How to treat tenosynovitis?

Written by Na Hong Wei
Orthopedics
Updated on September 20, 2024
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In clinical practice, the treatment of stenosing tenosynovitis is divided into three stages. The first stage involves general treatments, including early immobilization, followed by localized heat therapy, microwave therapy, and shock wave therapy, as well as the topical application of anti-inflammatory and pain-relieving medications. If there is no improvement after one week of conservative treatment, the second stage is initiated. The second stage involves an injection treatment, which is quite effective for this type of tenosynovitis in clinical practice. Generally, one or two injections can significantly alleviate symptoms, and some people may even fully recover. However, if after three injections the symptoms do not improve or worsen, further injections should be avoided, as this method is not beneficial for you, and you would then proceed to the third stage. The third stage involves surgical treatment. There are two types of surgical treatments: one involves a minor procedure using a small needle knife in traditional Chinese medicine, and the other involves conventional surgery. However, for radial styloid stenosing tenosynovitis, surgery is generally recommended due to the proximity of the radial nerve, which could be at risk of damage.

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Causes of tenosynovitis

The causes of tenosynovitis, simply put, the tendon sheath is a double-layered dense synovial tube that encases the tendons. It acts as a protective fluid sheath for the tendons, consisting of two layers enveloping the tendon. Between these two layers is a cavity filled with synovial fluid. The inner layer is closely attached to the tendon, while the outer layer lines the inside of the tendon fibrous sheath, jointly attaching to the bone. It primarily functions to stabilize, protect, and lubricate the tendons, preventing them from friction-induced damage and compression. Long periods of excessive friction can lead to damage in both the tendon and its sheath, leading to swelling and pain, which are the symptoms of tenosynovitis. For example, certain occupations such as bricklayers, carpenters, those who work extensively with computers, and chefs who frequently stir with spoons, as well as seamstresses in textile factories, are prone to developing tenosynovitis. There might be a link between this condition and occupational diseases. In such cases, applying heat can be helpful, and if the pain is particularly severe, enclosed treatments might be conducted. Additionally, taking drugs that promote blood circulation and relieve pain might be advisable. In severe cases, surgical treatment may be necessary. (The use of medications should be under the guidance of a doctor.)

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Consequences of the deterioration of tenosynovitis

If tenosynovitis recurs repeatedly and is not given enough attention, it can become quite persistent and may not significantly improve with appropriate treatment. In such cases, surgery may be necessary. When tenosynovitis worsens, it leads to local pain, limited movement, and even noticeable swelling. Generally, there is no malignant transformation in the local tissues of tenosynovitis. The underlying mechanism of tenosynovitis involves aseptic inflammation due to the tendons' load-bearing activities. Long-term recurrence can lead to local scar hyperplasia. Post-surgical treatment should avoid repeated load-bearing activities to reduce recurrence.

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How to treat tendon sheathitis?

This mainly depends on the severity of the patient's tendinitis, which determines the proactive treatment plan. For instance, if the tendinitis is very severe, with local snapping and limited flexion and extension movements, it is necessary to actively carry out treatments such as small-needle-knife surgery, tenosynovectomy, or partial excision surgery. However, for tendinitis that merely presents as pain symptoms, conservative treatment can still be chosen. For example, local injection, reducing physical activity, and insisting on daily local hot washing. Using some topical ointments that promote blood circulation and remove blood stasis, many patients will gradually recover through these active treatment methods.

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What department should I go to for tendon sheathitis?

Tendinitis refers to a sterile inflammation of the tendon sheath around the tendons, caused by chronic strain, characterized by local pain and limited mobility. If tendinitis occurs, it is recommended to seek medical attention at the orthopedics department of a formal hospital. After assessing the extent of the inflammation and its impact on movement, and determining the presence of symptoms of constrictive tendinitis, an appropriate treatment method can be selected. In the early stages, conservative treatment such as rest and topical non-steroidal anti-inflammatory pain medications can be used. If the symptoms are severe, surgery may be required to remove the narrowed tendon sheath or the inflamed sterile tendon sheath to alleviate symptoms.

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How to treat tenosynovitis?

In clinical practice, the treatment of stenosing tenosynovitis is divided into three stages. The first stage involves general treatments, including early immobilization, followed by localized heat therapy, microwave therapy, and shock wave therapy, as well as the topical application of anti-inflammatory and pain-relieving medications. If there is no improvement after one week of conservative treatment, the second stage is initiated. The second stage involves an injection treatment, which is quite effective for this type of tenosynovitis in clinical practice. Generally, one or two injections can significantly alleviate symptoms, and some people may even fully recover. However, if after three injections the symptoms do not improve or worsen, further injections should be avoided, as this method is not beneficial for you, and you would then proceed to the third stage. The third stage involves surgical treatment. There are two types of surgical treatments: one involves a minor procedure using a small needle knife in traditional Chinese medicine, and the other involves conventional surgery. However, for radial styloid stenosing tenosynovitis, surgery is generally recommended due to the proximity of the radial nerve, which could be at risk of damage.