumed. Schuessler Salts No. 1, 2, 3, 4, 7, 8 and 11 administered by a homeopath can also be used as a therapy trial.