Treatment of tendinitis
introduction
Tendonitis, or tendovaginitis, is an inflammation of a tendon, mostly in the wrist, shoulder or ankle area.
Although this inflammation causes similar symptoms regardless of the cause, it must be treated differently depending on the underlying cause.
There are three main causes that can cause tendinitis. The most common group is irritation caused by incorrect stress, so it is important to think about adequate rest.
In the case of tendinitis caused by bacterial pathogens (e.g. Staphylococci) antibiotic therapy is in the foreground.
In the case of tendinitis that arises on the basis of an existing rheumatic disease, the treatment depends on the respective underlying disease.
Further information on the subject can be found at: Tendonitis and causes of tendonitis
Therapy of tendinitis caused by improper use
Basic measures
In the event of inflammation in the area of the tendons caused by incorrect stress, the acute improvement in symptoms often already Immobilization of the affected joints a first step.
If this is not easily possible, you can supportive bandages, bandages or even a plaster cast be helpful.
It can also help to elevate the affected areato so the Improve lymph drainage. It also relieves the pain to cool affected area, especially if the irritation is accompanied by severe swelling. You can also click cooling and anti-inflammatory ointments To fall back on.
But you already have one chronic tendinitis, is instead of cooling often even warmth is more pleasant.
Generally, if the Symptoms even after 7-14 days with protection and cooling not gone are, at the latest then a doctor should be consulted.
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In our very economic world in particular, there is too little time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
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The aim of any treatment is treatment without surgery.
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Medication
Therapy with anti-inflammatory painkillers is recommended as a medicamentous measure, of course after consulting the attending physician. In most cases, this is sufficient to get the complaints under control.
These include the so-called non-steroidal anti-inflammatory drugs, such as. Ibuprofen or diclofenac. This has the particular advantage that it not only soothes the pain that occurs, but also inhibits the inflammatory reaction as the cause of the problem.
For long-term use, however, stomach protection, such as proton pump inhibitors, should always be prescribed in order to avoid side effects.
Other pain relievers, such as Paracetamol or aspirin do not have this anti-inflammatory effect and are therefore less suitable.
Injection therapy with cortisol
If these resources are not sufficient, a doctor can also use injections to contain the inflammation. These usually contain cortisol and a local anesthetic and thus have an anti-inflammatory and analgesic effect. Since this is a relatively invasive procedure, the advantages and disadvantages should be carefully weighed.
However, the contained cortisol can interrupt the inflammation very quickly and effectively on the spot.
Avoid triggers
In any event, steps should be taken to prevent further irritation.
This includes, for example, the use of ergonomic keyboards at the workplace or, if possible, avoiding harmful activities.
This includes anything that involves repetitive execution of monotonous movements in the affected joint. For example, movements in sports or playing an instrument.
If the irritation can be traced back to a certain type of sport, the respective activity should be avoided for approx. 3-6 months in order to prevent renewed irritation or the development of a chronic inflammation. Often a too hasty resumption of the triggering activity is the cause of long-lasting or recurring problems.
Further measures
As a supportive measure, depending on the symptoms, physiotherapy can also be helpful to correct bad posture that is already used to.
In addition, therapy with electrical stimulation devices (see: Electrotherapy) or ultrasound is also offered as a further option, which should also lead to a healing of the inflammation.
Operative therapy
If the conservative therapy options are not sufficient, the can Step to surgery be useful.
This is particularly the case when due to the individual anatomical conditions or due to the damage to the tissue caused by inflammation Bottlenecks and sources of friction exist. Often times are especially in the case of protracted disease such nodular adhesions developed.
During the operation, the affected tendon sheath split, or adjacent connective tissue structures loosened become. This will be Bottlenecks resolved and removed inflamed tissueso that the affected tendon can function again without irritation.
Depending on the affected joint, these interventions are also in local anesthesia or regional anesthetic procedures and therefore also possible on an outpatient basis.
The operation is always an invasive procedure, but it can for a large number of patients to be free of symptoms to lead.
Therapy of infectious tendinitis
In the Tendinitis due to an infectious event, a distinction is made between two forms.
For one, it can become a Inflammation after a bacterial infection come, on the other hand they can Pathogen also directly, gets into the tendon area due to stab wounds, bites or cuts, for example. Since there is a clear cause of the inflammation in this case, it stands antibiotic treatment the shutter button in the foreground.
An infectious tendonitis usually falls through much faster progression of symptoms on.
The antibiotic treatment should be done as soon as possible, because if it is started too late or if the treatment does not take effect immediately, it leads to a Spread of the bacteria through the blood vessels and Lymphatic system can come.
This can in the worst case scenario too widespread foci of inflammation up to Blood poisoning (sepsis) to lead. Therefore, if the inflammation continues to spread despite antibiotic therapy, one should not hesitate to proceed operationally if necessary.
Purulent tendon sheaths are an emergency that operated on immediately must and should by no means be taken lightly.
Unlike the above-mentioned surgery after chronic irritation, this is primarily about the Removal of the infected tissue.
