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Tendinitis
Is it good to get a steroid injection for tenosynovitis?
Treating tenosynovitis with injections is acceptable. Injections can significantly alleviate the pain caused by tenosynovitis and symptoms of limited joint mobility. However, it is imperative to take precautions during this treatment. Firstly, the injection contains steroids and anesthetics, so the number of injections must be limited. Generally, it is advisable to administer it once or twice a month. Excessive injections should be avoided as they can damage the local tendons or even the tendon sheaths, potentially exacerbating the pain from tenosynovitis or leading to spontaneous tendon ruptures. Therefore, the frequency of injections should be limited to a maximum of one to two times per month. Secondly, it’s crucial to ensure proper disinfection of the area during injections to prevent infections at the injection site and attend to potential bacterial infections. (Use of medication should be under the guidance of a physician.)
What causes tendinitis? How does tendinitis occur?
The cause of tenosynovitis is the repeated mechanical friction between the local tendon and tendon sheath, leading to chronic aseptic inflammatory changes. It is often related to repeated activity in the affected area. Excessive repetitive movement of the affected area causes local congestion, exudation, edema, and other inflammatory changes. The stimulation of inflammatory factors leads to local pain and discomfort. As the condition progresses, thickening of the tendon sheath causes the local tendon to move less smoothly within the sheath, thereby causing restricted local movement. Additionally, tenosynovitis in infants and young children is often considered to be caused by congenital factors.
How to apply heat to tendinitis
Patients with tenosynovitis can use heat application to improve symptoms and promote recovery. Heat can be applied with a hot towel or a hot water bottle to the affected area for about 10 to 20 minutes at a time, and can be done several times a day. Caution should be taken to avoid burns during heat application. Heat helps promote blood circulation and can play a role in alleviating symptoms of tenosynovitis and aiding in recovery. Additionally, patients with tenosynovitis need to rest and can also use anti-inflammatory and analgesic medications and medications that invigorate the blood and disperse stasis. Treatment can be combined with physical therapy and encapsulation techniques. These methods can be effective in improving symptoms and promoting recovery. When motor impairments occur, surgical treatment may also be necessary. (Please use medications under the guidance of a doctor.)
Diagnosis methods for tenosynovitis
Diagnosis relies on the doctor's physical examination, as well as the patient having localized pain and restricted movement, with definite tender points. Moreover, if local symptoms are atypical, an X-ray can be performed to rule out other conditions such as osteoarthritis, or bone hyperplasia, allowing for a localized diagnosis. In addition, localized symptomatic treatment can be administered, and if there is improvement, it can indirectly confirm the diagnosis of tendinitis. Typically, when there is localized pain with significant movement restriction, and apparent pain and hyperplasia at the tendon's central axis, a clear diagnosis can be made.
How to reduce swelling from tendon sheath inflammation.
Suggest local physical treatments, often involving electrical therapy and physiotherapy, along with the use of non-steroidal gels applied topically, all of which can effectively reduce local swelling. It is advised to apply for 10-20 minutes per session, two to three times per day, typically improving swelling and pain effectively within one to two weeks. For recurrent, stubborn tenosynovitis, local injection treatments are recommended when necessary, and if there is no significant improvement, local surgical treatment may be considered. (Medication should be used under the guidance of a doctor.)
Causes of recurrence of wrist tenosynovitis
Tendinitis is most commonly seen in the wrist or metacarpophalangeal joints. Typically, patients will experience redness, swelling, heat, and tenderness in the wrist, along with limited joint mobility. It is usually recommended that patients rest and avoid overexertion. Due to repeated friction caused by overexertion, swelling of the annular ligament or tendon sheath can occur. This leads to insufficient circulation of synovial fluid within the joints, and excessive friction can cause damage to the tendons and tendon sheaths, resulting in chronic inflammation and swelling. This is how tendinitis develops. Repetitive tasks, such as flipping a spoon at the wrist or cooking, can cause pain, with the most common being de Quervain's tenosynovitis, which can be confirmed by physical examination. Activities like wringing a towel or cooking can lead to pain. When necessary, treatments such as injections or small needle knife therapy may be required. Rest can relieve most symptoms, but there is a high chance of recurrence. Attention should be paid to wearing wrist braces and applying local heat can help.
Symptoms of tenosynovitis
The symptoms of tenosynovitis mainly manifest as pain, swelling, and limited mobility in the affected area. Tenosynovitis is primarily a condition caused by long-term engagement in certain activities, leading to frequent movement of the tendon within the tendon sheath, which results in inflammatory damage to the sheath. When a patient with tenosynovitis is asymptomatic, treatment may not be necessary, and rest is typically sufficient. However, when symptoms do appear, treatment becomes necessary. Initial measures include rest and the symptomatic use of anti-inflammatory and analgesic medications, as well as medications that invigorate the blood and dispel stasis. Treatment can also be supplemented with methods such as heat application, physical therapy, and local injections to help improve symptoms and achieve favorable outcomes. When mobility impairments occur, surgical treatment may also be needed.
Tendon sheath inflammation X-ray manifestations
Tendon sheath inflammation typically shows no noticeable abnormalities in the early stages on X-rays. However, in cases of recurrent constrictive tendon sheath inflammation, it may lead to abnormal changes in the local ligaments and joints, such as ectopic ossification, calcification, and bone proliferation. Generally, an X-ray examination of tendon sheath inflammation shows no significant local abnormalities. In stubborn cases, which relapse after multiple treatments, X-rays may reveal changes such as bony proliferation or ectopic ossification with high-density shadows.
Tendinitis, cold compress or hot compress?
First of all, it must be affirmed that patients with tenosynovitis need to actively apply heat. The condition known as tenosynovitis is mainly caused by local excessive irritation and friction, leading to the proliferation of connective tissue and resulting in aseptic inflammation. Therefore, active heat application is necessary. The main purpose of heat application is to promote local blood circulation and the absorption of inflammatory exudates, which can effectively alleviate the clinical symptoms of the patient's tenosynovitis. Additionally, patients with tenosynovitis need to actively rest and protect the affected area. For those with severe pain, local injection treatment can also be considered.
How to reduce inflammation in tendinitis
To reduce inflammation in tendinitis, non-steroidal anti-inflammatory drugs (NSAIDs) should be used rather than antibacterial drugs such as cephalosporins, as the two are entirely different. In addition to using NSAIDs, it is also recommended to combine this with local physical therapy, such as electrotherapy, physiotherapy, acupuncture, etc. Topical NSAIDs can be applied locally and used in conjunction with physical therapy. For initial occurrences of tendinitis, these treatments can also provide good relief and improve symptoms of pain. However, for recurrent, stubborn tendinitis, the effectiveness of oral and topical medications in improving symptoms is limited. If necessary, local pain point block treatments can be performed, which can also result in good therapeutic effects. (The use of medications should be under the guidance of a doctor.)