Tendonitis

Tendonitis is a condition in which a tendon becomes painful and inflamed. Sometimes the sheath / tunnel surrounding the tendon can become inflamed/swollen rather than the tendon itself, this is called tenosynovitis. It is managed in much the same way.

What are tendons?

Tendons are fibrous cords in the body joining bones to muscles allowing bones to move.

Why does it occur?

Tendonitis can occur due to:

• A tendon injury
• Overuse/ strain of a tendon (also known as RSI- repetitive strain injury)
• As a result of some inflammatory conditions such as Rheumatoid Arthritis.

Tendonitis is more common in individuals with diabetes.

What are the symptoms?

• Pain that becomes worse when moving/ using the affected joint/ area
• Grating/ cracking sensations when moving/using the affected joint/ area
• Swelling/ inflammation and sometimes redness and heat
• Lumps over the affected area
• Weakness/ loss of strength of the affected area

What tests might be done?

A doctor may be able to diagnose tendonitis/tenosynovitis by examining a patient and listening to their symptoms.

On occasions ultrasound / MRI (magnetic resonance imaging) scans may be required to locate the exact area / tendon affected X-Rays can also help to help rule out other causes/ confirm tendonitis through calcium deposits which can be an indicator of tendonitis.

What is the treatment?

Non-surgical treatment

• In most cases the painful tendon will get better on its own but in some cases the following may be used:
• Pain Killers
• Anti-inflammatories such as ibuprofen to help with the pain and swelling
• Advice: sometimes avoiding doing the activity/ action or modifying the activity/action that caused the symptoms can help the tendon to settle down
• Rest: resting affected joints can help the tendon settle and relieve inflammation
• Splinting affected joints to rest the tendon and help to relieve inflammation
• Steroid Injections: to help reduce the inflammation/swelling in / around the affected tendon

Surgical Treatment

Surgical Release: surgery is performed in persistent cases to release soft tissues around the tendon to relieve pressure over it and settle down the inflammation/ swelling. This may involve a period of splinting / hand therapy following the operation.

What to expect after your operation.

You may be sent to see a hand therapist after your operation to give you some advice on exercises to do to help re-gain movement in the affected joint.

You may also be given splints to help protect the affected joint and prevent you from overuse/ irritating the tendon again following the operation.

Your hand therapist will also help you to manage the small scar following your operation.

Things to consider before having surgery:

• As with all surgery there is a small risk of infection
• Incomplete resolution of pain (20-30% of cases) I.e the pain may not go away
• Risk of nerve injury/ neuroma (a painful growth/ spot over the nerve)
• Risk of Reflex Sympathetic Disorder (RSD). Can also be known as Chronic Regional Pain Syndrome (a malfunction of the nervous system that controls your pain)
• Risk of problematic scar tissue. After the operation there is a risk that you may have problems with scarring including tender/ sensitive scarring. Thick/ hard scarring causing reduced movement