Two major problems associated with tendons include tendonitis and tenosynovitis. Tendonitis, inflammation of a tendon (the tough cords of tissue that connect muscles to bones) can affect any tendon, but is most commonly seen in the wrist and fingers. When the tendons become irritated, swelling, pain, and discomfort will occur.
Tenosynovitis is the inflammation of the lining of the tendon sheaths which enclose the tendons. The tendon sheath is usually the site which becomes inflamed, but both the sheath and the tendon can become inflamed simultaneously. The cause of tenosynovitis is often unknown, but usually strain, overuse, injury, or excessive exercise may be implicated. Tendonitis may also be related to disease (i.e., diabetes or rheumatoid arthritis).
Common tendon disorders include the following:
- lateral epicondylitis (commonly known as tennis elbow) - a condition characterized by pain in the back side of the elbow and forearm, along the thumb side when the arm is alongside the body with the thumb turned away. The pain is caused by damage to the tendons that bend the wrist backward away from the palm.
- medial epicondylitis (commonly known as golfer's or baseball elbow) - a condition characterized by pain from the elbow to the wrist on the palm side of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm.
- rotator cuff tendonitis - a shoulder disorder characterized by the inflammation of the shoulder capsule and related tendons.
- DeQuervain's tenosynovitis - the most common type of tenosynovitis disorder characterized by the tendon sheath swelling in the tendons of the thumb.
- trigger finger/trigger thumb - a tenosynovitis condition in which the tendon sheath becomes inflamed and thickened, thus preventing the smooth extension or flexion of the finger/thumb. The finger/thumb may lock or "trigger" suddenly.
The following are the most common symptoms of tendonitis. However each individual may experience symptoms differently. Symptoms may include:
- pain in the tendon when moved
- swelling from fluid accumulation and inflammation, or a grating sensation if not swollen
The symptoms of tendonitis may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
Diagnosis of tendonitis is usually confirmed based on a complete medical history and physical examination. Tendonitis is often diagnosed after other diagnostic tests have been completed to rule out other conditions or diseases. Joint aspirations may help to rule out gout or an infection, while x-rays may help to rule out arthritis (although tendons cannot be seen on an x-ray).
Specific treatment for tendonitis will be determined by your physician based on:
- your age, overall health, and medical history
- extent of the condition
- your tolerance for specific medications, procedures, and therapies
- expectation for the course of the disease
- specific organs that are affected
- your opinion or preference
Treatment may include:
- activity modification
- splinting or immobilization
- steroid injections
- anti-inflammatory medications
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