Tendinitis of the foot ICD 10. Tendinitis of the foot. Symptoms of foot tendonitis

Tendinitis- inflammation of the tendon tissue, usually observed at the point of attachment to the bone or in the area of ​​the muscle-tendon junction; usually combined with inflammation of the tendon bursa or tendon sheath.

Code according to the international classification of diseases ICD-10:

Causes

Etiology. Increased motor activity and microtrauma. Diseases of a rheumatic nature.. Rheumatoid arthritis.. Gout.. Reactive arthritis.

At-risk groups. Athletes. Manual workers.

Pathomorphology. Degenerative changes in tendons: presence of fibrinoid, mucoid or hyaline degeneration of connective tissue. Clinical picture

Pain.. With active movements made with the participation of the affected tendon, while similar passive movements are painless.. With palpation along the affected tendon.

Hyperemia, hyperthermia over the area of ​​the affected tendon.

Crepitus when the tendon moves, audible at a distance or only through a phonendoscope.

The most common localization.. Tendinitis of the rotator cuff, tendinitis of the biceps tendon (see Periarthrosis humeroscapular)... Lateral epicondylitis (tennis elbow) - tendinitis of the wrist extensor muscles (brachioradialis, extensor carpi radialis longus and brevis) ... Pain with palpation of the area of ​​the lateral epicondyle of the humerus... Thomsen's test: when the patient tries to hold the hand clenched into a fist in the position of dorsiflexion, it lowers, moving to the position of palmar flexion... Belsh's test: the patient is given the command to simultaneously extend and supinate both forearms located on chin level in a position of flexion and pronation, while the affected side lags behind the healthy one.. Medial epicondylitis (“golfer’s elbow”) is tendinitis of the flexor and pronator muscles of the forearm (pronator teres, flexor carpi radialis and ulnaris, palmaris longus). .. Pain on palpation of the area of ​​the medial epicondyle of the humerus... Pain when flexing and pronating the forearm, radiating along its inner edge... Concomitant neuropathy of the ulnar nerve (25-50% of patients) .. Stenosing tenosynovitis of the extensor brevis and abductor longus muscles finger of the hand (de Quervain's disease), accompanied by narrowing of the first canal of the dorsal ligament of the wrist... Pain when extending and abducting the thumb... Pain when palpating the styloid process of the radius... Elkin's test: pain when bringing the tip of the thumb together with the tips index finger and little finger.. Stenosing tenosynovitis of the extensor ulnaris (ulnar styloiditis) is accompanied by narrowing of the VI canal of the dorsal ligament of the wrist... Pain in the area of ​​the styloid process of the ulna... Swelling in the same area.. Tendonitis of the patellar ligament... Pain in the area of ​​the tibial tuberosity when walking, running, going down stairs... Swelling in the area of ​​the tibial tuberosity.. Tendinitis of the Achilles tendon and plantar tendons (talalgia)... Pain when stepping on the heel and when flexing the plantar... Local swelling - with concomitant achillobursitis and subcalcaneal bursitis.

Children and teenagers. The most common form is patellar tendonitis associated with inflammation of the tibial apophysis (Osgood-Schlatter disease).

Diagnostics

Research methods. Laboratory tests: changes are observed only with concomitant rheumatic pathology. X-ray examination.. Possible calcium deposits in the tendons.. Heel spurs - with tendonitis and tendobursitis of the Achilles tendon or plantar tendon.. With tendonitis of the patellar tendon, signs of aseptic necrosis of the tibial tuberosity (Osgood-Schlatter disease) are possible. Special studies.. Echography of the tendon - contraction of the tendon, changes in its structure. It is necessary to ensure that the ultrasound wave does not cross the tendon along the oblique diameter. CT/MRI is informative for identifying tendon ruptures, but is not very informative in diagnosing stenosing tenosynovitis.

Differential diagnosis. Tendon rupture. Bursitis (it should be remembered that it is often combined with tendonitis). Infectious tenosynovitis (usually on the arm; pain on palpation and swelling are located along the tendon sheath, and not at the point of attachment to the bone).

Treatment

Treatment. Management tactics... In the acute phase - rest, immobilization... Shoulder sling or splints for the upper extremities... Braces, cane and/or crutches for the lower extremities... Plasters tightly applied to the forearm slightly distal to the elbow joint - when epicondylitis.. Exercise therapy. Drug therapy... NSAIDs... Piroxicam 10 mg/day... Indomethacin 25 or 50 mg 3 times a day... Ibuprofen 1800-2400 mg/day... Ointments with NSAIDs, for example ibuprofen, 3 times a day. GC (injection into painful areas) ... 40 mg of methylprednisolone with 4-6 ml of 1-2% lidocaine solution... 1-20 mg of hydrocortisone with the same volume of 1-2% procaine solution. It is necessary to avoid insertion into the tendon sheath; in case of medial epicondylitis, the proximity of the ulnar nerve should be taken into account. After periarticular injections, despite a significant reduction in pain intensity, it is recommended to avoid physical activity due to the risk of tendon rupture. Surgical treatment - dissection of tendon aponeuroses, is used in the absence of the effect of conservative treatment, in the presence of signs of stenosing tendinitis, in Osgood-Schlatter disease.

Complication- tendon rupture.

Forecast favorable.

ICD-10 . M65.2 Calcific tendinitis. M75.2 Biceps tendonitis. M75.3 Calcific tendinitis of the shoulder. M76.0 Tendinitis of the gluteal muscles. M76.1 Tendinitis of the lumbar muscles. M76.5 Patellar tendonitis. M76.6 Tendinitis of the heel [Achilles] tendon. M76.7 Peroneal tendinitis. M77.9 Enthesopathy, unspecified

• Codes according to ICD 10

According to the latest 10th version of the international classification of diseases, the knee joint is affected by a large number of diseases, which are described in detail and presented according to special codes. The classification was developed with the aim of unifying medical statistics, which should truthfully reflect the level and frequency of morbidity in each individual region. A bruise or injury to the knee joint is coded under ICD 10 in its classification of injury.

Codes according to ICD 10

In the International Classification of Diseases, 10th revision (ICD-10), more than 66 codes are devoted to injuries and other pathological conditions of the knee joint, reflecting the category and name of each individual nosology.

The codes are arranged in specialized groups that allow you to find the category of the disease and determine the type of nosology.

Note, at present, not all doctors adhere to the clear ICD-10 classification, which affects statistics, disease prevention planning and the allocation of free medicines for the treatment of the most common ones.

Groups of knee joint diseases that can be found in ICD-10, including knee joint injuries:

• G57 – Damage to peripheral nerve endings (G57.3-G57.4). The codes characterize the dysfunction of the lateral and median popliteal nerve. Often this pathology occurs with a severe bruise or fracture of the knee. We should not exclude tumor formations that block the work of nerve cells at the site of their development.

M17 – Gonarthrosis or arthrosis of the knee joint (M17.0-M17.9). Classification codes reflect the clinical picture of the disease (bilateral or unilateral disease), as well as the etiological cause of the pathological condition. Code M17.3 characterizes post-traumatic gonarthrosis, the cause of which may be a bruise of the knee joint.

• M22 - Lesions of the patella. It is known that damage to the patella occurs when force is directly applied to the sesamoid bone. In cases of subluxation or dislocation of the patella, there may be an indirect application of force (asynchronous contraction of the muscles of the anterior surface of the thigh). In any case, damage to the patella is impossible without bruising the knee, since the inflammatory process cannot be localized exclusively in front of the joint. Codes M22.0-M22.9 classify damage to the patella according to the cause, extent of the process and other features of inflammation of the patella.
• M23 – Intra-articular lesions of the knee. This category covers a variety of pathological processes occurring in the intra-articular bursa of the knee joint. M23.1-M23.3 – code for variants of meniscal lesions. M23.4 – presence of a free body in the joint cavity. In traumatology, this disease is called “articular mouse,” which is caused by a chronic inflammatory process of cartilage tissue. Also included in this category are complete and incomplete intra-articular comminuted fractures of the knee, because bone fragments with untimely and unqualified medical care can remain in the joint cavity and significantly reduce the quality of life. M23.5-M23.9 - codes describe all kinds of intra-articular lesions of the ligamentous apparatus of the knee.

M66 - Spontaneous rupture of the synovium and tendon. This category characterizes a violation of the integrity of soft anatomical structures due to impact, bruise or other reasons. Code M66.0 is classified as popliteal cyst rupture, and code M66.1 is classified as synovial rupture. Of course, a rare injury is characterized by a violation of the function and integrity of one anatomical structure, but in order to describe the patient’s condition in more detail, it is customary to consider each case separately.

• M70 - Diseases of soft tissues associated with load, overload and pressure. This category describes diseases associated with the inflammatory process of various etiologies in the knee joint and not only. M70.5 - Other bursitis of the knee joint. This code means any inflammatory processes formed in the joint capsule of the knee.
• M71 – Other bursopathies. In this category there is code M71.2 describing a synovial cyst of the popliteal region or Baker's cyst, which most often occurs after a bruise or other injury to the knee joint and its structures.

  Clinical picture of purulent inflammation of the knee joint...

  Why do knees shake and tremble in children and adults...

  How to get rid of goose bumps on the knees of adults and children...

• M76 - Enthesopathies of the lower limb, excluding the foot. In this category, the knee includes code M76.5 - Tendinitis of the patella region, which characterizes chronic and acute inflammation of the bursa and ligaments of the knee joint. The cause of this pathology is often an untreated inflammatory process resulting from a bruise, wound or other type of grass.
• Q74 - Other congenital anomalies (malformations) of the limb(s). The code for the knee in this category is Q74.1 - Congenital anomaly of the knee joint. Even if surgical intervention was performed to correct this pathology, the issue of removing the diagnosis is decided exclusively by the medical commission of category 1 medical institutions, the highest accreditation.

S80 - Superficial injury of the leg - hemarthrosis, hematoma, closed contusion. The most common category of traumatology. This category contains ICD 10 code S80.0 – Contusion of the knee joint. The coding does not provide an indication of the cause and duration of the disease; it only records the case and nature of the injury.

• S81 – Open wound of the leg. In this category there is a code S81.0 - Open wound of the knee joint, which may coincide with the presence of a contusion or fracture of the knee, but in this case indicates the primary pathology that led to the presence of other associated symptoms. For example, with an open wound of the knee joint there will be signs of a bruise, but they will be secondary, since the bruise is caused by a violation of the integrity of the skin of the knee itself.
• S83 Dislocation, sprain and damage to the capsular ligamentous apparatus of the knee joint. S83.0-S83.7 – code for any pathological conditions of the knee that are associated with a violation of the integrity and function of the anatomical formations of the knee joint.

According to the above data, as well as the pathogenetic features of the course of each of the diseases of the knee joint, we can say that they all occur with certain signs of bruise.

The doctor must correctly assess the patient’s current condition based on complaints, the patient’s medical and life history, objective examination data and the results of functional diagnostics. Without a full examination, it is impossible to make a correct final diagnosis.

Features of a knee joint injury

A knee joint bruise is an inflammatory process of the knee, accompanied by swelling, hyperemia and pain in the anatomical structures of the joint without compromising their integrity. The cause of this condition is most often a direct blow, a fall on the knee, or strong compression of the joint.

Symptoms of a knee injury:

1. Pain.
2. Swelling (relatively constant). If there is morning edema, it is necessary to exclude pathology of the kidneys, and evening edema - heart disease.
3. Impaired function. Often it is insignificant. It hurts to step on your foot with full weight or bend your knee as much as possible.
4. Hyperemia is mild, most often at the site of impact.

In every case of bruise of the knee joint, it is necessary to take an x-ray, which will allow you to correctly assess the condition of the joint and promptly identify possible complications. A knee joint bruise is treated within 14–21 days.

Tenosynovitis is a very severe disease of the tendon sheath (the sheath surrounding the tendon), which occurs with severe pain and pronounced inflammation.

Ineffective treatment and an advanced process of inflammation can provoke tendon necrosis and the spread of purulent inflammation throughout the body. Tenosynovitis can be caused by various injuries (bruises, injections, cuts), which lead to injury to the walls of the tendon sheaths located close to the surface. However, often the disease develops as a result of excessive stress on the tendon, and not as a result of infection. Such loads are often related to a person’s professional activity (milkmaids, pianists, machinists, etc.).

The disease can affect the hand, Achilles tendon, forearm, wrist, feet and ankle.

ICD-10 code

M65.2 Calcific tendinitis

M75.2 Biceps tendinitis

M75.3 Calcific tendinitis of the shoulder

M76.0 Gluteal tendinitis

M76.1 Lumbar tendinitis

M76.5 Patellar tendinitis

M76.6 Heel [Achilles] tendinitis

M76.7 Fibular tendonitis

Causes of tenosynovitis

Tenosynovitis can be either a separate, independently occurring disease or develop as a result of any complications after a general inflammatory process in the body.

In infectious diseases such as tuberculosis or syphilis, with a variety of minor injuries, the infection can penetrate into the tendon sheath, which leads to the development of various forms of tenosynovitis (purulent, nonspecific, tuberculous, brucellosis). In addition, infectious tenosynovitis can develop as a result of another inflammatory process in the body, for example, with rheumatism or rheumatoid arthritis.

Nonspecific tendovaginitis is widespread, which usually occurs after prolonged and heavy loads on the tendon. Quite often, nonspecific tendovaginitis occurs as a result of professional activities or hobbies that are associated with frequently repetitive movements. Tenosynovitis in this form is classified as an occupational disease. Post-traumatic tenosynovitis also occurs, which most often affects professional athletes, but sometimes develops as a result of domestic trauma.

Degenerative tenosynovitis directly depends on blood circulation in adjacent tissues. When blood flow is disrupted, for example, with varicose veins, a degenerative form of tendovaginitis develops, i.e. There is a change in the synoval membrane of the vagina.

Symptoms of tenosynovitis

In the acute form of tenosynovitis, severe swelling of the synoval membrane appears as a result of a rush of blood to the sore spot. A swelling appears at the site of tendon damage, which gives off severe pain when pressed or moved. In the acute course of the disease, finger movements are limited, a characteristic creaking sound occurs when pressing (crepitus), and pain. Limitation of movements in the acute form of tenosynovitis can be expressed in severe contraction of the fingers in an unnatural position.

As a rule, in an acute process, the tendons are affected only on the opposite palm or foot side; tenosynovitis in the acute form of the fingers is much less common. Usually this kind of inflammatory process develops into a chronic form. In acute cases of tenosynovitis, the forearm or lower leg may also become swollen. If a purulent form of the disease begins to develop, the patient’s condition worsens with fever (chills, temperature, inflammation of the lymph nodes, blood vessels). A serous or purulent filling forms in the synoval cavity, which presses on the place connecting the blood vessel to the tendon. As a result, tissue nutrition is disrupted and in the future this can cause necrosis.

Tenosynovitis of a chronic form is often caused by the performance of professional duties and appears as a result of frequent and severe stress on tendons and certain muscle groups; the disease can also be a consequence of ineffective or incorrect treatment of the acute form of tenosynovitis. The elbow joints and wrists are primarily affected. Chronic tenosynovitis is manifested by weak joint mobility, pain during sudden movements, a characteristic creaking sound or clicking sound when trying to squeeze the hand. Typically, the chronic form of tenosynovitis occurs in the sheath of the tendons responsible for flexion and extension of the fingers.

Crepitant tenosynovitis

Crepitant tendovaginitis is one of the most common occupational diseases. As a rule, the disease develops against the background of regular trauma to the tendons, muscles, and adjacent tissue due to frequently repeated monotonous movements of the fingers or toes.

The disease in most cases affects the extensor surface of the forearm (usually the right one), less often it occurs on the Achilles tendon and the anterior surface of the lower leg.

The disease is accompanied by swelling over the affected area, pain and a creaking sound similar to the crunching of snow. As a rule, the duration of the disease does not exceed 12-15 days; crepitant tenosynovitis may reappear and often progresses to the chronic stage.

Stenosing tenosynovitis

Stenosing tenosynovitis is an inflammation of the tendon-ligamentous apparatus of the hand. The most common cause of the disease is occupational injury. The disease progresses quite slowly; at first, painful sensations appear in the area of ​​the metacarpophalangeal joints. It is difficult to bend the finger, and this movement is often accompanied by a creaking sound (crepitus). You can also feel a dense formation along the tendons.

Purulent tenosynovitis

Purulent tenosynovitis usually develops as a primary disease, due to the entry of bacteria through microtrauma and damage. Less commonly observed is secondary tendovaginitis with the formation of purulent masses - as a rule, the tendon is affected as a result of the transition of purulent inflammation from adjacent tissues, for example, with phlegmon.

Typically, the causative agents of the purulent process in the tendon are E. coli bacteria, streptococci, staphylococci, and extremely rarely other types of bacteria. When bacteria enter the wall of the tendon sheath, swelling and suppuration appear, which prevents tissue nutrition, resulting in necrosis of the tendon.

With a secondary disease, usually purulent inflammation begins in the adjacent tissues, and only then spreads to the wall of the tendon sheath. As a rule, with purulent inflammation, the patient is worried about fever with high temperature and general weakness. With advanced forms of purulent tenosynovitis, the risk of developing sepsis (blood poisoning) increases.

Aseptic tenosynovitis

Aseptic tendovaginitis is non-infectious in nature, the disease occurs quite often, mainly in people who, by the nature of their professional activities, must perform monotonous movements for a long time, usually during such work only one group of muscles is used and as a result, due to overexertion, various microtraumas of the tendons and adjacent tissues the inflammatory process begins.

Tenosynovitis of the hand is often found in musicians, volleyball players, etc. Skiers, speed skaters and other professional athletes are more susceptible to foot damage. The aseptic form of tendovaginitis, which has developed into a chronic stage, can force a person to change profession.

The development of aseptic tenosynovitis in acute form can be caused by injury, and is often found in young athletes. Usually a person does not notice how he got injured, because during training he may not even notice a slight crunch in the wrist or foot. At the initial stage of the disease, the pain may not be severe, but over time it intensifies.

Acute tenosynovitis

Acute tenosynovitis usually occurs as a result of infection. In the acute course of the disease, severe pain in the affected tendon, swelling over the affected area, high temperature (the lymph nodes are often inflamed) are disturbing. The acute process usually develops on the back of the foot or palm. Quite often the swelling spreads to the lower leg or forearm.

In acute tenosynovitis, movements are constrained, sometimes complete immobility is observed. The patient's condition worsens over time: the temperature rises, chills appear, and pain intensifies.

Chronic tenosynovitis

Chronic tendovaginitis usually does not greatly affect the general condition of the patient. As a rule, with chronic tendovaginitis, the tendon sheaths of the extensor and flexor muscles of the fingers are affected, swelling appears, oscillating movements are felt when palpating, and the mobility of the tendons is limited.

The disease begins with the appearance of pain in the affected area (usually in the area of ​​the styloid process). A painful swelling appears along the tendons, finger movements are hampered by pain, stiffness, and the pain can radiate to the shoulder or forearm.

Tenosynovitis of the hands

Tenosynovitis of the hands is a fairly common disease, since it is the hands that bear the maximum load, they are most susceptible to injury and hypothermia, which provokes the disease. Typically, tenosynovitis of the hands affects people whose work involves frequently repeated movements that load only a certain group of muscles, as a result of which the tendons are injured and the inflammatory process begins.

Musicians often suffer from tenosynovitis of the hands; it is known that some famous musicians were forced to give up their favorite activity due to pain and become composers.

Tenosynovitis of the hand

As already mentioned, the hands are the most vulnerable organ. Frequent hypothermia, minor injuries, and excessive stress lead to inflammation of the tendon sheaths. Tenosynovitis of the hands is the most common pathological process that affects musicians, stenographers, typists, etc. In most cases, the disease is non-infectious and is associated with professional activities. Slightly less commonly, tenosynovitis of the hand develops as a result of infection.

Tenosynovitis of the forearm

The forearm (most often the back side) is usually affected by crepitant tenosynovitis. As a rule, the disease progresses quickly. In most cases, the disease begins with aching, increased fatigue of the hand, in some cases a burning sensation, numbness, and tingling appear. Many patients, even after the appearance of such symptoms, continue their normal work and after some time (usually after a few days, towards the evening) severe pain appears in the forearm and hand, while movements of the arm or hand increase the discomfort in the arm. Tenosynovitis in this case is associated with increased stress and fatigue of the arm muscles due to monotonous long-term movements.

In addition, the disease can develop as a result of bruises or injuries to the forearm.

If you do not spare a bruised hand, this can quickly lead to swelling, severe pain, and a creaking sound may appear. Usually a person independently notices the appearance of a swelling on the forearm, but does not pay attention to the appearance of a creaking sound.

But it is not even swelling, the appearance of a crunch or severe pain that forces a person to seek help from a specialist. Usually, when visiting a doctor, the patient complains of the inability to work fully due to arm weakness and increasing pain when moving. With crippling tenosynovitis, the swelling is oval in shape (resembles a sausage) and is concentrated on the back of the forearm, along the tendons.

Tenosynovitis of the finger

Tenosynovitis of the finger at the initial stage of development is quite difficult to recognize. The specialist makes a diagnosis based on examination, palpation, and medical history. There are several characteristic signs by which the development of tenosynovitis can be determined:

• swelling of the finger, swelling on the back of the hand;
• pain when pressing with a probe along the tendons;
• severe pain when trying to move a finger.

All these signs can appear either individually or all together at the same time (with tenosynovitis in a purulent form).

A purulent infection can quickly spread, resulting in excruciating pain, due to which a person cannot sleep or work normally, the patient keeps his finger in a half-bent position. The swelling spreads to the back of the hand, and when trying to straighten the finger, a sharp pain is felt. Against the background of inflammation, the temperature may rise, the lymph nodes may become inflamed, and the person takes a position in which he unconsciously tries to protect the sore arm.

Diagnosis of the disease can be helped by radiography, which reveals a thickening in the tendon with clear (less often wavy) contours.

Tenosynovitis of the wrist

Tenosynovitis develops on the dorsal ligament. The disease affects the tendon that is responsible for straightening the thumb. A typical sign is pain above the wrist at the base of the thumb. Over time, the pain intensifies with movement and calms down a little when the arm relaxes and rests.

Tenosynovitis of the wrist joint

Tenosynovitis of the wrist joint manifests itself, as in other cases, with pain during movement of the wrist and thumb. With this disease, the tendon responsible for the thumb is affected, and the affected tendon often thickens. Often pain from the wrist radiates to the forearm and even shoulder.

The most common reason for the development of tenosynovitis in the wrist canal is tiresome repetitive movements of the hands, often accompanied by injuries and damage. Infection can also trigger inflammation of the tendons.

Women are more susceptible to tenosynovitis of the wrist joint, and there is a connection between the disease and excess weight.

It is noted that women of short stature are more prone to developing tenosynovitis. Heredity also plays a significant role in the development of the disease.

A characteristic feature of tenosynovitis of the wrist joint is that the disease is expressed not only by severe pain, but also by numbness or tingling, which is associated with compression of the median nerve. Many patients are bothered by “unruly” hands and numbness. A tingling sensation appears on the surface of the hand, usually in the area of ​​the index, middle and thumb; in rare cases, tingling occurs in the ring finger. Often the tingling is accompanied by a burning pain that can radiate to the forearm. With tenosynovitis of the wrist joint, the pain becomes worse at night, and the person may experience temporary relief by rubbing or shaking the hand.

Tenosynovitis of the shoulder joint

Tenosynovitis of the shoulder joint is manifested by dull pain in the shoulder area. When palpated, pain appears. Most often, damage to the shoulder joint occurs in carpenters, blacksmiths, ironers, grinders, etc. The disease usually lasts 2-3 weeks and occurs in the subacute phase. With tenosynovitis, the pain has a burning character; when the muscles are tense (during work), the pain can intensify many times, swelling and a creaking sound often appear.

Tenosynovitis of the elbow joint

Tenosynovitis of the elbow joint is quite rare. Basically, the disease develops as a result of injury or damage. As in other cases of the development of tenosynovitis, the disease occurs with pronounced pain in the area of ​​the affected joints, swelling, and creaking. Usually, at rest, the joint does not cause the patient any particular discomfort, but when moving, the pain can be quite sharp and severe, which leads to forced immobilization.

Tenosynovitis of the digital flexors

Tenosynovitis of the finger flexors is expressed in damage to the tendon-ligamentous apparatus of the hand. In this case, there is pinching of the tendons that are responsible for flexion and extension of the fingers. The disease occurs most often in women. Typically, the development of the disease is related to professional activities associated with manual labor. In childhood, the disease can be noticed between the ages of 1 and 3 years. Most often, it is the thumb that is affected, although pinching of the tendons on other fingers also occurs.

Tenosynovitis of the foot

Tenosynovitis of the foot manifests itself in the form of pain along the tendons, and the pain intensifies when moving the foot. Along with the pain, redness and swelling appear. With infectious tendovaginitis, fever appears and general health deteriorates.

Tenosynovitis of the Achilles tendon

Tenosynovitis of the Achilles tendon develops mainly after increased stress on the Achilles tendon or calf muscles. The disease especially often affects cyclists, both professional and amateur, long-distance runners, etc. A sign of the disease is thickening of the Achilles tendon, pain when moving the foot, swelling, and when you palpate the tendon, you can feel a characteristic creaking sound.

Tenosynovitis of the ankle joint

Tenosynovitis of the ankle joint develops mainly in those who experience frequent and severe stress on the legs. Tenosynovitis often develops in military personnel after long marches. Athletes (skaters, skiers), ballet dancers, etc. also often suffer from ankle tendovaginitis. In addition to professional tendovaginitis, the disease develops after prolonged hard work.

In addition to external factors, tenosynovitis can develop due to a congenital abnormality of the foot (clubfoot, flatfoot).

Tenosynovitis of the knee joint

As in other cases, tenosynovitis of the knee joint develops as a result of prolonged physical stress on the joint, anatomically incorrect structure of the body, poor posture, and also as a result of infection.

The disease, as a rule, affects people whose lifestyle is associated with increased physical activity or who, due to the nature of their professional activities, are forced to remain in one position for a long time (often in an uncomfortable position). Patellar tenosynovitis is widespread among basketball players, volleyball players, etc., since frequent jumping leads to injury to the knee joint.

The classic symptoms of the development of tenosynovitis are the appearance of pain in the affected area, which becomes stronger over time (with the development of the inflammatory process). The pain may increase with physical activity and depend on the weather. In addition to pain, there is limited movement of the limb; when palpating, there is pain, sometimes creaking, and you can also feel a tendon knot that has formed. The affected area becomes red and swollen.

Tenosynovitis of the lower leg

Symptoms of tendovaginitis do not appear immediately, but several days after the inflammation process begins. Tenosynovitis of the lower leg develops, as in other cases, with increased load on the lower leg or infection, as well as in the case of abnormal development of the foot. On an x-ray, you can see a lump at the site of the affected tendon.

Tenosynovitis of the thigh

Quite often, hip tenosynovitis is caused by various injuries, overloads of tendons and muscles. Women are more susceptible to the disease, unlike men. The disease occurs as a result of overload of the legs, after a long or unusual walking, running, or after carrying heavy objects. In some cases, the disease develops as a result of injury.

Tenosynovitis de Quervain

De Quervain's tenosynovitis occurs with severe inflammation of the wrist ligaments, which is characterized by inflammation, pain, and limited movement. Many years ago, the disease was called "washerwoman's disease" because it mainly affected women who had to wash large amounts of laundry by hand every day, but after 1895 it was named after the surgeon Fritz de Quervain, who first described the symptoms.

De Quervain's tenosynovitis is characterized by soreness of the tendons on the back of the wrist; when inflamed, the walls of the tendon sheath thicken, which can cause a narrowing of the canal. Inflammation can cause the tendons to stick together. Women develop the disease eight times more often than men; as a rule, women over 30 years of age are affected.

Inflammation can be triggered by some injuries to the first canal of the dorsal ligament, for example, after various injuries to the radius. The disease can be triggered by frequent inflammation, injury, and muscle strain (especially caused by strenuous work involving one muscle group). However, for the most part, it is not possible to establish the exact causes of the disease.

Tenosynovitis is manifested by pain along the radial nerve, which can intensify with tension or movement (most often when trying to forcefully grab something). A painful swelling appears above the first canal of the dorsal carpal ligament.

Diagnosis of tenosynovitis

Based on the examination (palpation, induration, pain, stiffness of movement) and the characteristic localization of inflammation, the specialist will be able to diagnose tenosynovitis. Radiography will allow you to distinguish tenosynovitis from arthritis and osteomyelitis, in which changes in bones and joints are observed in the image.

Ligamentography (x-ray with contrast agent of ligaments and tendons) is prescribed to exclude stenosing ligamentitis. In addition, the specialist must exclude general diseases that can provoke tenosynovitis (brucellosis, tuberculosis).

Treatment of tendovaginitis

The main principle of successful treatment of tendovaginitis is timely qualified assistance and effective treatment. First of all, it is necessary to create rest for the diseased limb; in some cases, the doctor may consider it necessary to apply a plaster cast or a tight bandage.

Experts suggest several stages of treatment for tendovaginitis, first of all, the patient is released from work, he is injected with novocaine (to relieve severe pain) and, if necessary, a plaster is applied.

After 2-3 days, if the patient continues to suffer from pain, the blockade with novocaine can be repeated. After a few more days, warm compresses, heating, and UHF therapy are prescribed. As a rule, 4–6 paraffin applications are required for effective treatment. Over time, the passive load on the affected limb is increased, after which the plaster is removed and movement is increased. If after the completed course of treatment all unpleasant symptoms disappear, the patient is discharged, and a recommendation is given to do light work for a while.

Which doctor treats tenosynovitis?

If there is a suspicion of tenosynovitis (pain, swelling, redness over the sore spot begins to bother you), then you need to consult a rheumatologist, who, after the first examination, will prescribe the necessary tests and additional examination.

Treatment with folk remedies

Tenosynovitis can be treated in combination with traditional medicine methods, which will increase the effectiveness of treatment. Folk remedies should always be used as adjuvant therapy. Before starting treatment, it is better to consult a specialist to rule out other diseases with similar symptoms.

Treatment with traditional medicine is mainly local, using lotions, ointments, and compresses. An ointment made from calendula flowers helps cure inflammation of the tendons. Which you can prepare yourself. To do this you will need calendula flowers, which can be purchased at the pharmacy. A tablespoon of dried flowers must be thoroughly crushed to form a powder (you can use a coffee grinder), which is mixed with a tablespoon of base. You can use Vaseline or any baby cream as a base. Let the mixture brew for several hours, after which it can be used as an ointment or compress. It is best to apply the ointment before bed.

Tincture of chamomile, St. John's wort or calendula has good anti-inflammatory properties. For cooking you will need 1 tbsp. a spoonful of dried chamomile or St. John's wort flowers; if you use calendula, you will need 1 teaspoon. Pour a glass of boiling water over the herb and leave for half an hour. Then the tincture is filtered and consumed orally, half a glass for two weeks.

Treatment at home

Treatment of tenosynovitis at home will help increase the effectiveness of traditional treatment, help remove inflammation and speed up the healing process.

A fairly effective treatment for tenosynovitis is Rosenthal paste, which can be purchased at a pharmacy. The paste contains 10g of wine alcohol, 80g of chloroform, 15g of paraffin and 0.3g of iodine. Before use, the ointment must be warmed up a little (until it feels pleasant to the body), then the product is applied to the affected area, after hardening, cotton wool is applied on top and everything is fixed with a bandage. It is better to apply the paste before bed. Before using any folk remedy, it is better to consult a specialist to avoid possible complications.

Treatment with ointments

Tenosynovitis in any form is treated with medications, which are used depending on the causes of the disease and the complexity of the inflammatory process. Most often, anti-inflammatory drugs, compresses, ointments are used, and in some cases antibiotics are required. In almost any type of tenosynovitis, the affected limb must be provided with complete rest.

As a rule, for tendovaginitis, anti-inflammatory and analgesic ointments are prescribed. Also, effective assistance to traditional methods of treatment can be provided with the help of an ointment prepared independently. To do this, you need to mix 100g of pork fat and 30g of wormwood herb well, then let it simmer for a few minutes over low heat. After the ointment has completely cooled, it can be used. The ointment is applied in a thin layer to the affected area; the top can be covered with a napkin and secured with a bandage.

Treatment of crepitating tenosynovitis

If crepitating tenosynovitis is suspected, it is necessary to completely stop any load on the injured limb in order to avoid involuntary movements; a tight bandage (plaster) is applied for 6-7 days. After this, warm compresses and anti-inflammatory drugs are prescribed.

It is necessary to return to work after the swelling and crunching in the affected tendon has completely subsided.

Treatment of crepitating tenosynovitis of the hand

Tenosynovitis of the hand is treated successfully by modern medicine in the vast majority of cases. The main principle of effective treatment is timely recognition of the diagnosis and appropriate therapy. For crepitating tenosynovitis of the hand, physiotherapeutic procedures are indicated, which are highly effective in the early stages of the disease; in addition, the patient is prescribed maximum rest and fixation of the affected limb.

Before prescribing treatment, it is necessary to determine the cause of the disease (trauma, regular physical activity, infection). If bacteria enter the tendon, the doctor will prescribe a course of antibiotic therapy. If the inflammation process has gone far enough, suppuration has begun, surgical intervention is necessary. The danger of purulent tenosynovitis is that pus can break into adjacent tissues (bones, joints, circulatory systems), which threatens sepsis (blood poisoning).

Treatment of wrist tenosynovitis

Effective treatment of tenosynovitis depends on the cause of the disease. If the inflammatory process in the tendon began as a result of a general illness (rheumatism, tuberculosis, etc.), first of all, treatment is aimed at the underlying disease.

For severe pain in the wrist, a plaster splint is applied, which fixes the hand in one position, providing maximum rest to the sore tendons. After this, drug treatment and physical procedures are prescribed; as a rule, there is no need for hospitalization of the patient. If the process of inflammation in the tendons has gone too far, pus has appeared, and the tendons have fused together, then the patient is referred for surgical treatment.

Treatment of tendon tenosynovitis

Tendonitis in acute form is treated using local and general procedures. If the disease is nonspecific, then treatment is aimed at fighting the infection in the body (antibacterial agents, immunostimulants).

For tendovaginitis that occurs against the background of tuberculosis, specific anti-tuberculosis therapy is used.

For non-infectious tendovaginitis, anti-inflammatory drugs (butadione) are used.

Local treatment for any form of tendovaginitis consists of applying a plaster splint and warm compresses. After the inflammation of the tendons begins to subside, a number of physiotherapeutic procedures (UHF, ultraviolet, ultrasound, etc.), as well as therapeutic exercises, are prescribed.

If the inflammation process has acquired a purulent form, the affected tendon sheath must be opened and cleaned of accumulations of pus as early as possible.

The chronic form of tenosynovitis, in addition to all of the above treatment methods, includes paraffin or mud compresses, massage, and electrophoresis. If, with chronic tendovaginitis, an increase in the infectious process is observed, then a puncture is taken from the synovial vagina for detailed examination in the laboratory. Also, a targeted antibiotic is injected into the tendon sheath, and the patient is prescribed anti-inflammatory therapy. To reduce pain, a novocaine blockade is injected into the tendon. If the chronic process continues to progress, then a x-ray therapy session is prescribed.

Treatment of tenosynovitis of the wrist joint

With a disease such as tenosynovitis of the wrist joint, the patient’s hand first of all needs complete rest; it is best to apply a tight bandage or plaster to immobilize the diseased tendons as much as possible. Blockades with novocaine, Kenalog, etc. have a good effect, quite quickly relieving severe pain. Anti-inflammatory drugs (Voltaren, Nimesil, etc.) and physiotherapeutic procedures are also used.

Treatment of tendovaginitis of the forearm

As with other types of tendovaginitis, it is necessary to create all conditions for maximum rest of the patient’s hand. A tendon blockade with painkillers may also be prescribed; if the pain does not go away, it is recommended to repeat the procedure after a few days. After 3-5 days from the start of treatment, warming compresses can be used; if necessary, the doctor can supplement them with special physiotherapy procedures (paraffin baths, UHF). After a week, when the fixing bandage or plaster is removed, the doctor may allow short-term soft movements of the fingers; over time, the load on the hand must be increased. With proper treatment, recovery occurs after 10-15 days, but for about two more weeks the patient is advised to protect the arm from heavy loads and engage in light work.

Treatment of tenosynovitis of the foot

In the early stages of the disease, antibacterial therapy in combination with physiotherapy is quite sufficient. Purulent tendovaginitis is treated promptly by opening the abscess and cleansing (such treatment is necessary to prevent fistulas and breakthrough of pus into adjacent tissues).

Immediately after diagnosis, the foot should be tightly fixed (plaster, elastic bandage, tight bandage, etc.). To reduce inflammation in the tendons, anti-inflammatory therapy (reopirin) is prescribed. Compresses with dimexide and electropheresis with novocaine also have a good therapeutic effect. A blockade with hydrokartisone helps relieve pain; after the pain subsides, you can apply a compress with ozokerite. After 7-10 days from the start of treatment, the doctor may prescribe therapeutic exercises, during which the load on the foot will increase over time.

Treatment of ankle tenosynovitis

Tenosynovitis of the ankle joint, like other types of disease, is expressed by severe pain at the site of tendon damage. Treatment of the inflammatory process in the tendon consists of providing rest, anti-inflammatory, antibacterial therapy; over time, special gymnastics is added to the treatment, aimed at restoring the functionality of the tendons, muscles and joints.

Treatment of tendovaginitis does not always occur in a hospital setting. In the early stages of the disease, treatment can be carried out at home. You should not self-medicate, since tenosynovitis can acquire a purulent form, which can provoke a general infection of the body. Traditional methods of treatment are good to use as adjuncts to traditional medicine to speed up the healing process.

Treatment of tendovaginitis of the Achilles tendon

If the Achilles tendon is inflamed, the foot must be given maximum rest. In some cases, a soft insert placed under the heel can help reduce pain. For severe pain, a specialist may prescribe nonsteroidal anti-inflammatory drugs and physical therapy. If the pain does not subside, then a plaster splint is applied to the foot for 10-15 days. It is extremely rare that there is a need for surgical treatment of tendons.

Experts recommend that athletes who regularly exercise their feet (runners, skaters, etc.) do special stretching exercises for the tendons, and after training, apply an ice compress to the Achilles tendon for a while.

Prevention of tenosynovitis

Infectious tenosynovitis can be prevented by maintaining personal hygiene and promptly disinfecting various skin lesions. For severe or open wounds, it is best to apply an antiseptic bandage to prevent bacteria from entering.

To prevent occupational tendovaginitis, it is necessary to take regular breaks from work; at the end of the working day, it is good to massage the legs, forearms, and hands. Warm baths for hands and feet are also very relaxing.

Prognosis of tenosynovitis

In most cases, if tenosynovitis is detected at an early stage and timely and effective treatment is prescribed, the prognosis is favorable. After about two weeks from the onset of the disease, recovery occurs, and after another two weeks the person becomes fully able to work. However, if a person’s activity is associated with regular stress or injury, then the likelihood that the disease will return and be chronic is quite high.

If tenosynovitis proceeded in a purulent form, and the tendon was opened surgically, then there is a high risk that the functions of the foot or hand will be impaired.

Tenosynovitis is a fairly severe inflammatory disease that affects the tendon sheath. Progression of the disease can lead to serious complications (suppuration, fusion or necrosis of tendons, sepsis, etc.).

ICD 10 code

ICD stands for international classification of diseases and is a special document that is used to assess the general health of the population, in medicine, and epidemiology. This reference book is necessary for monitoring and monitoring diseases and their prevalence, as well as a number of other health-related problems. Every ten years the document is subject to revision.

In modern medicine, the tenth revision classifier (ICD 10) is in effect.

Tenosynovitis in ICD 10 is coded M 65.2 (calcific tendonitis).

Striated muscles have a formation at the end that serves as an attachment for the muscle to the skeletal bones. This structure is based on collagen fibers interspersed with rows of fibrocytes that form tendons.

As a result of traumatic or other impact, this tissue can become inflamed - most often this occurs in the area of ​​​​the transition from tendon to muscle or in the immediate place of attachment of muscle to bone.

Essentially, joint tendonitis is an acute or chronic inflammation of the tendon, which can also affect the tendon bursa or tendon sheath. Inflammation of the entire tendon rarely spreads; as a rule, this indicates an advanced chronic process, when degenerative processes have the greatest impact.

This disease, depending on the etiology and location, may have an ICD 10 code M65, 75, 76, 77.

The causes of tendonitis are excessive physical activity, which can be either one-time or regular. As a result, the tendon fibers receive micro-tears. Most often, professional athletes and people engaged in monotonous physical labor are susceptible to the disease.

Tendinitis can be recognized by painful physical activity, increased temperature in the affected area combined with hyperemia, as well as slight swelling of the soft tissues.

If tendonitis has acquired the character of a chronic disease, then stopping exacerbations will be an important area of ​​treatment. Treatment can include both medication and surgery.

Symptoms of tendinitis

Tendons are attached in close proximity to the joint. Therefore, when the tendon becomes inflamed, pain will be felt near the joint, which often makes a person think that the problem lies in the joint. Regardless of location, all tendonitis will have the following symptoms:

• At rest, the tendon does not bother you, but as soon as you start moving the affected limb, pain will immediately manifest itself. In addition, the affected tendon will respond painfully to palpation.
• When touched, the skin over the affected area may be red and feel warmer to the touch in the localized area.
• If you listen or use a phonendoscope, the tendon will make a characteristic crunching sound when active.

Depending on the location, each type of tendinitis will have its own specific characteristics.

Tendonitis is characterized by a gradual onset of symptoms. This may result in an increase in pain.
Initially, tendon soreness manifests itself exclusively in peak load situations and most patients do not attach any importance to this, maintaining their usual mode of activity.

During development, pain syndromes become more pronounced and the degree of stress gradually weakens to feel them. The patient begins to experience discomfort in everyday activities. A mild swelling of the soft tissue may form at the site of the lesion.

Types of disease

The inflammatory process of the tendon varies depending on the location. In each case, characteristic features of tendinitis can be identified.

Achilles tendonitis

When the heel tendon becomes inflamed, it is called Achilles tendonitis. Occurs due to poor quality metabolism and impaired tissue conductivity.

When the tendon tissue begins to crack and then scar, the preconditions for the formation of tendonitis gradually develop. Ultimately, it is even possible for the tendon to separate from the heel bone. In addition to the tendon itself, the adjacent tissues of the articular apparatus may be involved in the inflammatory process.

There are cases when the cause of the development of the disease lies in an imbalance of substances that cause the deposition of calcium salts in the tendon tissues. Ultimately, there is a chance of developing a heel bump called plantar fasciitis.

Achilles tendinitis can develop over several months. May manifest itself when going up and down stairs or an inclined plane. The pain is felt after sleep and does not go away after warm-up exercises. Soreness appears after sleep. The patient cannot rise to his toes, which clearly indicates a tendon injury.

Shoulder tendonitis

Near the shoulder joint there are tendons that provide attachment for a large number of muscles, because to ensure such freedom of action, good support is needed.

If the loads and operating mode are not observed, the tendon of the rotator cuff, which includes the tendons of the supraspinatus, teres minor, subscapularis and infraspinatus muscles, is the first to suffer. The second most popular is tendinitis of the biceps brachii or biceps muscle. The supraspinatus is most often affected.

This problem is especially troubling for manual workers and athletes, because they have to immobilize the joint during the rehabilitation period. For those who are familiar with chronic tendonitis, it is very important to properly develop the affected tendons and prevent injury.

Men over 40 are also characterized by calcific tendinitis, which is based on metabolic disorders. Calcium salts trigger pathological degenerative processes in tissues. If left untreated, the processes spread to adjacent joint tissues and muscles. The muscles, subacromial bursa, and shoulder joint capsule suffer.

Knee tendinitis

Jumper's knee is also known as patellar tendonitis. It is this tendon that receives the maximum load during the pushing activity of an athlete. The quadriceps muscle experiences enormous load during jumping, which leads to regular microtrauma.

The disease develops slowly and tends to be chronic. If you do not pay attention and continue to load the knee, you end up with a serious inflammatory process.

Knee tendinitis in the initial stages is successfully treated with conservative methods and physiotherapy. However, in advanced cases it is necessary to perform surgical intervention when the inflamed or torn part of the tendon is excised. The operation is performed using small incisions endoscopically. Healing will require time and constant development of the knee joint, otherwise mobility may be limited.

This pathology is also called “pes anserine tendinitis” because of the shape of the tendon. Sometimes it can be found in adolescents and children, who, due to the immaturity of the ligamentous apparatus, are at risk of receiving a similar injury.

Inflammation of the tendons in the ankle area is a real scourge for athletes and women who prefer high heels.

Tendinitis of the ankle joint develops against the background of regular injuries - dislocations, subluxations, bruises.

During treatment, it is very important to fix the joint and give the limb complete rest. This can be problematic, since the ankle is under load from its own body weight. If it is necessary to completely immobilize a limb, not only splints, but also crutches can be used.

Overweight people will also be at risk. Firstly, this is an additional load on the ankle tendons, and secondly, it is often an incorrect metabolism, which provokes an acceleration of the destruction of the collagen fiber of the tendon.

Treatment of the ankle requires the use of all resources to speed up the rehabilitation of the limb. If surgical intervention is necessary, the joint will be developed and the tendons will be adapted.

In addition, we must not forget that in the foot, as in the hands, there is also a large number of tendons responsible for the work of the fingers and the shock-absorbing properties of the foot when walking. The inability to support in case of inflammation will also require prompt intervention from a doctor.

Tendinitis of the elbow joint

When tendonitis occurs, the elbow joint may show signs characteristic of other common diseases - osteoarthritis or polyarthritis. It is very important to correctly diagnose the problem. It is necessary to find out by palpating the tendon area whether there is tunnel syndrome, supination or valgus, varus syndrome. These are also inflammatory processes, but not related to this case.

Elbows are often subject to stress when playing sports, where it is necessary to constantly keep tense arms bent or when carrying heavy objects. In this situation, it is necessary to avoid overloading the tendons, otherwise you can get an unpleasant chronic problem.

Biceps tendinitis

The biceps or biceps muscle provides flexion of the arm at the elbow joint, as well as rotation of the forearm, that is, the movement of turning the arm with the palm up or down.

Tendonitis of the biceps brachii muscle develops due to excessive sports stress or heavy physical work. This pathology is common among those whose job functions require them to hold their arms above their heads - swimmers, throwers, tennis players.

Biceps tendinitis can develop from a fall on the top of the shoulder. When the adjacent ligamentous apparatus is destroyed, the joint may become hypermobile and begin to fall out, causing dislocations and subluxations.

A distinctive feature of the fingers is that there is no muscle tissue inside. There are muscles only in the hand. The tendons are thin and long; due to them, the fingers move freely and can perform various manipulations.

Today, a very common problem is inflammation of the finger flexors. This is due to the fact that the hands and fingers are constantly under tension when it is necessary to hold or type something. Large loads on the use of fine motor skills make this disease very common.

You should not neglect the problem, since the tendon is thin, and the destructive effect of the disease occurs on it much faster. It is necessary to study therapy as early as possible so as not to suffer in the future. This pathology is inherent in those who work a lot with their hands - from musicians to adjusters.

Tendinitis of the hip

Tendons are attached to the femur at both the knee and hip joints. This is a large bone and a lot of stress falls on its tendons.

If the femoral tendons are torn, the pain, as in most cases, will increase gradually. It is characteristic that if a person begins to perform simple warm-up exercises, the pain disappears, but as soon as an increased load is given, the pain returns in a much more serious form.

A person, subconsciously protecting the injured area, soon begins to limp, his gait frankly changes. Lameness develops gradually, intensifying. When performing hip abduction, flexion, or walking, crunching sounds may be heard.

The quadriceps tendon is often affected, but clicking may simply be an anatomical feature of the tendon when its attachment slips. Such phenomena occasionally occur when the fastener slips to the greater trochanter of the gluteus maximus tendon. Sometimes this feature occurs in young women and does not cause any problems.

Temporal tendinitis

The temporal tendon can become inflamed due to the strain that occurs in the jaw muscles due to an incorrect bite. The second reason is the habit of gnawing hard food - crackers, nuts. The symptoms that accompany this form of the disease often force you to contact a dentist or neurologist.

Tendinitis in the area of ​​the temporal joint causes headaches and toothaches; when talking, the gums may hurt, and the longer the need to speak, the more sensitive the pain. Patients complain of discomfort when eating.

This form of tendinitis is characterized by irradiation of pain to the temporal and occipital region, and neck. If the patient seeks help in a timely manner, then this form of the disease can be perfectly treated with conservative methods. Physiotherapy has a good effect.

Gluteal tendinitis

When the tendons of the gluteal muscles become inflamed, a person may experience difficulty moving and changing body position.

The dystrophic nature of the pathology is expressed in atrophy and severe weakness of the muscles of the buttocks. When moving, clicks are heard and the person is unable to move normally.

Treatment

Considering the nature of the occurrence and course of tendonitis, it is worth warning that treatment with all kinds of folk remedies in this case can be more likely to cause harm. Because a tendon rupture can be much more serious than you might imagine. In cases where avulsion occurs, the surgeon excises the inflamed part and applies sutures.

Ointments for tendinitis play a supporting role when it is necessary to use not only oral NSAIDs, but also to promote local healing of the tendon. You won't be able to heal tendinitis quickly at home. On average, treatment takes 6 weeks, and if an operation was performed to excise part of the tendon, then rehabilitation can take up to six months.

After the diagnosis, the doctor builds a scheme and determines how to treat tendonitis in a particular case. It should be noted that surgery is an extreme case; most often, such a disease responds well to drug treatment.

The scheme resembles the general algorithm for treating joints and connective tissues:

• The joint must be immobilized with a bandage, splint or elastic bandage.
• Analgesics are prescribed for pain relief. This allows the patient to relax and not experience discomfort. For the purpose of relaxation, after the acute phase has passed, massage is prescribed for tendonitis.
• Corticosteroids and non-steroidal anti-inflammatory drugs are used to relieve inflammation. The doctor will select one so that in your case the likelihood of side effects is zero.
• In parallel, physiotherapy with the administration of medicinal drugs can be used.
• Exercise therapy is another method of rehabilitation for tendonitis. Physical education helps strengthen muscles and ligaments, and at the same time activate blood circulation in the tendon area, providing nutrition to the connective tissue.
• If the tendon is inflamed due to infection, antibiotics will be prescribed. You should not be afraid of this; on the contrary, such therapy will protect nearby joints.

Surgery is indicated for severe inflammation, when it is necessary to clean the tendon.

The main task for preventing the disease is careful control of the load and avoidance of injuries. If the last condition fails, then it is necessary to take care of adequate medical care and methodical implementation of all rehabilitation conditions.

To avoid sprains and dislocations that could injure the tendons, athletes use elastic fixing bandages. This allows you to reduce the load and minimize the number of micro-tears in the tendon. Also, a diet to replenish collagen reserves helps restore the elasticity of the tendon body, which also prevents the likelihood of tearing and the development of inflammation.

Considering the length of the recovery period for tendonitis, it is quite normal to be meticulous and play it safe. Compliance with safety precautions will help maintain the health of not only joints, but tendons and ligaments.

Tendinitis of the foot is an inflammatory process in the tendon, when the process involves the plantar muscles and the posterior tibial muscle, which connects the tibia and fibula and holds the arch of the foot.

As a rule, it is accompanied by painful sensations during active sports, walking, jumping and when lifting heavy loads.

ICD-10 code

M76.6 Heel [Achilles] tendinitis

Causes of foot tendinitis

Tendinitis often occurs as a result of injury or increased physical activity with constant stress on the foot and lower leg muscles. With regular and significant load, tendon fibers and cartilage at the sites of muscle attachment are subject to degenerative-dystrophic damage.

As a result of acquired tissue ischemia, zones of necrotic lesions are formed, tendon and cartilage tissue are structurally degenerated, and their partial mineralization occurs. Microtraumas of tendon fibers are accompanied by the deposition of mineral salts at the site of injury: a rather dense calcification formation develops, which can increase trauma to nearby tissues.

Degeneration and calcification of cartilage tissue contributes to the formation of osteophytes and bone growths.

Pathological processes in the tendons signal an increased load on them. This often happens in athletes and physically active people.

Symptoms of foot tendonitis

Symptoms of foot tendonitis can be almost invisible or pronounced:

• painful sensations of varying intensity when a particular tendon is loaded, while other movements of the foot do not cause pain;
• visible redness of the skin, possible increase in local temperature in the affected area of ​​​​tissue;
• crunching in the tendon, which can be heard both externally and through a phonendoscope;
• palpation may feel pain in the lower part of the leg;
• often tendonitis develops against the background of an inflammatory process of nerve trunks;
• slight swelling of the tissues of the foot and lower leg;
• discomfort when pressing on the heel and flexing the foot.

Walking in uncomfortable shoes and high heels significantly aggravate the discomfort in the back of the lower leg. The pain is especially pronounced when walking and trying to stand on tiptoes. The discomfort is aggravated in the morning when getting out of bed, after a long immobility of the lower extremities, and may be accompanied by swelling of the skin in the Achilles tendon area.

In the chronic course of tendonitis, clinical manifestations may be permanent.

Diagnosis of foot tendinitis

Diagnosis of foot tendinitis is based on the patient's history and visual examination.

The examination involves palpating the lower leg, especially in the area of ​​the Achilles tendon. There may be some tenderness, but it is most important to rule out tendon damage and measure the range of flexion of the foot.

If the tendon fibers are directly ruptured, swelling of the lower leg and foot should be noticeable, and significant bleeding into the soft tissue may be observed. If a void formation is found along the tendon, this may be the site of a rupture. With significant swelling, it is quite difficult to find it.

X-ray examination for tendonitis of the foot is not informative; it can only indicate the presence of calcification. An alternative method is ultrasound diagnostics, which provides visual access to the soft tissues of the lower extremities and tendons. This is a less expensive method compared to MRI.

Treatment of foot tendinitis

Treatment for foot tendinitis, depending on the severity of the process, may include:

• immobilization of the foot or ankle joint using bandages, bandages, splints. Absolute rest should be provided to the limbs;
• prescribing anti-inflammatory drugs that significantly alleviate the patient’s general condition. Oral administration of drugs, injection, as well as external use of a variety of ointments and compresses are possible. This therapy is usually prescribed for a period of no more than 14 days; longer use of non-steroidal drugs is undesirable due to the adverse effects on the gastrointestinal tract;
• prescription of antimicrobial agents for the infectious nature of tendinitis;
• the use of physiotherapy at the final stage of tendinitis treatment (high-frequency, microwave therapy);
• the use of massage procedures, elements of therapeutic exercises (yoga, gentle exercises that stretch and warm up the muscles);
• if conservative treatment is ineffective, it is possible to use surgical intervention, which consists of surgical excision of aponeuroses and affected tissues.

Conservative treatment of the inflammatory process in the tendon is quite long, up to two months, and with surgical intervention – up to six months.

Traditional methods of treating inflammation of the tendons of the foot include mainly anti-inflammatory and analgesic effects:

• compresses made from strong saline solution;
• lotions from a decoction of bird cherry fruits;
• massage the affected area of ​​the foot with ice cubes, especially effective immediately after an injury;
• internal intake of ginger infusion, as well as turmeric as an effective anti-inflammatory agent;
• using tincture from walnut partitions (0.5 liter glass of 40% vodka, leave for two weeks in a dark place, take orally).

Prevention of foot tendonitis

Preventing foot tendonitis in healthy individuals is not particularly difficult. When choosing shoes, you need to pay attention to their comfort and the absence of discomfort when walking and moving. During active sports, it is unacceptable to use ordinary everyday shoes - for this there are special sports models with reliable fixation of the ankle joint, with an adequate last.

Women need to treat shoes with unstable heels with great caution.

With prolonged foot strain, contrast baths and massage treatments usually help.

Immediately before training, sudden joint movements should not be allowed without first warming up the muscles by warming up.

Swimming strengthens the calf muscles well, while being gentle on joints and tendons.

Prognosis of foot tendinitis

The prognosis for foot tendinitis, which was diagnosed in time and adequately treated, is often favorable. Drug treatment is usually quite effective. The rehabilitation period after conservative therapy is about one month. If you follow your doctor's recommendations and eliminate the underlying cause of the pathological condition, relapses of tendinitis are unlikely.