Tendovaginitis, or tendonitis, is inflammation of the tendons in the tissues. Tendovaginitis often develops in the wrist because the hands are used in many ways through work and sports and are therefore also overloaded. But also simple activities, such as writing, playing computer games and arbieten at the computer can provide in the long run for a tendon sheath inflammation.
What is tendonitis?
Infographic on the to anatomy, location and areas of inflammation in tendon sheathitis. Click image to enlarge. Tendonitis is a complete overstimulation of the tendons that occurs with great potential for pain in the arm that is predominantly used. Thus, in a right-handed person, it is the right arm and vice versa. However, tendovaginitis can also occur in a leg in case of overstraining. Tendonitis is one of the very painful inflammations of the musculoskeletal system. It can usually be cured only by rigorous immobilization of the affected body part. However, as long as the affected body part begins to tremble as soon as it is used, tendovaginitis is by no means considered cured. Provided that the pain of tendonitis continues, the same applies, of course.
Causes
Tendonitis usually results from massive and persistent overexertion. Tendonitis can occur during frequent crocheting and knitting or other manual labor, as well as after hours of typing on a keyboard. But even writing with a classic pen, which tends to be cramped, can certainly lead to tendovaginitis. The same applies to relatively monotonous activities, such as plastering walls or sawing wood. Last but not least, the sport of tennis very often leads to tendovaginitis due to incorrect posture of the racket. This is where the erroneous but nevertheless widespread name “tennis elbow” for tendonitis comes from. Basically, any movement that tends to be similar and always repeated can lead to very painful tendon sheath inflammation due to incorrect posture or too few breaks and relaxation phases. Tendonitis can only be cured with absolute rest and permanent recovery. So it makes sense to take regular breaks before tendonitis even occurs.
Symptoms, complaints and signs
Tendonitis causes pain at the affected tendons that is described as pulling. The affected joints ache with every movement. At first, the pain is noticeable only when moving or under stress. Later, the joints may also ache and throb severely at rest. Redness and swelling may occur at the affected joints. Likewise, the skin feels heated. If tendonitis occurs in the forearm, grinding sounds may occur during movement. These rubbing sounds are called snowball crunches. Tendonitis can also be visible visually. Then a small bump appears under the skin. This occurs due to the congestion of the parallel tendon fibers. There may also be numbness. The wrists are most commonly affected. However, the disease can also affect elbows or ankles. Scarring leads to thickening and knotting of the tendons if the inflammation is not treated. If rheumatism proves to be the cause of the disease, deformed joints become apparent. The disease is associated with severe pain, but usually subsides after a few days without complications. If left untreated, a chronic course is possible and the patient may experience pain for months.
Complications
In most cases, tendonitis takes a favorable course. However, there is a risk of complications if the condition is recognized and treated too late. Thus, it is possible for the inflammation to take a chronic course. Some chronic forms of tenosynovitis are so complicated that even medical treatment can only provide insufficient relief. If a connection between the disease and the workplace is established, it may even be recognized as an occupational disease.In such cases, patients are forced to switch to other tools or pursue a new work activity. In some cases, psychotherapeutic treatments are also necessary due to the disease. If the tendon sheath inflammation takes a chronic course, it is also referred to in medicine as RSI (Repetitive Strain Injury). This clinical picture is caused by the same stresses that are constantly repeated. If the tendon sheath inflammation appears on the hand or the finger flexor tendon sheaths, this can result in a fast finger. Doctors then also speak of tendovaginitis stenosans. In this process, thickening of the tendon sheaths, which belong to the finger flexor muscles, takes place. Particularly affected by such thickening is the base joint of the finger, which is located on the inside of the hand. If the tendon sheath inflammation has to be treated surgically, there is also a risk of complications. These primarily include accidental injury to the nerves, growth of a nerve in the scar tissue, and inflammation of the surgical wound.
When should you go to the doctor?
Tendonitis must always be examined and treated by a doctor. Only proper medical treatment can prevent further complications. If tendonitis is not treated, the inflammation can spread in the worst case. A doctor should be consulted if the affected person suffers from very severe pain. This pain occurs mainly in a resting position and intensifies with movement. Frequently, the pain from tendon sheath inflammation also spreads to neighboring regions and causes considerable discomfort there as well. Furthermore, it is not uncommon for severe redness or swelling of the area to indicate tendovaginitis. Numbness can also indicate the disease. The pain lasts for a long period of time and does not go away on its own. In the case of tendon sheath inflammation, a general practitioner can be consulted in the first instance. Further treatment is then carried out by a specialist.
Treatment and therapy
In most cases, if tendonitis has been diagnosed, a cast is applied. This is to prevent any form of weight bearing while the tendonitis persists. Tendonitis can be treated supportively with radiation, which can often even calm it down somewhat. If this method of treatment is indicated, a plaster splint can also be made instead of a closed cast and put back on after each treatment. Splints made of lighter plastics, however, are just as often used to immobilize the arm during tendonitis but still allow direct radiation. Soothing ointments that relax and provide warmth to the diseased tendons are also administered. Regular light massage of the affected parts of the body with these ointments also relieves the pain caused by tendovaginitis. A tendonitis that has not healed before the body part is put under strain again is on the verge of becoming noticeable again, so to speak. Medical advice is absolutely necessary before resuming sports or work.
Prevention
To prevent tendonitis, it can be very useful, for example, to strengthen the muscles in the arm whose use is excessively required, with a so-called hand expander. However, this measure should be started at the earliest when tendovaginitis that has already occurred has definitely healed. Another form of prevention against tendovaginitis is to learn a craft or sport correctly by an expert or trainer. Only learning the required movements correctly can prevent the arm from being used incorrectly. This would inevitably lead to a possible recurrence of tendonitis in a very short time.
Aftercare
In most cases, there are no special or direct options and measures of aftercare available to the patient for tendon sheath inflammation, so first and foremost, a doctor should be consulted early for this condition.Therefore, a doctor should be contacted at the first signs and symptoms of tendonitis to prevent the occurrence of other complaints and complications. There can be no self-healing, so affected persons are always dependent on medical examination and treatment. In many cases, the symptoms can be alleviated with the help of medication. The affected person should always ensure that the medication is taken regularly and in the prescribed dosage in order to permanently alleviate the symptoms. Likewise, a doctor should be consulted first if there is any uncertainty or if there are any questions. Those affected should rest and take it easy on the body, refraining from exertion or stressful activities. In the case of tendonitis, the help and support of one’s family can also be very useful to ease the daily life of the affected person. As a rule, the patient’s life expectancy is not limited by the disease.
What you can do yourself
It is crucial to keep the inflamed area immobilized for several days and to rest the limbs. If the tendonitis occurs on the hand, for example, the other hand should be used more. After a few days, the affected hand can be carefully accustomed to loads again. It has proven effective to apply coolant or ice. These should be wrapped in a towel so that they do not lie directly on the skin. Otherwise they would cause reactions of the skin similar to those of a burn. Furthermore, it is useful to apply an analgesic and anti-inflammatory ointment several times a day, which can be purchased over-the-counter in pharmacies and drugstores. Depending on where the tendonitis occurs, the area can then be bandaged. If the pain is severe, appropriate pain medications can be taken. However, if the tendovaginitis does not improve even after days, it is advisable to consult a doctor. For everyday life, the cause of the tendonitis should be researched and possibly behavior and other circumstances should be changed to prevent it from recurring: for example, for frequent typists, a flatter keyboard on the PC helps to relieve the tendons, and more breaks should be taken when playing the piano or knitting.
