Aseptic tendovaginitis treatment. Tenosynovitis - what is it? Tendonitis. Tenosynovitis of the hand - treatment. Causes and types of tendovaginitis

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The pathological process often leads to tendon necrosis and generalized sepsis. The occurrence of the disease is caused not only by infection, but also by the characteristics of physical activity. Thus, tenosynovitis is often registered in musicians, milkmaids, machinists, office workers, athletes, and loaders.

Anatomical features of the tendon

Tendon structures are an element of the muscular-articular system that ensures movement of the human body by transmitting muscle force impulses to bone tissue. In children and adolescents, the tendons contain a large amount of fluid, which explains the low incidence of injury and rapid recovery from injury. Fluid-filled tendon and muscle fibers are elastic and have high regenerative abilities. Tendons develop until 18-20 years of age.

Considering their anatomical purpose, tendon ligaments make tens of thousands of similar movements per day. These movements contribute to the friction of the tendons against adjacent tissues, but no pathological effects occur from this, thanks to the vaginal cavities.

Synovial tendons consist of layers of cylindrical epithelial tissue, welded together at the ends and forming a capsule-shaped shell. The first layer covers the tendon fibers, and the second protects the first. Synovial fluid flows between them, nourishing and moisturizing the contact surfaces.

Types and classification

The classification allows us to clearly formulate the diagnostic criteria by which clinicians recognize the type of tenosynovitis.

By nature of manifestation

Tenosynovitis of any localization has the following forms:

acute;
chronic.

By type of exudate

There are 4 main types for severe inflammation:

serous (typical inflammation);
serous-fibrous (with tissue changes);
hemorrhagic (with accumulation of blood);
purulent tendovaginitis (infection with pyogenic bacteria).

According to etiological factors

Possible causes are divided into separate groups with characteristic signs, features and type of course.

Non-infectious course

It occurs during the same joint movements, microtrauma as a result of increased muscle activity. From the group of non-infectious diseases, degenerative tendovaginitis (with changes in internal tissues) is separately distinguished, the consequence of which is a violation of the elasticity and mobility of blood vessels (varicose veins, thrombophlebitis) and disruption of the usual blood flow.

Infectious course

The infectious nature of the onset of the disease is classified into two main types:

specific;
nonspecific.

By jet stream

Reactive tendovaginitis is often a complication of the underlying disease with other concomitant chronic diseases (changes in scleroderma, ankylosing spondylitis, progressive Reiter's syndrome, rheumatoid tissue diseases, deforming, of any localization).

Given the many options for the occurrence of pathology, a whole range of diagnostic studies are carried out to identify one form from another, as well as from other diseases with similar symptoms.

According to the location of the source of inflammation

Tendon sheaths are located mainly in the distal parts of the upper and lower extremities (feet, hands). This is due to the greatest anatomical extent (the tendons are quite elongated) and intense friction as a result of multiple movements per day.

The following localizations are distinguished:

carpal tenosynovitis – distal parts of the hands;
tenosynovitis of the wrist joint;
tenosynovitis of the forearm;
Achilles tendon;
ankle joint;
feet;
tenosynovitis of the knee joint.

Depending on the location of the pathological process, patients note a characteristic clinical picture. It is the complaints of patients that become an important diagnostic criterion in identifying the location of the source of inflammation.

Causes

Despite the classification according to etiological criteria and the division of causes into whole groups, some common predisposing factors are also identified:

arthrosis and arthritis;
endocrine disorders (including diabetes mellitus);
phlebeurysm;
chronic diseases of organs and systems;
infectious diseases of a bacterial or viral nature;
traumatic injuries to the skin and joints;
autoimmune diseases;
overweight;
bad habits (alcoholism, smoking);
some mental illnesses.

The presence of other diseases in a patient always contributes to chronic impairment of certain body functions (excessive excretion of calcium and thinning of bones, degenerative processes in osteochondral tissue, intoxication and slagging of the body, circulatory disorders due to cardiovascular diseases). In such cases, tendovaginitis is a complication of a concomitant disease, a secondary process.

Symptoms

Symptoms of tenosynovitis are quite varied, which is determined by the classification of the disease. The main ones include the following:

soreness;
swelling due to the accumulation of synovial fluid;
skin redness;
limitation of joint mobility.

Different forms of the disease have their own symptoms:

Clinical manifestations with purulent infection cavity fluid is always bright, accompanied by general malaise, nausea, vomiting, and increased body temperature. Against the background of a purulent process, regional lymphadenitis develops with enlargement of the lymph nodes.
In acute aseptic tendovaginitis The vaginal components of the dorsum of the hand are affected. In rare cases, the pathogenic focus affects the tendon cavities of the foot and biceps brachii muscle. The onset of the pathological lesion is acute, with pronounced swelling; the lesion crunches on palpation. Patients experience pain when moving the joint.
Chronic tendovaginitis are accompanied by a general lesion of the tendon cavity (carpal tunnel syndrome) in the hand, as well as in the wrist joint. The wrist area is significantly swollen, painful, palpation reveals convex subcutaneous fragments, and fluctuation syndrome appears (fluid movement in an enlarged cavity).
Chronic tendovaginitis has another special form - stenosing tenosynovitis. The walls of the shell increase in size, thicken significantly, and the cavity narrows. Pain with stenotic tendovaginitis radiates to the fingers, elbows, and is accompanied by swelling.
For tuberculous tendovaginitis Dense formations resembling rice bodies are palpated in the area of the vault of the vaginal tendon. The disease is secondary in nature against the background of infection of the respiratory system with tubercle bacilli.

Which doctor treats tenosynovitis?

If unpleasant symptoms appear or if you suspect tenosynovitis, you should consult a traumatologist. Surgeons and rheumatologists will be able to help patients. In some cases, the primary diagnosis can be made by a therapist or neurologist.

Diagnostics

The main diagnostic methods are the following:

studying the patient’s clinical history;
study of patient complaints;
palpating the affected area;
blood and urine tests;
X-ray of hands, feet;
MRI or CT examination.

Treatment tactics

The treatment process depends entirely on the severity of the pathology and the location of the inflammatory focus. Treatment for tendovaginitis can be conservative and surgical.

Conservative therapy

The basis of therapeutic tactics is immobilization of the diseased joint. If the cause of tendovaginitis is professional activity, then you should temporarily abandon the work conditions that provoke the disease. For immobilization, compression hosiery, soft or hard orthoses (fixing bandages) are suitable. The products can then be worn to prevent relapse of the disease.

Drug treatment is determined by the following purposes:

analgesic painkillers (any pharmacological form);
non-steroidal anti-inflammatory diseases;
antibiotics (for infectious tendovaginitis);
long-acting glucocorticosteroids;
enzyme medicines;
local agents (gels, warming ointments in the absence of pus);
blockade with Novocaine (for severe, unremitting pain).

Additionally, a course of physiotherapy is prescribed for deeper penetration of drugs (phonophoresis, electrophoresis) and to improve tissue trophism (shock wave therapy, laser therapy). After eliminating the inflammatory focus and severe pain, a course of therapeutic exercises is carried out.

Treatment of tenosynovitis of the shoulder joint begins with immobilization using orthoses.

The use of traditional methods for inflammation of tendon structures is not only ineffective, but also threatens with numerous complications, diseases of an infectious-purulent nature.

Carrying out the operation

Surgery is advisable only in the presence of complications of the disease. The main indications for surgical treatment are:

inflammatory focus of a purulent nature and ineffectiveness of antibacterial therapy;
stenosing tenosynovitis;
intense pain that worsens quality of life;
formation of contractures with a progressive adhesive process.

The type and extent of the operation is completely determined by the individual clinical course of the disease. Traditionally, the tendon sheath is incised, the sheath is removed, and the tendons are released. Plastic surgery is performed when the tendon structures are severely damaged. The operation is performed laparoscopically or open access.

Taking into account the peculiarities of the localization of tendovaginitis, the rehabilitation period lasts no more than 14 days. After the sutures have healed, the joint should be temporarily immobilized using compression stockings.

Prevention and prognosis

Preventive measures against tendovaginitis include distributing the load to other muscle groups and exercising. So, with a routine type of activity, you should ensure a variety of movements (carrying out gymnastics for your fingers, wrists, forearms) during work. Prevention of infectious tendovaginitis is a complete and course treatment of inflammatory diseases of organs and systems. When the first symptoms appear, you should consult a doctor.

The prognosis, provided the full scope of therapeutic procedures is carried out and timely contact with a specialist, is favorable. When the disease becomes chronic, the functioning of the distal limbs is impaired, which can lead to disability of the patient.

Localized tenosynovitis is an inflammatory disease that has a common clinical picture for all inflammations. The patient's general condition worsens, intense pain appears, and the ability to work decreases or stops. Timely treatment will allow you to avoid many health problems, and prevention helps to get rid of serious consequences in relation to the motor activity of the joint and the musculoskeletal system as a whole.

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The sheath covering the tendons is called the tendon sheath. If, under the influence of certain factors, its inflammation begins, spreading to other articular tissues and the tendon itself, a disease such as tenosynovitis develops. Tenosynovitis is often confused with tendon, a common inflammation of the tendon itself that does not affect the sheath.

The difference between tenosynovitis is that it develops only in those parts of the tendon that are covered with a sheath. The following areas are usually affected:

Forearm and shoulder;
Wrist joint and hand;
Ankle and foot.

Tenosynovitis of the hand is very common among women and workers who daily perform repeated, similar movements that involve the wrist joint (for example, sewing, cutting, packaging, food processing). In women, the cause of illness is the daily performance of household chores.

In acute form, if you consult a doctor in a timely manner, treatment of the disease is almost always successful and quite quickly. But if it becomes chronic, treatment of the tendon can be protracted.

Often a limb loses functionality completely or partially, relapses constantly occur, as a result the patient is forced to change his type of work.

Tendons are dense and inelastic connective tissue located between a bone or bones and muscles. When muscle tissue contracts when moving an arm or leg, the tendons also move along with it. Researchers have recorded that the tendon of the wrist joint makes more than 10 thousand movements per day.

This is a huge burden. If the surface of the tendon were not covered with a protective synovial membrane, it would be severely injured by the bone, which would inevitably eventually lead to its rupture.

This sheath, or tendon sheath, consists of two parts. The inner sheath tightly encloses the tendon. And the external one forms a kind of capsule around the tendon.

Vibrations and friction during movements are reduced by synovial fluid, which fills the space between the two sheaths of the tendon sheath. All this provides optimal protection of the tendon from mechanical damage.

With tenosynovitis, the inflammatory process involves both the tendon sheath and the tendon itself. The nature of the inflammation can be either infectious or aseptic. The accumulation of fluid in the tendon sheath causes swelling, and the swelling causes limited mobility of the limb and pain.

Important information: if treatment is not started in a timely manner, the disease becomes chronic and produces numerous complications.

A purulent infection can spread to neighboring organs and cause sepsis and the formation of phlegmon.

Causes and types of tendovaginitis

Regardless of location, the disease can be divided according to etiology into two groups:

Infectious tendovaginitis;
Aseptic tendovaginitis.

Infectious form

This form of the disease is often called septic or purulent. Inflammation is caused by pathogenic microorganisms that get inside the tendon coupling. The infection can come from outside, through injury or surgery. Or it can get inside the tendon along with blood or lymph from other infected organs.

Purulent tendovaginitis is very dangerous. Pus can extend beyond the tendon sheath, and then the infection can spread to the entire limb. In severe cases, when conservative treatment turns out to be ineffective due to delay, an arm or leg has to be amputated.

There are two types of purulent tenosynovitis:

Nonspecific, provoked by the growth of opportunistic microorganisms such as staphylococci, streptococci, and E. coli.
Specific, caused by tuberculosis, syphilitic, gonorrheal, brucellosis infection.

In the first case, treatment is carried out using antibiotics, in the second case, treatment is aimed at eliminating the underlying disease that caused such a complication as tenosynovitis.

Aseptic form

This type of disease is more common than infectious. It is most often diagnosed in people whose activities involve performing the same type of movements, which use the same groups of muscles and tendons. These are cooks, musicians, stenographers and typesetters, as well as housewives.

Constant, significant loads on the joint and tendons lead to a decrease in the amount of synovial fluid. The friction of the tendon on the bone increases, the sheath is injured and aseptic inflammation begins.

Serous or hemorrhagic exudate may accumulate inside the vagina, causing symptoms such as swelling, swelling and pain.

Main symptoms of the disease

According to the nature of the course, chronic and acute forms of the disease are distinguished - their symptoms are somewhat different.

The acute aseptic form of the disease occurs when there is severe overload of a limb - hand or foot. The tendons of the forearm become inflamed most often, but tenosynovitis of the foot also occurs. Visually, the joint looks a little swollen, its contours are smoothed. The skin does not change color.

Pain is felt with active or passive movements of the limb. The localization of pain depends on which tendons are affected (often the thumb).

Characteristic symptoms that make it easy to recognize the disease are crunching and clicking sounds when moving the injured limb. In this case, a diagnosis of crepitant tenosynovitis of the forearm or foot is made.

In the acute purulent form of the disease, the symptoms are:

The injured finger becomes very swollen;
The skin feels hot and smooth, as if stretched;
Externally, the skin is red and shiny;
Pain even at rest, often throbbing and jerking.

The patient complains of general malaise - weakness, lack of appetite, headaches, fever. Lymph nodes become denser and increase in size. If treatment is not started, the inflammation will spread to the entire hand or foot, then to other organs. Sepsis will develop, and septic shock and death are possible.

Chronic crepitant tendovaginitis is possible only in an aseptic manner. Develops immediately as a result of monotonous, but not intense loads on the limb for a long period of time. Or acute crepitant tendovaginitis develops into it if treatment has not been carried out.

Symptoms of this type of tendovaginitis are very vague and often absent altogether. The patient may complain of pain, sometimes occurring after intense finger movement. When palpating and pressing on the damaged area, slight pain may also be noted. The joint does not swell or redden.

Women often experience chronic de Quervain's tenosynovitis or stenosing tenosynovitis. With this variant of the disease, the inflamed tendon is pinched in the osteofibrous canal. This causes constant and quite severe pain and stiffness in the arm.

If nearby nerve endings are affected, a complication such as carpal tunnel syndrome may develop. Women suffer from this form of the disease several times more often than men.

How is the disease diagnosed?

Tenosynovitis of the foot or hand is detected only clinically. There are no special studies that would help accurately diagnose this disease. For an experienced doctor, a visual examination of the patient is enough to determine it.

In case of doubt, if the symptoms are mild, the following examinations are performed:

Various tests using different movements to determine which tendon is affected.
X-ray of the diseased limb.
Computed tomography or MRI.
Clinical blood and urine tests.

Additionally, an examination by a neurologist may be necessary if injury to nerve endings is suspected.

Treatment of tendon inflammation

Treatment will depend on the type and form of tenosynovitis; conservative or surgical methods are used.

Conservative therapy is as follows:

Ensuring complete rest for the hand or foot;
Wearing an orthosis that fixes the first finger and joint of the hand or foot;
Cooling compresses on the affected area;
Medicines to relieve pain and inflammation.

In case of severe pain, analgesics in the form of tablets or injections, and non-steroidal anti-inflammatory drugs are prescribed. If the disease is infectious, the doctor selects antibiotics. Additionally, enzymes are taken to accelerate the resolution of inflammation and adhesions.

If the pain is painful and prolonged, a joint block is performed. The doctor injects an anesthetic in combination with long-acting glucocorticosteroids into the joint cavity.

To fully restore the functionality of the limb, a course of physical therapy is carried out. Massage, electrophoresis, phonophoresis, shock wave and laser therapy have a good effect.

Surgery is necessary if the disease produces the following complications:

A purulent inflammatory process that cannot be treated with antibiotics and has spread beyond the joint (abscess, phlegmon);
A stenosing form of the disease, when due to incessant pain a person cannot perform even the simplest actions;
Carpal tunnel syndrome;
Contractures of the fingers caused by the formation of adhesions.

The purpose of the operation is to release the tendons. To do this, the tendon sheath is incised and removed. If the tendon is severely damaged, it is also removed and plastic surgery is performed. The operation can be performed in two ways: with open access, when the skin and soft tissues of the wrist or foot are dissected, and through micro-incisions and punctures.

Tenosynovitis of the forearm is an inflammatory disease that affects the tendon and its surrounding sheath. Pathology develops only in tendons with synovial sheaths that resemble soft connective tissue pockets. The most common cause of tenosynovitis in the forearm is professional or sports microtrauma. Much less often, the tendon is damaged as a result of the progression of an autoimmune disease or infection with pathogenic microorganisms.

The leading symptoms of forearm pathology are pain that increases with rotation of the shoulder, flexion or extension of the arm. To establish the cause of clinical manifestations, a number of instrumental and biochemical studies are carried out. In therapy, only conservative methods are usually used. This is a course of NSAIDs, analgesics, muscle relaxants, and antibiotics. Patients are prescribed physiotherapeutic procedures, massage, and exercise therapy.

Causes

The tendons of the forearm are connective tissue structures; unlike ligaments, they are inelastic. With any movement of the muscles of the upper arm, the tendon moves, but does not stretch. Therefore, injuries to this part of the musculoskeletal system are rarely diagnosed. Muscles and tendons are united by a special dense case of connective tissue, lined inside with a synovial membrane. It produces a thick viscous liquid that has shock-absorbing properties. It facilitates the sliding of the tendon inside the sheath and ensures its smooth movement relative to nearby tissues. With the development of tenosynovitis, inflammatory edema forms and the amount of synovial fluid decreases. Any displacement of the tendon causes severe, sharp pain.

The most common cause of tenosynovitis is microtrauma. Those at risk include tennis players, basketball players, volleyball players, skiers, painters, loaders, and typists. Throughout the day, they make frequent, monotonous hand movements that use the forearm tendon. Gradually, the integrity of its individual fibers is compromised. And with significant damage, an inflammatory process of varying variability is triggered. The following pathologies also cause tenosynovitis:

degenerative diseases (deforming osteoarthritis, cervical osteochondrosis), accompanied by inflammation of the periarticular soft tissues;
arthritis: infectious, metabolic, autoimmune, reactive, traumatic, dystrophic;
diabetes mellitus, thyrotoxicosis and other endocrine diseases;
congenital or acquired dysplasia of the shoulder joints;
previous injuries to the shoulder or arm, after which scars remained on the connective tissue structures.

Often the inflammatory process develops due to the penetration of pathogenic microorganisms, often pathogenic bacteria, into the tendon. Tenosynovitis can occur several days after a respiratory, intestinal, or, less commonly, urogenital infection. Pathogenic bacteria penetrate the tendon sheath and begin to multiply there intensively. In the process of life, they release toxic substances into the surrounding space, causing inflammation and general intoxication of the body.

Tenosynovitis occurs when affected by both nonspecific (staphylococci, streptococci) and specific (treponema pallidum, gonococci, mycobacterium tuberculosis) infectious agents. The forearm tendon can become inflamed after deep cuts or wounds in which bacteria enter it from the surface of the skin.

Classification

When choosing a treatment method, doctors take into account the form of diagnosed tenosynovitis of the forearm. The most severe is purulent pathology, which develops as a result of tissue infection. It is characterized by the accumulation of purulent exudate in the tendon vagina, provoking a rapid worsening of symptoms and the spread of the inflammatory process to healthy areas. Serous tenosynovitis of the forearm is also isolated, in which the inner layer of the membrane is affected and a transparent protein-serous serum is released. Less common is a serous-fibrous disease, which occurs against the background of the formation of a specific plaque and the accumulation of serous exudate. The treatment methods used also depend on the form of the pathology:

initial. There is hyperemia (overflow of blood vessels) of the synovial vagina, accumulation of perivascular infiltrate, usually localized in the outer membrane;
exudative-serous. A small amount of effusion is detected in the tendon sheath, and the clinical picture is complemented by the formation of a small round swelling in the inflamed part of the tendon;
stenosing. Sclerotic changes occur: the structures of individual layers are smoothed, the canal of the synovial vagina is partially or completely narrowed.

Tenosynovitis of the forearm can be aseptic or infectious, chronic or acute. There are primary diseases that develop after tendon injury. Secondary tendovaginitis occurs due to pathology already present in the body: arthritis, arthrosis, venereal, respiratory, intestinal infections.

The main cause of tendovaginitis is microtrauma.

Clinical picture

In the acute course of tenosynovitis, severe pain occurs, which intensifies when trying to raise the shoulder or move the arm. But traumatologists note that it is not painful or other sensations that force patients to quickly seek medical help. The main complaint is weakness in the hand, which makes any work impossible. Also, the following symptoms are characteristic of forearm tenosynovitis:

weak aching, nagging pain at night;
swelling of the upper arm, sometimes spreading to the forearm;
redness of the skin, local increase in temperature;
crunching, crackling in the inflamed tendon when moving.

Infectious tenosynovitis is accompanied by clinical manifestations of general intoxication of the body. The temperature rises, the lymph nodes become inflamed, digestion and peristalsis are upset, headaches, chills, and cold sweat occur. Antibiotic therapy is required to eliminate these symptoms.

Diagnostics

An experienced doctor will assume the development of tenosynovitis of the forearm during the initial examination of the patient and based on his complaints. Pathology may be indicated by anamnesis - previous injuries, diabetes mellitus, arthritis, arthrosis, thyroid dysfunction. An X-ray examination is usually performed to determine the degree of inflammation and complications that have arisen. If radiography is not informative, CT or MRI is indicated. The results of these diagnostic measures reveal the stage of the pathology. Other connective tissue structures are also found to be involved in the inflammatory process.

Bacterial culture.

A bacteriological examination is required to exclude an infectious etiology of tenosynovitis. A biological sample taken from the patient is inoculated into a nutrient medium. After a few days, colonies of microorganisms form on its surface. Laboratory diagnostics allows us to identify the species of microbes and their sensitivity to antibiotics.

Treatment

Treatment methods and the severity of symptoms of tenosynovitis of the shoulder joint are closely interrelated. If acute pain and severe swelling occur, patients are advised to wear a fixing bandage and use a rigid or semi-rigid orthosis. This avoids unwanted stress on the inflamed tendon and compression of sensitive nerve endings by swelling. Immobilization also promotes rapid regeneration of damaged tendon tissue. In the first days of treatment, traumatologists recommend applying a bag filled with ice cubes to the upper part of the arm. It is wrapped in thick cloth to prevent frostbite. The duration of one cold procedure is no more than 15 minutes.

Fixing bandage.

To reduce the severity of pain and inflammation, drugs from various clinical and pharmacological groups can be used:

- Ketoprofen, Nimesulide, Diclofenac, Meloxicam, Celecoxib, Ketorolac, Ibuprofen. They stop inflammatory processes, eliminate pain, and promote the resorption of swelling. Effectively cope with high temperature, fever, chills;

glucocorticosteroids (synthetic hormones) - Prednisolone, Hydrocortisone, Dexamethasone, Kenalog, Flosterone, Triamcinolone. In the form of tablets for tenosynovitis of the forearm, they are rarely used. It is practiced to insert them directly into the inflamed tendon.

For mild pain, analgesics (Paracetamol, Efferalgan) or ointments with NSAIDs are used - Fastum, Voltaren, Artrosilene, Ketonal, Nurofen. External agents are rubbed into the area of pain and inflammation 1-3 times a day for 7-10 days. After the inflammatory process has stopped, the doctor may prescribe (Capsicam, Viprosal, Finalgon). The active ingredients of the drugs have a local irritating, distracting, analgesic and stimulating tendon regeneration effect.

To resolve inflammatory edema and prevent the accumulation of exudate, compresses with Dimexide, electrophoresis with analgesics, NSAIDs, Lidase, and phonophoresis with hydrocortisone are used. Patients are prescribed 5-10 sessions of laser therapy, magnetic therapy, and UHF therapy.

In the treatment of infectious tendovaginitis, antibiotics are used, to which the microorganisms that provoke them are sensitive. Most often, treatment regimens include Clarithromycin, Azithromycin from the macrolide group, Cefazolin, Cefotaxime from the cephalosporin series, semi-synthetic protected penicillins Augmentin, Amoxiclav. Sulfonamides are also used, and, if necessary, immunomodulators or immunostimulants.

After antibiotic therapy, patients are recommended to take a course of eubiotics to restore the intestinal biocenosis. Treatment of tendovaginitis provoked by specific infectious agents is carried out by a phthisiatrician, urologist, and venereologist.

Folk remedies

Remedies made according to recipes from traditional healers are effective during the rehabilitation period. After the main treatment, warming up the damaged tendon is practiced to accelerate its healing. Linen bags with drawstrings filled with hot sea salt or flaxseeds are used. For warming, a homemade rub is also used:

a dark glass container is filled to the top, without compacting, with freshly picked leaves of burdock, plantain, sorrel, dandelion flowers, calendula, chamomile, finely chopped horseradish roots;
carefully pour vodka without additives or 96% ethyl alcohol diluted with an equal volume of water along the wall;
Place for a month in a warm, dark place, shake periodically.

Alcohol tincture of herbs.

The resulting tincture is rubbed on the forearm 1-3 times a day. Biologically active substances transferred into an alcohol solution have an analgesic, anti-inflammatory and blood circulation-improving effect.

In the absence of medical intervention, the pathology gradually takes on a chronic form. Painful sensations occur during physical exertion, after hypothermia, or during a sharp decrease in immunity. The biceps and deltoid muscles begin to weaken and atrophy, reducing the functional activity of the arm. Fibroplastic tendomyositis develops, in which irreversible fibrous degeneration of the tendon occurs. You can avoid such negative developments by seeking medical help when the first pathological signs appear.

Tenosynovitis is a disease in which inflammation of the connective tissue membranes surrounding the tendon occurs. The disease can be acute or chronic, so treating tendovaginitis is not always an easy task even for an experienced doctor.

Most often affected:

wrist joint and hand;
elbow joint;
ankle joint;
Achilles tendon.

There are many causes of tenosynovitis. The disease can be independent or become a complication of any infection: syphilis, tuberculosis. Depending on the causes of the disease, several types of tendovaginitis are distinguished:

Acute aseptic tendovaginitis occurs after severe overload. For example, for children before an exam at a music school or for athletes before competitions. The disease begins acutely. Severe pain and swelling appear in the affected area. The patient hears clicking and crunching sounds when the joint moves.
Acute post-traumatic tendovaginitis appears after a bruise or sprain, most often in the area of the wrist joint.
Acute infectious tenosynovitis. It may be nonspecific when the pathogen entered the body through an open wound or specific if the disease occurred against the background of tuberculosis, syphilis or other infectious diseases. The symptoms are similar, but in addition to them, the patient will have a high fever, chills, and general malaise.
Chronic tendovaginitis develops as a complication of acute aseptic or infectious tendovaginitis. There is usually no swelling. The patient notes pain and crunching when moving. Upon palpation (feeling), the patient will notice pain along the tendon.

Treatment

Treatment of tendovaginitis should begin with the creation of functional rest for the affected tendon. In addition, you can use warming ointments and compresses.

Drug treatment

Treatment of the disease will depend on its type. For infectious tendovaginitis the following are prescribed:

Ciprofloxacin;
Tsiprolet;
Erythromycin;
Ampicillin.

Antibacterial drugs have many side effects. If these medications are used irrationally, dysbacteriosis may develop, fungal skin diseases, and much more may occur. Therefore, antibiotics must be used strictly as prescribed by the doctor. It is also necessary to remember that medications must be taken according to the schedule. At the same time. While taking antibiotics, drinking alcoholic beverages is prohibited.

Antipyretic drugs:

paracetamol;
ibuprofen.

Immunomodulators. To increase immunity, a multivitamin complex is prescribed:

complivit;
alphabet;
Vitrum;
bio-max.

If the disease is a complication of tuberculosis, the patient needs anti-tuberculosis drugs:

Isoniazid;
Rifampicin;
Streptomycin.

For nonspecific tendovaginitis, the main thing will be to prescribe non-steroidal anti-inflammatory drugs:

Voltaren;
Nise;
Diclofenac;
Indomethacin;
Butadion.

For purulent tendovaginitis, a puncture of the synovial vagina is performed and antibiotics are administered, taking into account their sensitivity. Non-steroidal anti-inflammatory drugs and local administration of hydrocortisone and novocaine are also used. If all of the above methods do not help, several sessions of X-ray therapy or the injection of steroids into the affected tendon are prescribed.

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Physiotherapeutic treatment

Physiotherapeutic procedures are prescribed:

ultrasound;
microwave therapy;
massage;
electrophoresis;
mud applications;
paraffin therapy.

Acupuncture

This method involves the introduction of special needles into biological points of the human body.

How is the manipulation carried out?

The doctor takes a special syringe with a very thin needle and injects about 0.1 ml of the drug. About 200 punctures are performed in 1 session. A papule forms at the injection site, which will disappear after a while.

Precise impact on the right points.
Quick impact.

Pain at the time of manipulation.
Violation of skin integrity.

Hirudotherapy

Treatment with leeches can have a beneficial effect on the entire human body. After hirudotherapy, patients note a decrease in pain and swelling. Leeches improve blood circulation in the diseased area, thereby speeding up the healing process.

Surgical treatment

Surgical treatment is carried out only for infectious tendovaginitis, when pus forms in the joint capsule. The doctor makes an incision, removes the purulent contents, treats it with antiseptic solutions or antibiotics, and stitches it up. Sometimes the surgeon can install a drainage - a device through which pus from the wound will come out.

Traditional treatment

Traditional medicine has many recipes for treating any disease. Tenosynovitis can be treated with ointments, infusions, and homemade compresses. The main thing to remember is that the disease must be treated with traditional methods, and folk remedies should be used as additional treatment. In any case, before starting to use traditional medicine, you should consult with your doctor.

Ointments

Calendula ointment. You need to take dry calendula flowers and mix them with baby cream in a 1:1 ratio. After this, apply the ointment to the affected area, bandage it and leave it overnight. Calendula has anti-inflammatory and antimicrobial effects.
Wormwood ointment. Take 30 grams of wormwood and mix it in 100 grams of lard. Put on gas, cook over low heat. After cooling, apply to the sore spot.

Compresses

Compress with medical bile. Take the bile, melt it in a water bath and apply to the affected area. After this, wrap with compress paper or a plastic bag and a warm scarf. Leave overnight. Instead of medical bile, you can use bear bile. This compress has an anti-inflammatory and absorbable effect.
Compress with herb shepherd's purse. First you need to make a decoction of shepherd's purse herb. To do this, pour 1 glass of water into a thermos and add a tablespoon of herbs. Leave for several hours. Then strain and use as compresses or lotions.

Infusions

To prepare an anti-inflammatory infusion, take: 1 tablespoon of St. John's wort, 1 tablespoon of chamomile and 1 teaspoon of calendula. Pour all this into a glass of water, leave for 1 hour, and then take 100 ml orally 3 times a day.

The course of treatment is several weeks.

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Prevention

To prevent you from developing tendovaginitis, you must follow several rules:

Eat properly.
Maintain a sleep-wake schedule.
Do exercises.
Do not overload muscles and joints.
Treat infectious diseases in a timely manner.
Seek medical help promptly if you suspect tenosynovitis.

To prevent tenosynovitis of the wrist joint, you need to wear a special cuff on the forearm.

It is better to prevent any disease than to treat it. But if you have already developed tenosynovitis, then you must follow all the doctor’s recommendations, strictly take the prescribed medications, and then recovery will not take long.

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Tenosynovitis is an inflammation of the inner lining of the fibrous sheath of a muscle tendon, or synovium.

The synovial membrane is designed to facilitate the sliding of the tendon in the costofibrous canals when performing muscle work.

There are chronic and acute tendovaginitis. The acute form is manifested by swelling of the synovial membrane, as well as the accumulation of fluid inside it.

Tenosynovitis of the chronic variety provokes thickening of the synovial membrane, and accumulation of effusion in the synovial cavity with a large amount of fibrin occurs. Over time, as a result of the formation of fibrinous effusion, “rice bodies” appear and the lumen of the tendon sheath narrows.

Features of the inflammatory process affect vaginitis, which can be:

purulent,
serous or serous-fibrinous.

Symptoms of tenosynovitis

Nonspecific tenosynovitis of acute form is characterized by the rapid onset and development of painful swelling in the area where diseased synovial membranes of the tendon sheaths are localized.

As a rule, acute tenosynovitis begins in the tendon sheaths on the dorsum of the feet and hands. Sometimes it occurs in the synovial sheaths of the fingers, as well as in the sheaths of the flexor tendons of the fingers.

Soreness and swelling usually move from the foot to the lower leg, as well as from the hand to the forearm. Motor limitation begins, and flexion contracture of the fingers may appear.

If the inflammation begins to take on a purulent form, then the following manifestations begin:

general body temperature rises,
chills begin
regional lymphadenitis is formed,
inflammation of the lymphatic vessels develops, that is, lymphangitis.

Tenosynovitis is a purulent form that usually appears in the area of the flexor tendon sheath.

There is acute aseptic or crepitant tenosynovitis. It is characterized by damage to the synovial sheath on the back of the hand, sometimes to the foot, and most rarely to the intertubercular synovial sheath of the biceps.

The condition begins abruptly: the area of the affected tendon swells, and when palpated, a crunching sensation (crepitus) is felt. There is limited movement of the finger and (or) pain when moving. The disease can become chronic.

Chronic tendovaginitis is characterized by damage to the tendon sheaths, as well as to the extensors of the fingers in the area of their retinaculum. As a rule, there are symptoms of chronic tendovaginitis of the common synovial sheath of the flexor fingers, that is, carpal tunnel syndrome, this is an elongated tumor-like painful neoplasm in the area of the carpal tunnel. The tumor is elastic and often takes on the contours of an hourglass, which shifts slightly while walking.

Sometimes “rice bodies” are felt or fluctuation is detected. Fluctuation is the sensation of a transmission wave, which is caused by the accumulation of fluid. Characteristic motor restriction of tendons.

There is a peculiar form of chronic tenosynovitis - stenosing tenosynovitis, or de Quervain's disease. This is a lesion of the short extensor pollicis muscle and the tendon sheath of the abductor longus muscle.

With this type of tendovaginitis, the vaginal walls thicken and the cavity of the synovial vagina narrows. De Quervain's tenosynovitis leads to pain in the area of the styloid process of the radius and swelling.

The pain subsides if the patient presses the first finger to the palm and bends the other fingers over it. Along the course of the vagina, palpation determines the most painful swelling.

In tuberculous tenosynovitis, the appearance of dense formations called “rice bodies” is observed along the expansion of the tendon sheaths; they are easily palpable.

Tenosynovitis has a number of complications

Purulent radiation tenobursitis is, in most cases, a complication of purulent tenosynovitis of the thumb. It can develop when purulent inflammation spreads completely to the tendon sheath of this flexor pollicis.

There is always pronounced pain on the surface of the palm, thumb and further along the outer edge of the hand up to the forearm. If tenosynovitis actively develops, the purulent process will spread to the forearm.

A complication of purulent tenosynovitis of the little finger is purulent ulnar tenobursitis. Due to anatomical features, inflammation quite often passes from the synovial sheath of the little finger to the common synovial sheath of the hand flexors. Sometimes the synovial sheath of the flexor pollicis longus tendon becomes inflamed.

Then a cross phlegmon is formed, which is characterized by a severe course and complications in the form of impaired functioning of the hand. This type of phlegmon has the following manifestations:

severe pain on the palmar side of the hand,
swelling of the thumb, palmar surface, little finger,
significant limitation of finger extension or inability to extend.

The appearance and clinical manifestations of carpal tunnel syndrome are caused by compression of the median nerve in the carpal tunnel. In this case, in the 1st, 2nd and 3rd fingers of the hand, there are:

severe pain,
tingling sensation
"Crawling of goosebumps."

The same manifestations are observed on the inner surface of the 4th finger. In addition, there is a decrease in the muscle strength of the entire hand, and the sensitivity of the fingers decreases.

Most often, the pain intensifies at night, which significantly disrupts the rest regime. There may be some relief when lowering the limb down. Quite often the color of the skin of painful fingers changes; they can be pale or bluish.

A spot increase in sweating and a decrease in pain sensitivity is also possible. When palpating the wrist, you can determine pain and swelling. Strong bending of the bone and lifting the limb upward often causes aggravation of pain and paresthesia in the area of innervation of the median nerve.

Carpal tunnel syndrome is often observed together with Guyon's canal syndrome, which rarely occurs independently. With Guyon's canal syndrome, due to the fact that the ulnar nerve is compressed in the area of the pisiform bone, pain and a feeling of numbness appear, as well as tingling and goosebumps in the 4.5 fingers.

Swelling in the area of the pisiform bone and pain when palpated on the palmar side.

Laboratory tests in the process of identifying tenosynovitis

Diagnosis of tendovaginitis makes it possible to find out the characteristic localization of the pathological process. Laboratory tests allow you to obtain accurate information about the condition of tenosynovitis, in particular they determine:

cord-shaped painful lumps in specific places,
features of movements,
presence of “rice bodies” upon palpation.

When studying acute purulent tenosynovitis in a general blood test, specialists determine leukocytosis - an increase in white blood cells of more than 9 x 109 / l and an increased content of band forms of neutrophils (more than 5%), as well as an increase in the erythrocyte sedimentation rate - ESR.

Purulent discharge is examined by bacterioscopic (examination of the material under a microscope after staining it) and bacteriological (isolation of a pure culture on nutrient media) methods. Such tests make it possible to identify the nature of the pathogen by determining its sensitivity to antibiotics.

If the course of acute purulent tenosynovitis is complicated by sepsis (if the causative agent of the infection has entered the bloodstream from a purulent focus), then the blood must be checked for sterility. Such a study also makes it possible to study the nature of the pathogen and identify its sensitivity to antibacterial agents.

X-rays show the absence of pathological changes in bones and joints. Only soft tissue thickening in the relevant area can be detected.

Chronic tendovaginitis is differentiated from Dupuytren's contracture. This is a painless developing flexion contracture of the 4th and 5th fingers of the bone.

Acute infectious tenosynovitis is differentiated from acute osteomyelitis and arthritis.

Treatment of tendovaginitis

Treatment of acute tenosynovitis can be local or general. General treatment of nonspecific acute infectious tenosynovitis involves eliminating the infection; for this, the use of antibacterial drugs and measures to develop the body's protective functions are indicated.

The presence of tuberculous tenosynovitis suggests the use of anti-tuberculosis drugs:

streptomycin,
ftivazid,
PASK and others.

To successfully treat aseptic tenosynovitis, it is necessary to use non-steroidal anti-inflammatory drugs, such as butadione, aspirin or indomethacin.

Local treatment of tendovaginitis in both aseptic and infectious forms in the initial stages involves ensuring rest of the diseased limb. In the acute phase of tendovaginitis, immobilization is carried out with a plaster splint, a suitable ointment and warm compresses are applied.

After the elimination of acute manifestations, physiotherapeutic procedures are indicated:

ultrasound,
microwave therapy,
ultra-violet rays,
electrophoresis of hydrocortisone and novocaine,
physiotherapy.

In case of purulent tenosynovitis, it is necessary to urgently open and drain the tendon sheath, as well as purulent leaks. For tuberculous tendovaginitis, it is important to administer local streptomycin (solution) and excise the affected synovial vagina. Sometimes after this a certain ointment is applied.

Chronic tendovaginitis should be treated with the listed physiotherapeutic methods, as well as ozokerite and paraffin applications, lidase electrophoresis and constant physical therapy.

If chronic infectious processes are actively developing, then it is necessary to puncture the synovial vagina several times and administer targeted antibiotics.

For aseptic chronic tendovaginitis, non-steroidal anti-inflammatory drugs will be needed. In particular, local administration of glucocorticosteroids, such as metipred, hydrocortisone, dexazone, is effective.

If chronic crepitating tendovaginitis is difficult to treat, then radiotherapy is used. Sometimes, if conservative treatment of stenosing tenosynovitis is ineffective, surgical treatment must be performed, that is, dissection of the narrowed canals.

Tenosynovitis, which accompanies rheumatic diseases, is treated in the same way as the underlying disease. So, they are appointed:

anti-inflammatory medications (including gel and ointment),
basic drugs,
electrophoresis of non-steroidal anti-inflammatory drugs,
hydrocortisone phonophoresis.

Prognosis for tendovaginitis

If adequate and timely treatment has been carried out, tenosynovitis has a favorable prognosis.

But with the purulent form of the disease, sometimes there may be disturbances in the functioning of the affected foot or hand.

It is no secret that muscle tendons are located in tendon sheaths. If the inflammatory process extends to these formations (tendon sheaths), then it is called tenosynovitis or tenosynovitis. Tenosynovitis can be acute or chronic. According to the etiological (causal) factor, the disease can be aseptic and infectious. Most often, the location of the pathological process is the hands and feet, forearms, and ankles.

Causes diseases tenosynovitis

Nonspecific aseptic tendovaginitis occurs due to minor injuries to the synovial membrane, formed during prolonged muscle loads, overwork, muscle strains, prolonged exposure to low temperatures.

The occurrence of infectious tenosynovitis is associated with specific and nonspecific infections. Purulent arthritis, infected wounds, and osteomyelitis can act as a source of nonspecific infection. A specific infectious process is characterized by the entry of pathogens of various infectious diseases (brucellosis, tuberculosis) into the tendon sheath. Also, the cause of tenosynovitis can be a reactive type of inflammation due to rheumatism or infectious arthritis.

Clinical signs tenosynovitis A

The main symptoms of the disease are swelling of the tendon sheath, soreness of the tendons, hyperemia and swelling of the skin. If we are talking about infectious tendovaginitis, there is an increase in body temperature, enlarged lymph nodes, chills, and weakness.

Treatment tenosynovitis A

Treatment methods for tendovaginitis can be divided into general and local. In acute cases of the disease, the limb must be fixed (immobilized). After this, various methods of physiotherapy are prescribed.(warming compresses with paraffin, ozokerite are used, electrophoresis is performed using a dimexide solution). For the treatment of chronic tendovaginitis, UHF therapy and the use of Rosenthal paste are effective.

Medication treatment consists of the use of antibacterial and anti-inflammatory drugs. In addition, painkillers and vitamin preparations are used.

When choosing a method of therapy, you need to take into account the characteristics of the course of tenosynovitis. Treatment of specific tendovaginitis is carried out taking into account the characteristics of the underlying pathology. Treatment of nonspecific tendovaginitis is often carried out surgically. The success of treatment of the disease is influenced by the stage of the inflammatory process during tenosynovitis. Therefore, the chances of a complete recovery in patients who seek help from a specialist when the first symptoms of the disease appear will be significantly higher than in patients with an advanced form of tenosynovitis.

It is necessary to understand that if you consult a doctor in a timely manner, the risk of complications and the possibility of tenosynovitis transitioning from an acute to a chronic form are reduced.

VIDEO

Treatment of tendovaginitis using traditional medicine

Treatment of inflammation of the tendon sheath with folk remedies is an excellent addition to the main treatment of the disease. Before starting self-treatment, you need to consult a medical specialist to clarify the diagnosis and predicting possible complications with this treatment method.

Therapy of tendovaginitis using bile and Rosenthal paste

First recipe. Rosenthal paste successfully copes with the task of curing crepitant tenosynovitis. This medicine consists of iodine, wine alcohol, paraffin, chloroform. The heated paste must be applied to the site of inflammation, it hardens, then a cotton bandage is applied on top.

Second recipe. The fabric must be soaked in medical bile. The fabric should be made of thick and soft material. Next, the bile-soaked tissue is applied to the painful area. Then this area is wrapped with a warm scarf and compressor paper. Every other day, the procedure must be repeated up to 10 times.

Treatment tenosynovitis and homemade ointments

First recipe. In this case, an ointment is prepared from herbs and calendula flowers. The above plant materials are crushed to a powdery state and mixed with the required amount of base (one tablespoon), consisting of petroleum jelly or baby cream. The ointment is applied in the form of compresses or used to lubricate the site of inflammation.

Second recipe. An ointment is also made, which contains chicken egg white, flour (in the amount of one tablespoon) and a tablespoon of alcohol. Next, all the components of the ointment are mixed and applied to cotton fabric, which should be cut into strips (like a bandage). This fabric, which is soaked in the above ointment composition, must be applied to the site of inflammation. The course of treatment is a couple of weeks. The treatment procedure should be repeated once a day in the evening.

Treatment of tenosynovitis with ointment and tincture of wormwood

First recipe. Wormwood tincture has a general strengthening and anti-inflammatory effect. To prepare the tincture, you need to take two tablespoons of wormwood herb, pour 200 milliliters of boiling water over the raw material and leave for 30 minutes. The tincture is ready. Next, you need to strain it through a filter material. Drink two tablespoons of tincture 2-3 times a day 30 minutes before meals.

Second recipe. By taking two components: 100 grams of pork fat and 30 grams of dried wormwood herb, you can prepare a medicinal ointment for tendovaginitis. These components need to be mixed and the mixture boiled over low heat, then cooled and applied to the affected area.

Therapy of tendovaginitis through infusions and tinctures of medicinal plants

Recipe 1. The use of an infusion consisting of chamomile (calendula), St. John's wort. This infusion has an anti-inflammatory effect. To make the medicine you need to take 1 tablespoon of St. John's wort and chamomile. Then the plant material is poured with boiling water (in the volume of one glass - 200 milliliters). The infusion is carried out for 30 minutes, then the infusion is filtered and used half a glass per dose 2-3 times a day for 1-2 weeks.

Recipe 2. A good anti-inflammatory effect for tenosynovitis occurs as a result of the use of diluted calendula tincture. One teaspoon of calendula tincture is diluted in a glass of boiled water.

Recipe 3. Using an infusion prepared from shepherd's purse herb in the form of compresses. To get an infusion, you need to pour one tablespoon of dried shepherd's purse herb into 200 milliliters of boiling water and leave for several hours. Next, the infusion should be filtered. After this, you can install compresses.

Chronic tenosynovitis

Often the chronic form of this disease occurs as a complication of acute inflammation of the tendon sheath. In this case, special attention of specialists is required. If tenosynovitis was diagnosed in the early stages of development and its treatment was competent, then the prognosis of the disease will be favorable. Importance in eliminating clinical signs of chronic tenosynovitis has the patient contact a specialist in a timely manner.

Forms, symptoms, localization of chronic inflammation of the tendon sheath

The localization of inflammation in the chronic form of tenosynovitis is the tendon sheath, which is involved in the flexion and extension of the fingers in the place of their retinaculum. Most often, clinical signs of the disease appear in the common synovial sheath of the fingers located in the carpal tunnel. In this place, an elastic tumor with an oblong shape can be felt. By palpating the tumor, fluctuation can be detected. The tendons are painful and their mobility is limited.

Stenosing tenosynovitis is one of the forms of the disease. In this case, the tendon sheaths of the extensor brevis and abductor pollicis muscles are affected. As a result, the lumen of the synovial cavity decreases.

The first symptom of chronic tendovaginitis is pain in the area of the styloid process of the radius. Palpating the tendon sheath, a tumor is detected; palpating it causes acute pain in the patient. When the thumb is abducted and flexed, pain appears, radiating to the area of the forearm and shoulder.

Clinical signs of stenosing tenosynovitis are similar to symptoms stenosing ligamentitis. With stenosing inflammation of the ligaments, the inflammatory process spreads to the entire ligamentous apparatus of the hand. The disease occurs as a result of injuries, overexertion, and infectious diseases.

The localization of inflammation is the area of the collateral ligaments of the interphalangeal and metacarpophalangeal wrist joints. Movement and palpation of these joints cause pain, and the site of inflammation is characterized by swelling, redness and swelling. The disease can cause necrosis of some part of the ligamentous apparatus, which is accompanied by a decrease in tendon slip and difficulty in moving the finger.

Tenosynovitis in tuberculosis is diagnosed by palpation. In the tendon sheaths, so-called “rice bodies” of dense consistency are found.

Treatment of chronic tendovaginitis

Therapy for the chronic form of inflammation of the tendon sheath is carried out using physiotherapy methods, applying paraffin compresses, and taking mud baths. Patients are prescribed electrophoresis using lidase and massage. To restore joint function, therapeutic physical training is recommended.

If the pathological process intensifies, then it is necessary to perform a puncture of the synovial vagina. In this case, antibacterial and non-steroidal anti-inflammatory drugs are prescribed. In addition, hydrocortisone and novocaine are injected into the area of inflammation.

If chronic tenosynovitis is not particularly effectively treated, then positive dynamics in the treatment of the disease is achieved with the help of x-ray therapy sessions. However, their number should be no more than two. In order to expand the lumen of the tendon sheath in case of stenosing tenosynovitis, it is advisable to dissect a certain area of it.

Purulent tenosynovitis may be accompanied by complications: persistent changes in the functions of the feet or hands.

For workers in certain professions such as pianist, office worker, engineer, and the like. The hands suffer from the same type of movements during which the disease develops tenosynovitis of the hand.

The development of the disease can occur in all joints, but the hands are most often affected. In the area of which discomfort and limitation of actions occur. People who play sports also have this problem. This type of disease primarily affects certain areas of the tendons.

The information presented in this article will be useful to the young and mature generation. So that your joints are not affected by this disease. They did not create discomfort in movement and work that brings you pleasure.

Tenosynovitis of the hand - description

Tenosynovitis of the hand

Tenosynovitis is an inflammation that affects the tendon sheath. This disease rarely comes alone. It often leads to its close relatives - tendevitis, tenosynovitis and others. The fact is that all the tissues of the joints and tendons are located very close to each other, so when there is inflammation, for example, of the synovial vagina, the disease affects both the tendon and the ligamentous canal.

Tenosynovitis is a disease that does not have any specific localization and can affect the tendon sheaths of any organ. One of the most vulnerable organs in this regard are the hands. Tenosynovitis of the hand is a fairly common disease. This is due to the greatest vulnerability of this part of the body.

Hands are often exposed to hypothermia and various injuries, which contributes to the occurrence of the disease. It occurs in the area of the foot, knee and elbow joints, but the most common site of injury is the hand. This type of tendovaginitis will be discussed in the article.

Infectious tenosynovitis is characterized by a sharp rush of blood to the lesion and a subacute course of the inflammatory process.

A painful swelling forms against the background of general inflammation, expressed by chills and increased body temperature. If the treatment of tenosynovitis is not implemented in a timely manner, this symptomatology is added to the reduction of the fingers of the limbs and severe convulsive syndrome.

In the most complex and advanced cases, compression of blood vessels and necrosis of adjacent tissues is possible, followed by the development of septic infection. The terms “tenosynovitis”, “tendevit”, “tenosynovitis”, “ligamentitis” are often used as synonyms, since all closely adjacent tissues are often affected - the tendon, its synovial sheath and the ligamentous canal.

Tenosynovitis manifests itself as pain during active movement of any muscle or group of muscles, swelling along the tendon sheath, and crunching when moving. Most often, tenosynovitis affects the extensor tendon sheaths of the forearm, fingers, hand, leg, foot and Achilles tendon.

The tendons are surrounded by tubes that contain synovial fluid: during the process of contraction or relaxation, it protects the tendons from damage. When the tendon sheath swells, nodules appear, which are painful when the muscle moves.

Thus, the disease tenosynovitis develops. The disease occurs as a result of infection of the tendon sheaths, which occurs when the hands are injured. But it can also develop due to the transmission of inflammation from nearby tissues. Tenosynovitis can be infectious in nature, developing against the background of infections such as tuberculosis, brucellosis and others.

It is worth noting that this form of tenosynovitis of the hands is quite rare, but non-infectious tenosynovitis is widespread. Its causes are well known - excessive physical exertion, injury, hypothermia. Most often, tenosynovitis is an occupational disease.

Frequently repeated identical movements lead to microtraumas, from which inflammation develops. In athletes, post-traumatic tendovaginitis can often be observed. But this does not mean that a simple household injury cannot lead to the disease. Sometimes the disease can be degenerative.

It may be caused by poor circulation in the periarticular tissues, which can be caused by a disease such as varicose veins. Poor circulation leads to degenerative changes in the synovium of the tendon sheath.

Tenosynovitis can occur in both acute and chronic forms. Tenosynovitis of the flexor fingers most often occurs. Frequent monotonous movements and excessive loads cause tenosynovitis of the hand.

Causes and types

The causes and high incidence of the disease are associated primarily with the vulnerability and high load on the hands.

The main reasons that provoke the occurrence of tenosynovitis are:

History of numerous microtraumas. Most often they are associated with the patient’s professional activities or sports activities.
They are usually caused by the fact that the load on the constantly involved muscle group is distributed incorrectly.
Due to the traumatic nature of the disease, doctors formed a risk group for tenosynovitis. It consists of people whose profession involves straining their wrists for a long time. These are musicians, programmers and other specialists who work at the computer for a long time.
Degenerative changes. Their cause may be poor blood supply to the periarticular tissues.
Rheumatic diseases. In this case, tenosynovitis develops as a result of reactive toxic inflammation.
Infections. Depending on the type of infection, there is a specific form of the disease, which occurs with gonorrhea, tuberculosis, syphilis and other diseases, and a nonspecific form, which occurs due to the presence of a nearby focus of purulent infection, for example felon, purulent arthritis and osteomyelitis.

Tenosynovitis can be either an independent disease (primary tenosynovitis) or secondary - as a complication of any process of a specific or infectious nature.

The most common non-infectious (aseptic) tendovaginitis is crepitating, stenotic. The cause of non-infectious (aseptic) tenosynovitis is most often excessive stress on the tendons. Frequently repeated movements cause microtraumas, as a result of which tenosynovitis develops.

This is usually associated with the patient’s professional activities or sports activities, which is why such tenosynovitis is called professional. There is also post-traumatic tenosynovitis, which is also most often observed in athletes, although household trauma may well lead to its appearance.

Tenosynovitis can also be degenerative in nature - if it is associated with circulatory disorders of adjacent tissues (for example, with varicose veins).

The cause of degenerative tendovaginitis is a violation of the blood supply to the periarticular tissues, leading to degenerative changes in the synovium of the tendon sheath. The vulnerability of the hand is largely related to the prevalence of this disease and its causes.

Among the main reasons leading to this disease are the following:

Traumatic injury. Most often the cause is numerous microtraumas associated with intense sports or professional activity. In this case, as a rule, a certain group of muscles is involved, the load on which is distributed incorrectly. Speaking about the traumatic nature of tendovaginitis, we can identify a risk group for this disease. It includes people who work at a computer for a long time, pianists, as well as those whose professional activities involve prolonged wrist tension.
Degenerative changes. Such changes can be caused by disruption of blood supply to the surrounding tissues.
Rheumatic diseases. In this case, the direct cause of the development of the disease is toxic reactive inflammation.
Presence of infection. There may be specific tendovaginitis, which occurs with tuberculosis, syphilis, gonorrhea and other diseases. In this case, the infection enters the synovial sheath of the tendon of the hand with blood flow. A nonspecific form of the disease develops if there is a source of purulent infection nearby. For example, this may be due to purulent arthritis, panaricia, or osteomyelitis.

The main factors provoking the disease:

Infections.
Penetration of pyogenic microflora into the joint.
Rheumatism, rheumatoid arthritis.
Tuberculosis, syphilis.
Violation of tissue trophism (varicose veins).
Increased load on the joint.
Bruises.
Monotonous work with the hand (due to the nature of the profession).

Tenosynovitis of the wrist joint can occur independently or manifest itself as a complication of various diseases. Almost any inflammatory process in the body can give rise to the development of tenosynovitis if, with minor damage, the infection penetrates into the joint.

The cause of tenosynovitis can be wounds or purulent diseases of the surrounding tissues, through which pyogenic microbes penetrate into the tendon sheaths. But sometimes the infection is not involved in the disease; the cause may be frequent stress on the tendons.

Tenosynovitis of the hand most often occurs in musicians, computer scientists, etc. The disease often manifests itself during active tennis. Tenosynovitis can also occur as a result of a person receiving a serious injury.

The disease can be primary or secondary (infectious). Secondary tendovaginitis can be a consequence of an inflammatory infectious process in the body, but this happens very rarely. The most common type is stenosing tenosynovitis (non-infectious, professional).

Another cause of tenosynovitis can be varicose veins, which manifests itself as a result of degenerative changes in the synovium of the tendon sheath.

Symptoms

Infectious tenosynovitis occurs as a result of infection entering the tendon sheath due to wounds and microtraumas, purulent inflammation of surrounding tissues. Infectious tendovaginitis (nonspecific purulent tendovaginitis or specific - tuberculosis, brucellosis) is quite rare.

In the case of the development of an independent disease before the onset of the acute period, the incubation period of the course may be minimal (2 - 3 hours). Although in most cases the subacute course is preceded by pronounced crepitus (crunching in the affected area), to which the patient often does not pay attention.

After the crunch, a painful swelling occurs at the site of the lesion and weakness in the limb with the inability to continue with the usual work or sports activities, which is what they usually come for the first examination with.

Infectious tenosynovitis is characterized by a sharp rush of blood to the lesion and a subacute course of the inflammatory process. A painful swelling forms against the background of general inflammation, expressed by chills and increased body temperature.

If the treatment of tenosynovitis is not implemented in a timely manner, this symptomatology is added to the reduction of the fingers of the limbs and severe convulsive syndrome. In the most complex and advanced cases, compression of blood vessels and necrosis of adjacent tissues is possible, followed by the development of septic infection.

Sharp pain, sharply intensifying with the slightest movement, swelling along the tendon, fever. With tenosynovitis from overload, the pain is not sharp, movements are painful, accompanied by the sensation of crunching or creaking (cretting tenosynovitis), the general condition of the patient is not disturbed.

However, without proper treatment, this tendovaginitis can lead to persistent limitation of movement or become chronic. When talking about the signs of this disease, it is necessary to distinguish between the symptoms of aseptic and infectious processes. It is also necessary to distinguish between symptoms of acute and chronic inflammation.

Symptoms of aseptic tendovaginitis The acute process develops most often after prolonged stress on the hand (for example, associated with intensive work at the computer).

The onset of such tendovaginitis is acute, and the following symptoms may be observed:

swelling in the affected area (most often from the back surface of the hand);
movements in the joints of the hand become sharply limited;
a noticeable crunch appears in the area of the affected tendon; redness of the hand at the site of the affected tendon;
There may be periodically occurring pain of a nagging nature;
cramps of the limb, as well as contraction of the affected area (typical for the sub-acute period).

This disease can affect a wide variety of tendon sheaths, among which the hand is often affected. Some differences in symptoms may occur with traumatic injury tendovaginitis. In this case, pain and swelling at the site of injury come first. The chronic form of the disease may be the result of an acute process.

In this case, the following characteristic symptoms can be identified:

pain is felt only during movement or upon palpation of the affected tendon;
there may be a crunch when moving;
There is no swelling at the site of the lesion.

Symptoms of infectious tendovaginitis

Acute nonspecific tendovaginitis manifests itself with the following symptoms:

severe hyperemia and swelling of the affected area;
movements in the hand cause severe pain;
there are signs of general intoxication - increased temperature, weakness.

Acute specific tendovaginitis is characterized by almost the same symptoms as nonspecific. The only difference is the presence of an underlying disease, which makes diagnosis easier for the doctor.

Chronic tendovaginitis is an occupational disease, since it primarily affects the hands (wrists, elbow joints). Symptoms of chronic tenosynovitis include pain when moving, poor joint mobility, a crunching or clicking sound when squeezing the hand, or when moving the wrist.

There are three forms of tendovaginitis - a mild form, or the initial one. This form is characterized by hyperemia (redness) of the synovial vagina with perivascular infiltrates in the outer layer; such symptoms are typical when the tendons of the hand, feet and fingers are affected.

In the exudative-serous form, a moderate amount of effusion accumulates in the synovial vagina and a small round swelling appears in this area; such symptoms are characteristic of the development of carpal tenosynovitis, as well as tenosynovitis of the peroneal muscles.

The form is chronic stenotic. The main symptom of this form is the “snapping finger” and stenosing tenosynovitis de Quervain et al.

Diagnostics

Before starting treatment for tendon tenosynovitis, it is necessary to differentiate the aseptic course from the infectious one. The initial examination involves visual diagnosis (the swelling is usually oblong) and palpation of the affected area (pain increases with palpation).

Subsequently, a test for crepitus is carried out. The final stage of recognition is the appointment of tests for the presence of the underlying disease. The diagnosis of tenosynovitis is based on the characteristic localization of the process and clinical examination data.

In case of doubt, if the symptoms are mild, the following examinations are performed:

Various tests using different movements to determine which tendon is affected.
X-ray of the diseased limb.
Computed tomography or MRI.
Clinical blood and urine tests.

Additionally, an examination by a neurologist may be necessary if injury to nerve endings is suspected.

Treatment

Treatment of tenosynovitis of the hand depends on the degree and course of the disease. In case of severe inflammation, surgical intervention is indicated, which consists of opening and sanitizing the vaginal cavity. With severely advanced inflammation, the tendon may melt and foci of necrosis will appear.

In this case, its resection is indicated. The finger is fixed in the optimal position for the functioning of the hand. This is followed by a course of antibiotics and rehabilitation treatment.

Self-massage gives good results. It begins with stroking above the affected area. Next, they do a few squeezes and move on to stroking again. Gradually, movements should approach the affected area.

Kneading is added to squeezing and stroking. Massaging the affected area should begin with light movements, gradually moving to stronger ones. Treatment of tenosynovitis of the hand can be quite lengthy. Treatment of acute tendovaginitis is divided into general and local.

General treatment

To treat acute infectious nonspecific tendovaginitis, the doctor prescribes drugs designed to fight the infection. For this purpose, it is recommended to take antibacterial agents, as well as drugs aimed at increasing the body's defenses.

Treatment of infectious tendovaginitis will depend on the underlying disease. If it is tuberculosis, then anti-tuberculosis drugs are prescribed. Direct Treatment of aseptic tendovaginitis involves taking NSAIDs - non-steroidal anti-inflammatory drugs. The doctor can prescribe the following drugs - butadione, indomethacin, etc.

Local treatment

Local therapy for both infectious and aseptic tendovaginitis at the initial stage should be limited to ensuring rest of the affected hand. The doctor may also prescribe warming compresses; in case of illness, periodically arising pain of a nagging nature may be noted.

If there is a purulent process, then opening the tendon sheath and its subsequent drainage is required. Also, local treatment will differ for specific tendovaginitis. For example, in case of tuberculous nature of the process, a solution of streptomycin can be administered locally.

At this stage, the doctor may recommend the following types of physiotherapeutic procedures:

ultrasound;
ultraviolet rays;
microwave therapy;
electrophoresis of novocaine and hydrocortisone.

Physiotherapy treatment will be somewhat different for chronic tendovaginitis.

In this case, the doctor may recommend the following procedures:

lidase electrophoresis;
massage;
ozokerite applications;
therapeutic physical education.

As you can see, tenosynovitis can be different both in its causes and in its clinical manifestations.

Therefore, his treatment should only be carried out by a specialist:

With infectious tendovaginitis, first of all, it is necessary to stop the development of the infectious process, for which various antibacterial agents are used, as well as drugs that strengthen the body's defenses.
For acute non-infectious tenosynovitis, non-steroidal anti-inflammatory drugs are used.
In case of a purulent process, an urgent opening and drainage of the tendon sheath is performed to remove purulent exudate. It is necessary to ensure rest and fixation of the limb.

After the acute effects of tendovaginitis subside, warm compresses, physiotherapeutic procedures (microwave therapy, ultrasound, UHF, ultraviolet rays) and physical therapy are prescribed.

At this stage of treatment of tenosynovitis, the use of a modern innovative drug is effective - the therapeutic pain-relieving anti-inflammatory patch NANOPLAST forte.

A course of use of NANOPLAST forte in the treatment of tenosynovitis allows you to reduce the dosage of anti-inflammatory and painkillers, provide deep heating of the affected area, reduce inflammation and speed up recovery.

Chronic tenosynovitis

In case of exacerbation of chronic tendovaginitis, rest and warming up are recommended first of all. If necessary, anti-inflammatory and painkillers are prescribed.

A course of use of the therapeutic anti-inflammatory patch NANOPLAST forte is effective and convenient in the treatment of chronic tendovaginitis. Gentle heat and the therapeutic effect of a magnetic field relieve inflammation and swelling during tendovaginitis, improve blood circulation in the affected area, and promote the restoration of damaged tissues.

Additional treatments:

Antibiotic therapy using general-spectrum drugs with a course of treatment of at least two weeks.
The use of non-steroidal drugs to relieve inflammatory processes. As a rule, hydrocortisone is prescribed, which can be supplemented with novocaine in the presence of pain.
Use of paraffin applications.
Massage the affected area. It is most effective in the treatment of tenosynovitis of the hands.
Physical therapy, which consists of a gradual increase in physical activity and its correct distribution.

In general, tendon tenosynovitis has a very favorable prognosis when treated. But it is important to start therapy on time and under the supervision of a qualified specialist.

Treatment of acute tenosynovitis

The affected limb must be provided with maximum rest. For this purpose, a plaster splint is applied for a period of up to 10 days. Novocaine and, in some cases, hydrocortisone and hyaluronidase are administered locally. When acute symptoms subside, thermal (compresses, paraffin, ointments) and physiotherapeutic procedures are prescribed.

For nonspecific infectious tendovaginitis, antibacterial drugs, vitamins, restorative therapy, and painkillers are prescribed. If necessary, surgical treatment is used.

What to do if you cannot see a doctor right away? First of all, it is necessary to provide rest to the sore limb using a splint. To do this, you can use a ruler, cardboard, or small board. It must be applied so that at least two joints are fixed.

When the acute period has passed, the pain has decreased, and you have removed the splint, they are treated with warm compresses and ointments. Can tendovaginitis be treated with folk remedies or not? In order not to overlook the infectious form of the disease, be sure to first consult with a specialist.

After all, the infectious form of the disease can turn into purulent inflammation and end with a surgical operation. In some cases, for example, with crepitant tenosynovitis, treatment with folk remedies is used successfully.

Treatment with folk remedies

There are situations when the question arises of how to treat tenosynovitis without the use of drugs. If you have drug intolerance or allergies to antibacterial drugs, you have to turn to medicinal plants. Traditional medicine recommends treatment for tendovaginitis with folk remedies in the form of herbal infusions, decoctions, ointments, and compresses.

Here are some recipes:

Treatment of tendovaginitis with calendula ointment. To prepare the ointment, take equal amounts of dried calendula flowers and baby cream and mix well. The ointment is applied to the affected surface and, covered with a bandage, left overnight. Has anti-inflammatory and antimicrobial effects.
Treatment of tenosynovitis with wormwood tincture. Take two tablespoons of dry wormwood herb, leave for half an hour, adding 200 ml of boiling water. Then the infusion is filtered and given to drink a tablespoon before meals 2-3 times during the day. Has an anti-inflammatory and restorative effect.
Treatment of tenosynovitis using compresses and lotions with an infusion of shepherd's purse herb. The infusion is prepared by taking a tablespoon of herb per 200 ml of boiling water. Infuse in a thermos or in a water bath for 2 hours. Strain and apply as a local treatment in the form of overnight compresses or lotions.
Treatment of tenosynovitis with ointment made from wormwood and pork fat. Prepare an ointment by taking 30 g of dry wormwood per 100 g of lard. Everything is cooked over low heat, cooled, and applied to the sore spot.

Compresses with medical or bear bile for the treatment of tendovaginitis. The bile is heated in a water bath and a compress is made with it in the usual way on the sore spot. Keep it overnight. Bile has a resolving and anti-inflammatory effect.

For crepitant tenosynovitis, treatment with such compresses gives good results. There are remedies that can be taken internally, for example, a decoction of St. John's wort or chamomile. To prepare it, pour a tablespoon of herb with a glass of boiling water, let it brew and drink half a glass twice a day.

Arnica infusion or medicinal clay will help relieve pain. These products are also available in pharmacies.
To prevent the disease, try to avoid overwork during work, injuries and tendon strains.

During this time, treat wounds and cracks in the skin of the extremities, preventing the development of felons. At the first signs of tenosynovitis, try to consult a specialist to avoid possible purulent complications.

Prevention

The main preventive method is to monitor your overall health. It is necessary to identify and treat infectious diseases in a timely manner, and do not forget to periodically visit a doctor for routine examination.

If you feel that a job that involves physical labor, strain, or monotonous movements of your hands causes ongoing discomfort or pain, you may want to consider changing your profession to maintain your health.

Maintain your immune system and overall body tone, don’t forget about strengthening physical exercises, and give up bad habits. Prevention of the disease involves avoiding overwork during physical work, as well as injuries and various tendon sprains.

It is necessary to promptly treat all microtraumas of the skin of the extremities, prevent the development of felons, ensure constant cleanliness of the hands, and maintain personal hygiene. It is advisable not to do production processes manually, it is better to mechanize them, you need to rest for the required amount of time, take breaks during work (at least 5 minutes every hour), and do finger exercises.

At the first symptoms of tenosynovitis, you should consult a doctor to avoid possible complications. In the prevention of occupational tendovaginitis, a special mode of work with a clear schedule of short-term ones is important. Inflammation of the tendons: regular breaks for gymnastic exercises and light massages of tired areas.

After exercise, when you come home, it is recommended to take warm baths to relax your muscles. Before training, athletes should not forget about special exercises to stretch the tendons in those places that are most subject to stress. After training, it is good to apply ice compresses to strained tendons.

Prevention of tenosynovitis of the hand:

Mechanization of all production processes.
Compliance with the work and rest regime.
Introduction of micro-breaks in work (every 50-55 minutes there should be a break in work for 5-10 minutes).
Industrial gymnastics.
Proper organization of work.

Pauses in work are desirable (every 50-55 minutes, breaks in work for 5-10 minutes); after vacation, practice gradually increasing the load to full over 3-5 days. Wearing special bandages (“wristbands”) is recommended.

Source: "yalike.ru; nanoplast-forte.ru; vashortoped.com; narmed24.ru; artrozamnet.ru; sustavy-svyazki.ru; sustav.info; nanoplast-forte.ru; knigavracha.ru; osteocure.ru; medichelp .ru."

megan92 2 weeks ago

Tell me, how does anyone deal with joint pain? My knees hurt terribly ((I take painkillers, but I understand that I’m fighting the effect, not the cause... They don’t help at all!

Daria 2 weeks ago

I struggled with my painful joints for several years until I read this article by some Chinese doctor. And I forgot about “incurable” joints a long time ago. That's how things are

megan92 13 days ago

Daria 12 days ago

megan92, that’s what I wrote in my first comment) Well, I’ll duplicate it, it’s not difficult for me, catch it - link to professor's article.

Sonya 10 days ago

Isn't this a scam? Why do they sell on the Internet?

Yulek26 10 days ago

Sonya, what country do you live in?.. They sell it on the Internet because stores and pharmacies charge a brutal markup. In addition, payment is only after receipt, that is, they first looked, checked and only then paid. And now everything is sold on the Internet - from clothes to TVs, furniture and cars

Editor's response 10 days ago

Sonya, hello. This drug for the treatment of joints is indeed not sold through the pharmacy chain in order to avoid inflated prices. Currently you can only order from Official website. Be healthy!

Sonya 10 days ago

I apologize, I didn’t notice the information about cash on delivery at first. Then, it's OK! Everything is fine - for sure, if payment is made upon receipt. Thanks a lot!!))

Margo 8 days ago

Has anyone tried traditional methods of treating joints? Grandma doesn’t trust pills, the poor thing has been suffering from pain for many years...

Andrey A week ago

No matter what folk remedies I tried, nothing helped, it only got worse...

Ekaterina A week ago

I tried drinking a decoction of bay leaves, it didn’t do any good, I just ruined my stomach!! I no longer believe in these folk methods - complete nonsense!!

Maria 5 days ago

I recently watched a program on Channel One, it was also about this Federal program to combat joint diseases talked. It is also headed by some famous Chinese professor. They say that they have found a way to permanently cure joints and back, and the state fully finances the treatment for each patient

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