My Shoulder Hurts And I’ve Been Diagnosed With Tendonitis… What Is It?
02/16/2010
My Shoulder Hurts And I’ve Been Diagnosed With Tendonitis… What
Is It?
By Nathan Wei
When patients go to their rheumatologist or orthopedist with
aches or pains, they are often told they have tendonitis.
The term “tendonitis” means inflammation of a tendon. Tendons
are tough fibrous cords of tissue that connect muscles to bones.
When muscles contract (tighten) the tendon attachment makes the
bone the tendon is attached to move in the direction of the
contracted muscle. When the muscle relaxes the bone moves back
to its original position.
To picture this, imagine tying a rope (“the tendon”) to a piece
of wood that is lying on the floor. When you pull on the rope
(contract the muscle), the piece of wood moves up into the air.
When you let go (muscle relaxation) the piece of wood drops back
to the floor.
Most tendons move inside a sheath that is lined with synovial
tissue (the same kind of tissue that lines the inside of joints)
and which contains a small amount of lubricating fluid that
allows the tendon to glide easily.
Since tendons are made of relatively inelastic tissue, they do
not stretch. While this property is good for movement, it makes
tendons susceptible to injury. Tendonitis can also occur from
overuse. When this situation occurs, the synovial lining that
encases the tendon becomes inflamed and swollen.
Tendonitis is more common in middle-aged or older people
(“weekend warriors”) but also occurs in younger people who
perform repetitive motion tasks or who are engaged in athletics.
Also, different types of inflammatory arthritis such as
ankylosing spondylitis, psoriatic arthritis, Reiter’s disease,
and rheumatoid arthritis may make people more susceptible to
developing tendonitis. Also, certain antibiotics such as
fluoroquinolones can also cause tendon inflammation.
Tendonitis is most common at the following area: shoulder
(rotator cuff or biceps), elbow (lateral epicondyle, known as
“tennis elbow” or medial epicondyle known as “golfer’s elbow”),
knee (patellar or quadriceps tendons), hip, Achilles, ankles,
and wrists. Tenoitis occurring in the hand can lead to a
condition called "trigger finger."
Symptoms consist of pain and stiffness as a well as swelling
over the affected tendon. Sometimes it is difficult to see the
swelling in large joint areas such as the shoulder or hip.
Because significant inflammation is present, pain with pressure
over the tendon and movement of the affected area are common
symptoms. There may be redness and warmth over the affected
area.
The diagnosis of tendonitis is primarily a clinical one that is
suspected by taking a careful history and doing an equally
thorough examination. Sometimes, in cases where the diagnosis is
uncertain, diagnostic tools such as diagnostic ultrasound or
magnetic resonance imaging (MRI) may be useful.
Treatment of tendontis is symptomatic. Non-steroidal
anti-inflammatory drugs (NSAIDS) can be helpful for alleviating
soreness and pain. Resting the affected area along with icing
can also be of assistance.
After a short period of rest, gentle stretching and
range-of-motion exercises can be started.
When tendonitis does not respond to these conservative
measures, more aggressive approaches are needed. Injection of a
combination of lidocaine and a long-acting glucocorticoid
(“cortisone”) may be very helpful for breaking the attack. The
use of injections should be limited to no more than two or three
to the affected area within a given year. The reason is that
repeated injections of glucocorticoid weaken the tendon and make
it more likely to rupture.
(An incidental note is that the Achilles tendon should never be
injected with glucocorticoid because of the danger of rupture).
The use of a splint for a few days to rest the injected area is
a good idea.
Surgery may be needed in some stubborn cases.
A new procedure called tenodesis is effective for chronic
tendonitis in areas such as the elbow or Achilles. With this
procedure a needle is used to irritate the tendon and then
platelet rich plasma is injected into the area. This stimulates
healing and can make chronic tendonitis better and therefore
eliminate the need for surgery.
About the Author: Nathan Wei, MD FACP FACR is a board-certified
rheumatologist. For more info:
http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html
Arthritis Treatment and http://www.tendonitis-treatment-tips.com
Tendonitis Treatment Tips
Source: http://www.isnare.com
Permanent Link:
http://www.isnare.com/?aid=209747&ca=Medicines+and+Remedies
Is It?
By Nathan Wei
When patients go to their rheumatologist or orthopedist with
aches or pains, they are often told they have tendonitis.
The term “tendonitis” means inflammation of a tendon. Tendons
are tough fibrous cords of tissue that connect muscles to bones.
When muscles contract (tighten) the tendon attachment makes the
bone the tendon is attached to move in the direction of the
contracted muscle. When the muscle relaxes the bone moves back
to its original position.
To picture this, imagine tying a rope (“the tendon”) to a piece
of wood that is lying on the floor. When you pull on the rope
(contract the muscle), the piece of wood moves up into the air.
When you let go (muscle relaxation) the piece of wood drops back
to the floor.
Most tendons move inside a sheath that is lined with synovial
tissue (the same kind of tissue that lines the inside of joints)
and which contains a small amount of lubricating fluid that
allows the tendon to glide easily.
Since tendons are made of relatively inelastic tissue, they do
not stretch. While this property is good for movement, it makes
tendons susceptible to injury. Tendonitis can also occur from
overuse. When this situation occurs, the synovial lining that
encases the tendon becomes inflamed and swollen.
Tendonitis is more common in middle-aged or older people
(“weekend warriors”) but also occurs in younger people who
perform repetitive motion tasks or who are engaged in athletics.
Also, different types of inflammatory arthritis such as
ankylosing spondylitis, psoriatic arthritis, Reiter’s disease,
and rheumatoid arthritis may make people more susceptible to
developing tendonitis. Also, certain antibiotics such as
fluoroquinolones can also cause tendon inflammation.
Tendonitis is most common at the following area: shoulder
(rotator cuff or biceps), elbow (lateral epicondyle, known as
“tennis elbow” or medial epicondyle known as “golfer’s elbow”),
knee (patellar or quadriceps tendons), hip, Achilles, ankles,
and wrists. Tenoitis occurring in the hand can lead to a
condition called "trigger finger."
Symptoms consist of pain and stiffness as a well as swelling
over the affected tendon. Sometimes it is difficult to see the
swelling in large joint areas such as the shoulder or hip.
Because significant inflammation is present, pain with pressure
over the tendon and movement of the affected area are common
symptoms. There may be redness and warmth over the affected
area.
The diagnosis of tendonitis is primarily a clinical one that is
suspected by taking a careful history and doing an equally
thorough examination. Sometimes, in cases where the diagnosis is
uncertain, diagnostic tools such as diagnostic ultrasound or
magnetic resonance imaging (MRI) may be useful.
Treatment of tendontis is symptomatic. Non-steroidal
anti-inflammatory drugs (NSAIDS) can be helpful for alleviating
soreness and pain. Resting the affected area along with icing
can also be of assistance.
After a short period of rest, gentle stretching and
range-of-motion exercises can be started.
When tendonitis does not respond to these conservative
measures, more aggressive approaches are needed. Injection of a
combination of lidocaine and a long-acting glucocorticoid
(“cortisone”) may be very helpful for breaking the attack. The
use of injections should be limited to no more than two or three
to the affected area within a given year. The reason is that
repeated injections of glucocorticoid weaken the tendon and make
it more likely to rupture.
(An incidental note is that the Achilles tendon should never be
injected with glucocorticoid because of the danger of rupture).
The use of a splint for a few days to rest the injected area is
a good idea.
Surgery may be needed in some stubborn cases.
A new procedure called tenodesis is effective for chronic
tendonitis in areas such as the elbow or Achilles. With this
procedure a needle is used to irritate the tendon and then
platelet rich plasma is injected into the area. This stimulates
healing and can make chronic tendonitis better and therefore
eliminate the need for surgery.
About the Author: Nathan Wei, MD FACP FACR is a board-certified
rheumatologist. For more info:
http://www.arthritis-treatment-and-relief.com/arthritis-treatment.html
Arthritis Treatment and http://www.tendonitis-treatment-tips.com
Tendonitis Treatment Tips
Source: http://www.isnare.com
Permanent Link:
http://www.isnare.com/?aid=209747&ca=Medicines+and+Remedies
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