Tendonitis of the tendon of the supraspinatus

Tendonitis of the shoulder joint

Mostly inflammation in the shoulder region begins with a tendon bag( tendobursitis) or the vagina of the shoulder joint( tendosinovitis, tenosynovitis) and only then spreads to the tendon itself - this pathology and is diagnosed as tendonitis of the shoulder joint.

In this article:

This disease affects not only people, they are sick and animals. Modern medicine distinguishes two forms of its manifestation: acute and chronic.

Causes of tendinitis of the shoulder joint

There are a lot of sources that can provoke the nucleation and progression of the inflammatory process in the human body. And in order to prevent the disease, it is necessary to remove the cause provoking it, and for this, the "enemy" must be known. We learn the most common causes of tendonitis of the shoulder joint:

  • It is quite high risk to acquire this disease in people whose professional activity is associated with heavy physical exertion. The athletes of such sports as tennis, basketball, volleyball, hammer throwing( nuclei, spears), handball, gymnastics are considered to be in the risk zone."Dangerous" and such professions: almost all construction( painter - plasterer, mason), drivers of vehicles and many others.
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  • Numerous microtrauma associated with increased motor activity.
  • The presence of a history of human diseases related to the bone and muscle system:
    • Reactive arthritis.
    • Osteochondrosis.
    • Gout is a disease associated with a malfunction that occurred in the work of metabolic processes. It has a negative effect on bone, connective and muscle tissue.
    • Osteoporosis is a pathology in which bones lose their strength, become more brittle and can easily break.
    • Rheumatoid arthritis.
    • And others.
  • Congenital or acquired pathology of tendons, loss of elasticity and elasticity.
  • Problems with posture.
  • Infectious diseases, provoked by pathogenic flora. Disease bacteria quickly spread with blood throughout the body and primarily affect its weakest point.
  • Stressful, depressive states of a person can provoke muscle spasms, which causes an increased burden on connective tissues.
  • To provoke tendinitis of the shoulder joint, the allergic reaction of the body to taking medications can also occur.
  • Inherited or received in the process of life joint dysplasia.
  • Diseases of the endocrine system: diabetes, thyroid disorders.
  • Deterioration of the body's defenses.
  • The need for a long time to use gypsum or a tight bandage.
  • An error in the prescribed therapy and in the process of rehabilitation rehabilitation after surgical intervention associated with the shoulder joint area.
  • Features in the anatomical structural configuration of the patient - if the violations are associated with a deviation in the normal structure of the shoulder joint, then its degradation can cause the formation of a foci of inflammation, and hence the development of tendonitis of the shoulder joint.
  • Osteochondrosis of cervical vertebrae can provoke this pathology.
  • May lead to this development of events and a long stay in the draft, climatic cataclysms( fell under the cold pouring rain).

Symptoms of tendinitis of the shoulder joint

In principle, any inflammatory process, the symptoms of tendinitis of the shoulder joint begin to manifest pain symptoms.

  • First, a person feels pain in the shoulder only during movement, but gradually it begins to pester and in the rest position.
  • Hyperemia begins to appear on the skin of the shoulder area: the epidermis becomes reddish, when touched, its greater density and increased temperature are felt.
  • When driving, even without using a phonendoscope, you can hear light clicks.
  • In some cases, minor swelling can be observed, which slightly limits movement in the joint. It is difficult for a person to take an item from a shelf or put it back, and there are problems with clothes.
  • Over time, pain can also appear during sleep. And after a while, spread to the elbow joint.
  • Pain can be either monotonous, or sharp and prolonged.
  • Prolonged disregard of the problem can lead to complete or partial atrophy of the muscular tissue of the shoulder region. This pathology is much more difficult to cure, and sometimes it is simply not possible.

Calcifying tendinitis of the shoulder joint

If in the process of some disease or lifestyle, on the tendons of the shoulder zone salt is observed, the specialists diagnose already calcifying tendinitis of the shoulder joint. In the tissues adjacent to the salt accumulations an inflammatory focus begins to form( this pathology often infects people after 40 years).The reasons for the emergence of this pathology have not been thoroughly studied, but physicians suggest that this development of the scenario can be facilitated by multiple micro-ruptures, injuries, and age-related wear of connective tissues. Not the least role in this process is played by the lack of oxygen in the cellular and intercellular layers of the tendons.

For calcifying tendinitis of the shoulder joint, there are inherent pain sensations that appear when the upper limb moves( it is very hard to raise your hand).As a result of this change in position, discomfort begins to increase, the pain symptomatology intensifies mainly at night. The protocol of medical therapy attributed to the attending physician largely depends on the radiography data.

Tendonitis of the supraspinatus of the shoulder joint

The joint of a man is a rather complex, it is possible to say, unique design, from the joint work of all elements of which the adequate functioning of the "mechanism" as a whole depends. One of these components is the supraspinatus, which completely fills the supraspinal fossa of the scapula. Its main function is to divert the shoulder and stretch the joint capsule in order to protect it from infringement. Tendonitis of the supraspinatus of the shoulder joint can develop if the muscle capsule is injured by an acromioclavicular joint, an acromial-beak-like ligament or the acromion itself. Such damage is fraught with the subsequent deterioration of the physiological characteristics of the joint complex, the induction, slow or rapid inflammation and thinning of the tendon, which leads to complete degradation of the shoulder joint. And as a result, a person can get tendinitis of the supraspinous muscle of the shoulder joint.

Diagnosis of tendinitis of the shoulder joint

Time passes and any mechanism begins to wear out, the human body is no exception. Joints, muscles and connective tissues also have their limits, so frequent microcracks, bruises, other negative effects and lead to pathological changes in the human body. Diagnosis of tendonitis of the shoulder joint includes:

  • Detection and analysis of patient complaints.
  • Survey of a specialist aimed at determining the location of pathology, pain symptoms during palpation of the area, determining the mobility of the joint, establishing the presence of edema and hyperemia.
  • It is necessary to differentiate this disease from other pathologies. For example, arthritis is characterized by constant pain even at rest, whereas tendonitis of the shoulder joint is pain associated with motor activity.
  • Laboratory tests usually do not show any changes. An exception is tendonitis, which developed on the basis of bacteriological damage to the patient's connective tissue( infection or rheumatoid processes).
  • The radiography method will be informative only if the calcifying tendinitis of the shoulder joint is diagnosed. In this case, a cluster of calcinates( crystals of calcium salts) can be seen on the film - this is a rather late stage of the disease.
  • Computer and magnetic resonance tomography makes it possible to determine degenerative changes in the structure of the shoulder joint: tendon rupture, structural structure defects. Such a survey result may indicate the need for surgical intervention.
  • Sometimes an ultrasound is used as an additional diagnostic. This technique allows you to establish changes that have affected the structure of connective tissue, its contractility.

Treatment of tendinitis of the shoulder joint

First of all, it must be said that the treatment of tendonitis of the shoulder joint largely depends on the stage and severity of the course of the disease. If the disease is diagnosed early in its development, the treatment protocol is fairly sparing, and includes:

  • Maximum limitation of mobility and load on the affected joint, and, consequently, on the affected tendon.
  • Cold therapy is used as an auxiliary therapy.
  • For fixing the joint and bringing it to rest, use tires, bandages, the imposition of elastic bandage.
  • Active physical therapy:
    • Laser therapy.
    • Shockwave therapy
    • Magnetic therapy.
    • Exposure to ultraviolet and ultrasonic rays.
    • In case of a chronic manifestation of the disease, mud and paraffin baths, lidase-based electrophoresis are practiced.
  • Not the last place is taken by medicinal treatment - antibiotics, painkillers and anti-inflammatory drugs, antimicrobial drugs.
  • After relief of the acute form of the disease and the effective course of therapy, the doctor connects the patient with a set of exercises of therapeutic physical training.
  • If there is no exacerbation, the massages of the affected area are shown.

In the case of more severe forms of lesion, treatment of tendonitis of the shoulder joint begins with conservative therapy using anti-inflammatory drugs. If the tendonitis of the calcifying form is diagnosed, then a procedure is carried out to remove the salt deposits. To do this, two needles with a large opening are inserted into the joint and saline is washed out with a physiological solution. Then add cold therapy, massages, physical therapy, medical exercises. If such measures do not lead to a positive result, then one must resort to surgical methods of treatment. In this case, it would be appropriate to use an arthroscope - a medical device equipped with a video camera. It is introduced into the lumen of the joint and carries out the necessary manipulations. But a classical strip operation can also be carried out. The term of postoperative rehabilitation usually lasts two to three months, but it's not until three or four months later that you return to your usual active life.

Drug therapy may include multidirectional drugs. They are classified as non-steroid drugs.

Nimesil

This anti-inflammatory and analgesic is not prescribed for patients under 12 years of age. The drug is administered orally( orally) immediately after ingestion. The average daily dosage of the drug is 0.2 g, divided into two doses. Nimesil is prepared immediately before the reception. To do this, pour the contents of the sachet into a glass of warm water and mix well. Duration of treatment is no more than two weeks.

It is not recommended to take the drug if a history of man is diagnosed: ulcerative lesions of the stomach or duodenum, arterial hypertension, internal bleeding, congestive heart failure, severe degree of renal dysfunction, hypersensitivity to the component composition of the drug. Contraindicated drug nimesil during pregnancy and during breastfeeding.

Najz

This drug is used externally. Before the procedure, the skin area in the area of ​​inflammation should be washed and toweled. Gel a small layer on the skin( length of the path to 3 cm).Strongly not rub. The number of daily procedures is from three to four. It is not recommended to use more than ten days.

To contraindications of the drug include: acute phase of erosive and ulcerative lesions of the gastrointestinal tract, internal bleeding, dermatoses of a different nature, a tendency to allergic manifestations, renal and hepatic insufficiency, bronchospasm. Nyz is not prescribed to women during pregnancy and lactation, as well as to children under the age of seven.

Ketorol

It has pronounced analgesic properties, while the active substance( ketorolac tromethamine) is an excellent anti-inflammatory agent with a moderate antipyretic effect. In the form of tablets, the drug is prescribed once for 10 mg. In case of severe pathology, the same dosage can be taken, but up to four times a day. The need for re-introduction is determined only by the attending physician.

Ketorol is not recommended for people suffering from individual intolerance to the components of the drug, acute form of erosive and ulcerative lesions of the digestive system, problems with blood coagulability, stroke, respiratory problems. Do not prescribe the drug and women in the period of bearing the baby and breastfeeding, as well as children under 16 years.

Nurofen

This excellent analgesic and antipyretic agent is taken with a lot of liquid. For patients older than 12 years, the starting dose of the drug is 0.2 g, taken three to four times throughout the day. If necessary, a single dose can be raised to 0.4 g, while the maximum amount of a drug that is allowed per day is 1.2 g. For babies from 6 to 12, the drug is prescribed in an amount of 0.2 g four times throughout the day. Do not forget that nurofen can be given to children, whose weight has already reached 20 kg. The gap between the injections of the drug should not be less than six hours.

The drug is categorically contraindicated if there is a history of the patient: cardiovascular insufficiency, severe form of arterial hypertension, ulcer pathology of the gastrointestinal tract, hypersensitivity to the components of the drug, as well as in case of pregnancy( its third trimester), lactation and at the age ofchildren under six years old.

Physiotherapy in tendinitis of the shoulder joint

In the treatment of tendinitis, exercises of physical therapy are simple enough and are no longer directed to the pressure of the patient's joint, but rather to "developing" it, gradually making more deviation. The doctor can offer such exercises:

  • To carry it out, you will need a towel( it should be a long one).Throw it through some horizontal pole, holding hands separately for each end. Begin to smoothly lower the healthy upper limb down, while the patient hand will slowly begin to rise to the ceiling. At the moment when the first signs of pain appear, the movement is stopped and locked in this position for three seconds. After this, very smoothly return to the starting position.
  • It is necessary to take a stick, ideally a gymnastic one, but any other one will do. Operate the stick vertically on the floor at arm's length from the victim. With a sick hand write the letter "O".The circle should be as much as possible.
  • Healthy hand help to fix the palm of a sick hand on a healthy shoulder. With a healthy brush, grasp the elbow of the affected arm. We begin very carefully, without jerks, to raise the elbows by the elbow, following the sensations in the shoulder joint. At the upper point, fix the position for three seconds and smoothly lower it down. Daily, the amplitude of the rise should be slightly increased.
  • Hook your hands in the lock in front of you. Smoothly begin to raise your hands up. In this case, the main load goes to a healthy limb. She is like a tug behind a sick person.
  • Put the chair in front of you, a little behind him. A healthy upper limb leans against his back, while the body is bent in the lower back, the diseased limb simply hangs. We begin to carry out the patient's hand motion of the pendulum, gradually increasing its amplitude. Movements can be made back and forth, and to the right - to the left, and circular motions.
  • Upper limbs raise in front of him parallel to the floor and fold the palm of the left hand to the right elbow, and the palm of the right hand to the elbow of the left arm. In this situation, we begin to swing them in one direction or the other.

The natural treatment of tendonitis of the shoulder joint

Quite additional help can be provided by folk medicine with analgesic and anti-inflammatory properties:

  • Curcumin is effective in the treatment of tendonitis, which, with a daily dosage of half a gram, is taken together with food as a condiment. He declared himself as an excellent remedy to relieve pain, and copes well with inflammation.
  • Fruit cherries insist in a glass of boiled water and drink two to three times a day as tea. Tanning substances of berries perfectly remove the inflammation and strengthen the effect on the body.
  • A glass of collected partitions of the Voloch( walnut) walnut is poured into half a liter of vodka. Insist in a dark place for three weeks.30 minutes before meals, take 30 drops of tincture, washed down with a large volume of chilled boiled water.
  • The infusion, made of a mixture of two constituents, perfectly showed itself: the sassaparilla root and the ginger root were taken in equal proportions. A teaspoon of the crushed composition is poured into a glass of boiling water and drunk instead of tea. It is desirable to tea like this twice throughout the day.
  • In the first day after the injury, a cold compress should be applied to the sore spot, and warming therapy is preferred on the next days.

Prevention of tendonitis of the shoulder joint

To prevent the emergence of this pathology, prevention of tendonitis of the shoulder joint is necessary.

  • Before you begin more active exercise( increased stress), you must first warm up and stretch muscles and tendons.
  • If possible, avoid prolonged monotonous monotonous movements.
  • Be more attentive, thereby minimizing the likelihood of injuries and static or dynamic overloads.
  • The growth of loads and its intensity should be gradual.
  • Mandatory load periods should alternate with the rest time.
  • Regular exercise and active rest will enable you to constantly keep your muscles and ligaments in tone.
  • If in the process of work or playing sports there is pain, the action must be stopped and rest. If the pain symptomatology does not go away after a break, you should consult a doctor.
  • In any action, adhere to the safety rules.

Forecast of tendonitis of the shoulder joint

If to speak about the future, the prognosis of tendinitis of the shoulder joint is favorable enough, but the responsibility for the expected result is borne by the patient himself, how responsible he will be in the treatment of physical exercises. After all, you have to force yourself to do this by overcoming laziness.

Any disease is much easier to prevent than to mess with. This statement is acceptable and to such a pathology as tendonitis of the shoulder joint, a fairly common inflammatory disease. There is no need to make great efforts if the therapy has captured the initial stage of the disease. But if the primary process is neglected, the pathology can go into a chronic phase, which already requires much more effort. But the danger is that chronic tendonitis can develop into immobilization of the joint and, as a consequence, atrophy of the muscular and connective tissues of the shoulder joint, which in time can lead to irreversible consequences. So do not rely on "maybe it will pass itself."Only a specialist is able to deliver the correct diagnosis and give effective recommendations.

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Tendonitis of the shoulder joint

Tendonitis of the shoulder joint is an inflammation of the tendons located in the area of ​​the head of the shoulder. In the process, tendon of the supraspinatus, tendon of the biceps, joint capsule or all of the listed entities can be involved at the same time. The cause of development is trauma, prolonged immobilization, excessive physical exertion or cervical osteochondrosis. It manifests itself with pain and restriction of movements. Diagnosis is made on the basis of symptoms, radiography and MRI.Treatment is usually conservative, the prognosis is favorable.

Tendonitis of the shoulder joint

Tendonitis of the shoulder joint is a pathological condition in which tendons and other soft tissue structures surrounding the shoulder joint become inflamed. The disease is quite widespread, at least once in a lifetime they suffer from every fiftieth adult. Usually, tendonitis develops at the age of 40-60 years, but in sportsmen and persons who have suffered a shoulder injury in the past, the disease can be detected at a young and even adolescent age. Because of hormonal adjustment, women in menopause are more likely to suffer from men. The significance and relevance of the disease in traumatology is due to the influence of tendonitis of the shoulder joint on the quality of life of patients, the need for long-term and expensive treatment.

Causes of tendonitis of the shoulder joint

The shoulder joint is formed by the articular cavity of the shoulder blade and the head of the humerus. The ball-shaped head is only partially submerged in the cavity and held in the joint by the tendons and ligaments forming the rotator cuff of the shoulder. The rotational( rotator) cuff includes tendons of small round, subacute, supraspinous and subscapular muscles, attached to the small and large tubercles of the humerus. Between these tubercles is the tendon of the long biceps head.

Intense physical activity and joint injuries can damage the rotator cuff of the shoulder with a beak-acromial ligament, the anterior edge of the acromion or, more rarely, the acromioclavicular joint. Usually the inflammation first develops in the tendon of the supraspinous muscle, then the surrounding tissues are involved in the process: the muscles, the joint capsule and the subacromial bag. There are pains, the patient starts to spare his hand, because of the restriction of movements in the capsule, spikes are formed. The inflammation is replaced by degeneration and thinning of the tendons, they become less durable, with movements and stress in them, micro-ruptures often occur.

With prolonged immobilization, improper treatment after operations or injuries, as well as with cervical osteochondrosis at early stages, the mechanism of development of tendonitis of the shoulder joint is somewhat different: due to immobility or insufficient mobility of the shoulder, changes practically simultaneously develop in all soft tissue structures surrounding the head of the shoulder. Subsequently, the process proceeds, as in the first case: the adhesions limit the mobility of the shoulder, new degenerative tendons appear in the degenerately altered tendons, which provokes further inflammation, the formation of small scars and new adhesions.

Symptoms of tendinitis of the shoulder joint

Patients are concerned about shoulder pain. Pain syndrome occurs with certain movements in the shoulder joint: when the patient stretches and raises his hand to take the book off the shelf, puts on or takes a shower. Characterized by sharp pain while moving the "javelin thrower"( throwing the arm forward).Many patients note nocturnal pains at the time of a change in the position of the body, for example, when turning to the sick side, trying to throw a hand over the head, etc.

In the later stages, the pain syndrome appears even with minor movements without active involvement of the shoulder joint:clenching the brush, trying to lift some light object. There is stiffness and progressive limitation of mobility in the joint. Calcifying tendovaginitis( a kind of disease, accompanied by the formation of sites of ossification in the tendons and articular capsule) is manifested not only pain, but also a crunch during movements.

In the late stages of pain, not only in motion, but also in rest. Characterized by irradiation along the front and outer surface of the shoulder, often pain is given to the elbow joint area. When visually examined, sometimes markedly expressed swelling of the joint. Hyperemia and hyperthermia, as a rule, are absent. When palpation, soreness is determined in the area of ​​the intercampa groove and the anterior edge of the acromion. Because of the contracture of the joint, a decrease in the range of both active and passive movements is revealed.

Diagnosis and treatment of tendonitis of the shoulder joint

Diagnosis is made on the basis of the clinical picture. Tendonitis often has to be differentiated from traumatic damage to the rotator cuff of the shoulder. The difference is revealed by estimating the range of movements: with tendonitis, the volume of passive and active movements is the same, if the rotator cuff is damaged, the range of active movements is limited as compared with the passive ones. In doubtful cases, the patient is referred to the MRI of the shoulder joint. With tendinitis on MRI, a thickening of the tendon shells and capsules of the joint is determined, with a traumatic lesion, a section of the rupture is visible. To exclude other diseases and pathological conditions( arthrosis, the consequences of fracture or dislocation) is prescribed radiograph of the shoulder joint. In the absence of calcification, the radiographic picture is within the normal range. With the calcifying tendovaginitis, the sections of calcification are visible on the photographs.

Treatment is usually outpatient. The patient is recommended to reduce the load on the shoulder, in no case limiting the amplitude of movements, since prolonged inactivity in inflammation of the periarticular tissues provokes the rapid development of contracture. The patient is given a referral to LFK and shock wave therapy. For the removal of inflammation appoint NSAIDs for not more than 5 days( prolonged reception can provoke the development of gastritis and even peptic ulcer).With a persistent pain syndrome, blockades with corticosteroid drugs are performed.

In later stages, accompanied by contractures and marked cicatricial changes in the capsule, more active treatment may be required. In some cases, it is possible to repress the shoulder - manipulation, during which the doctor "breaks" the capsule of the joint, forcibly increasing the amplitude of the movements. The procedure is performed under general anesthesia. If the redression for some reason is not indicated, an operation is performed - dissection of the capsule and rotational cuff in the areas of greatest scarring and wrinkling. Intervention is carried out through open access( in a classical way) or through a small incision( using arthroscopic equipment).In the postoperative period, physiotherapy and exercise therapy are prescribed, the duration of the rehabilitation course is 1.5-3 months.

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Treatment of tendinitis by folk methods

Inflammation of the tendon, known as tendonitis, usually begins with a tendon bag or vagina, and then is transferred to the tendon itself and the muscles adjacent to it.

In the risk zone are:

  • heel tendon;
  • elbow;
  • thigh;
  • elbow;
  • shoulder;
  • thumb of the hand( base).

Causes of

Patients engaging in heavy physical labor are at greater risk of experiencing tendonitis than others.

Other reasons:

  • musculoskeletal diseases( gout, reactive or rheumatoid arthritis);
  • microtrauma( stretching);
  • high motor activity;
  • disorders of posture;
  • weakening of the tendons or their incorrect formation.

Symptoms of

Secondary symptoms may differ depending on the localization of the disease. There are some peculiarities in the manifestations of temporal tendinitis or lesion of the ankle joint. You will read about the forms of localization below.

There are also common symptoms you need to know about:

  1. Pain. It appears in the area of ​​the affected tendon during palpation and active movements. Passive movements do not cause unpleasant sensations.
  2. Redness of the skin. In addition, the affected area will feel warmer than the rest of the body.
  3. The crunch. Listens through the phonendoscope( at a distance) or during the movement.
  4. Local swelling.

Localization of

Inflammation can affect any joint.

  • Knee tendonitis. Uninformed patients often confuse him with sprains and tendons. This ailment can be caused by trauma. Basically from this disease basketball players and volleyball players suffer, in which activity jumps predominate. The main symptom is pain within the patella.
  • Inflammation of the shoulder joint. The main symptoms are severe pain and swelling. Especially sharply manifested in sudden movements. The cause of the disease is a chronic overstrain caused by constant microtrauma of the supraspinous tendon. The disease is divided into three stages.
  • Temporal tendonitis. Always begins with a painful syndrome( pronounced) in the cheek area. Pain intensification occurs during a meal - when a person chews. The focus of soreness can be shifted to the neck and head. Many confuse this symptom with a toothache and mistakenly turn to the dentist.
  • Achilles tendon injury. This is a typical disease of the siloviki. Degeneration occurs under the influence of increased loads. Leaning on the foot, the patient experiences painful sensations. If you do not turn to the doctor in time, you can get a tendon rupture.
  • Tendonitis of the biceps. The localization area is the point of attachment of the shoulder to the top of the bicep. Provoke this ailment can often be of the same type of manipulation of the hand - for example, when playing tennis.
  • Inflammation of the elbow joint. The carpal extension muscles are affected. Damage is associated with fatigue and stress. Suffer from these diseases mainly athletes engaged in tennis( large and table), badminton and golf.

Diagnosis

Before asking how to treat tendonitis, let's deal with its diagnosis. It consists of the following steps:

  1. Initial inspection. With the help of palpation, the doctor determines the area of ​​the lesion.
  2. Differential diagnostics. With arthritis, the patient suffers from pain constantly, and not only with movements of a certain kind.
  3. Laboratory research. There are no special changes.
  4. Radiography. In the picture, pathology is noticeable only in the formation of calcinates - and then only in the late stages.
  5. Magnetic resonance and computed tomography. Identifies degenerative changes and tendon ruptures.
  6. Ultrasound diagnosis. Shows tendon contractions and changes in its structure.


Traditional treatment of

We list the methods of traditional treatment, detailing them without stopping.

  • Conservative therapy. It implies cooling the affected area and complete rest. It is prescribed in the early stages of the disease. The goal is to relieve the inflammation.
  • Physical exercises. Applicable in later stages.
  • Bandage and bandage.
  • Medication. Injections( local) of corticosteroids and plasma enriched with platelets. In inflammation of the knee, puncture of the joint capsule, removal of fluid and administration of antibiotics are recommended.
  • Surgical intervention. It is performed in the most neglected cases, when the disease becomes chronic. Degenerative tissue is excised, the same happens with tendon aponeuroses.

Unconventional treatment of

Localization in this case is not of fundamental importance. It can be a defeat of the wrist or foot, the main thing - the principle. We are talking about shock wave therapy, pharmacopuncture, acupuncture and other methods, many of which came to us from eastern medical practices. These methods help to get rid of inflammation, calm pain, stimulate tissue regeneration and improve blood microcirculation.

If you want to improve your immune status and metabolism, doctors recommend using a point massage that affects the long-term bioactive points of your body. Phytopreparations will also be useful( an individual course is prescribed) with anti-edematous, anti-inflammatory and immunomodulating effects.

Folk remedies

Treatment of ailment by folk remedies can be considered as an additional conservative technique, sometimes yielding very good results. The effectiveness of therapy will increase with the parallel use of various recipes that affect the focus of pathology.

We list the most effective tools:

  • Ice massage. Traditional healers are advised to arm themselves with several plastic cups, fill them with water and place them in the freezer. Massage is performed within 15-20 minutes by the upper part of the formed ice.
  • The roots of sassaparel and ginger. We draw attention to the fact that ginger should be fresh. The drug copes well with diseases of joints and tendons. Roots are ground beforehand, then a teaspoon of the mixture is poured with boiling water( 1 glass).The resulting mixture is taken 1-2 times a day.
  • Turmeric. This substance is known to housewives as a seasoning. Healers thought of using it for medicinal purposes. In the root system of the plant contains the so-called curcumin, which has an analgesic and anti-inflammatory effect.
  • Fruits of bird cherry. If tannins contained in bird cherry juice are combined with anthocyanins, an anti-inflammatory and strengthening effect can be achieved. The broth bird cherry is prepared as follows: pour a tablespoon of dry berries with boiling water( 1 glass), then insist on a water bath. If the berries are fresh, take 3 tablespoons.
  • Salt dressings. Apply to the affected area. Preliminarily, dilute 1 tablespoon of salt in hot water( 1 glass) until the crystals completely disappear. Then a gauze cloth is taken, it is wetted in the resulting solution and wrapped in a cellophane bag. The compress is placed in the freezer. Later, the napkin is separated from the packet and applied to the diseased area. The compress should be bandaged and kept on the joint until fully dry.
  • Shepherd's bag. The dried grass is infused and absorbed into the gauze in the same way as described in the previous paragraph.

Prevention

Before serious physical exertion it is necessary to conduct an easy warm-up, the rate of which gradually increases. Frequent change of classes and rest will benefit your body. At the limit of the opportunity to work is not recommended. If the load is accompanied by a pain syndrome, we advise you to give up training and immediately consult a doctor.

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Tendonitis of the shoulder joint

The most common disease of the shoulder joint, not associated with trauma, is the tendonitis of the tendons of the muscles that form the muscular capsule. The tendons of these four muscles attach to the large and small tubercles of the humerus. In the intertubercular furrow passes the tendon of the long head of the biceps muscle, starting from the superarticular tubercle of the scapula.

When the muscular capsule breaks, the tendon of the supraspinous muscle first of all is damaged. Almost always the tendonitis of the tendon of the supraspinatus develops first, then the inflammation gradually spreads to the entire muscular capsule, the subacromial bag, the joint capsule and other structures, eventually leading to ankylosis of the joint.

The cause of tendonitis of the tendon of the supraspinous muscle is the damage to the muscle capsule by the anterior edge of the acromion, the beak-acromial ligament and, sometimes, the acromioclavicular joint;this leads to inflammation, degeneration and thinning of the tendon. As a result, the thinned tendon breaks, the tendons of the subacute muscle and the long head of the biceps muscle can also be torn.

Over time, with tendonitis, as a rule, there is an improvement, so enough conservative treatment.

Some experts believe that improvement occurs in all cases, regardless of the treatment, while others insist on the need for injections of glucocorticoids into the affected structures - as with arthritis of the shoulder joint, and in the defeat of tendons, tendon sheaths and synovial bags.

Periarthritis is a collective term describing inflammation of the tissues around the shoulder joint and combining a number of similar syndromes in the outcome of which contracture develops. Most experts agree that an active therapeutic tactic is needed to prevent contracture.

Tendonitis of the tendon of the supraspinatus and tenosynovitis of the long head of the biceps brachium muscle can lead to inflammation of other tendons, synovial bags, articular capsule, cartilage, bones and surrounding muscles.

Tendonitis of the tendon of the supraspinatus( even with the involvement of other parts of the muscle capsule) and tendovaginitis of the long head of the biceps brachii muscle do not affect the amount of passive movements in the shoulder joint. Limitation of mobility can cause inflammation of the joint capsule( adhesive arthritis), synovial bags and muscles.

Clinical picture

Sudden sharp or dull pain in the shoulder, a symptom of a painful arch. Soreness in the palpation of the anterior margin of the acromion and intercampa groove. The diagnosis is confirmed if the pain occurs when a local short-acting anesthetic is injected under the acromion.

Radiography

  • Stage I: norm
  • II stage: osteosclerosis, periostitis, cysts;osteophytes of tubercles of humerus
  • III stage: narrowing of the gap between the acromion and the head of the humerus, the upper subluxation of the shoulder, erosion of the anterior margin of the acromion.

An X-ray contrast test reveals a rupture of the muscle capsule and a communication between the subacromial sac and the joint cavity.

Treatment

I stage: rest with gradual increase in load;immobilization is contraindicated because of the risk of adhesive arthritis;Exercise therapy to strengthen the muscles and increase the mobility of the joint;Aspirin and other NSAIDs.

II stage: same as Stage I, plus injections of local anesthetics and glucocorticoids, eg 3 ml 1% lidocaine, 3 ml 0.5% bupivacaine, or 20 mg triamcinolone( as a long-acting drug);local short-acting anesthetic is used for diagnosis, long-acting anesthetic and glucocorticoid provide therapeutic effect.

Stage III: same as for stages I and II, plus resection of the anterior part of the acromion.

D.Hobel

"Tendonitis of the shoulder joint" and other articles from the section Joint diseases

medpanorama.ru

Treatment of tendonitis of the supraspinatus in the clinic "Orthopedics" in Moscow. Symptoms of tendinitis of the anatomical muscle

The specialists of the orthopedic clinic have many years of experience in the treatment of tendon tendon of the supraspinatus. Advanced techniques and modern equipment allow to obtain significant improvements from the first reception.

Relieve pain for 1-2 visits to the clinic. Restore motion in the joint. Consultations of a specialist are free of charge while treating us.

Tendonosis of the supraspinatus of the shoulder - what is it?

This is the so-called defeat of tendons of the supraspinous muscle, as a result of which its tissues become inflamed, degenerate and thinner. These disorders, in turn, can lead to rupture of the tendon.

Types of tendonitis of the supraspinatus with a photo

  • Simple tendonitis of the supraspinatus of the shoulder.

By this kind is understood the traumatization of the tendon by the edge of the acromion of the scapula or the beak-acromial ligament. Calcifying tendonitis of the supraspinatus.

This form of the disease occurs as a result of the deposition of calcium salts on the tendons, which leads to an inflammatory process. Most often it is observed in people after 40 years.

  • Posttraumatic tendonitis.

In this case, tissue damage occurs when the weight rises or falls with the support of the hand.

Moreover, due to multiple lesions, especially during the recovery period, chronic tendonitis of tendons of the supraspinatus can develop. Often this happens when the previous load on the joint resumes after the removal of the primary symptoms. Symptoms of tendonitis of the supraspinatus

• Pain in limb movements, • Reduced mobility of the joint and volume of movements, • Rarely reddening and fever, • Painful sensations in palpation of the shoulder joint, • Increased pain associated with muscle damage, at night.

Treatment of tendonitis of the supraspinatus in the Orthopedic Clinic in Moscow

The first action for the appearance of the above signs of the disease is to ensure the peace of the sick arm. Then, urgently, you should see a doctor to confirm the diagnosis, as these symptoms may indicate a number of other disorders. And self-treatment is fraught with deterioration of a condition which can lead to irreversible consequences.

In the medical center "Orthopedists" treatment of tendinitis is made in a complex. This allows not only to stop pain in the shoulder, but also to restore the full work of the tendons.

If you want to consult a specialist or make an appointment, go to the contacts page. Our specialists will consult you on the issues that are of interest to you.

klinika-ortopedov.ru

Tendonitis of the shoulder joint - clinical picture of the disease

Tendonitis of the shoulder joint is a pathology that affects people, regardless of their age, sex and professional activity. However, most often this disease affects patients older than forty years, as well as people actively engaged in sports or manual labor, loading the same zone.

Most often in clinical practice tendinitis tendon of the muscular muscle

Causes of the occurrence of

  1. Prolonged physical stress on the shoulder joint.
  2. Infectious diseases.
  3. Pathologies of rheumatic nature( arthritis or gout).Anatomical features of the structure of the body.
  4. Incorrect development or weakening of tendons.
  5. Non-observance of correct posture.

Characteristic symptoms of

When the patient is diagnosed with tendonitis of the shoulder, the most common symptoms of this pathology are the limitation of mobility and the occurrence of long-lasting pains not passing through the site of inflammation and in nearby areas. In some cases, pain may increase gradually, as the inflammatory process develops. Often, patients complain of a creaking sound( crepitation) that occurs when the limb moves. It can be heard even from a distance. The inflamed area is hyperemic, the local body temperature is increased. In some cases, tendonitis is complicated by the deposition of calcium salts in the shoulder joint, which leads to a weakening of the tendon and joint bag. In the passive state, pain is often absent, but pain begins to increase by night. Due to the forced position of the body and the severity of the pain syndrome, patients are disturbed by sleep. Also there are difficulties with the rotation of the hand. As a rule, the pain begins in the upper part of the shoulder and ends with a large brachial muscle on the back. Most often, the inflammatory process is localized in the rotator cuff of the shoulder, the extensor muscles of the wrist and the tendons of the biceps muscle.

Tendonites of the muscles of the rotator cuff of the shoulder

When the muscles of the cuffs are damaged, patients complain of pains that appear in the upper outer part of the shoulder, radiating to the elbow. Pain syndrome occurs after unusual physical exertion( work with high-raised arms).In case of a lesion of a small round muscle, a positive test of the resistance of the active external rotation of the shoulder is noted during a diagnostic examination. If the subscapular muscle is affected, a positive test of resistance to active internal rotation is positive. Such tests are conducted in the case when there is a suspicion of tendinitis tendons of the supraspinatus.

Inflammation of the long biceps head

Tendonitis of the tendon of the long bicep head is accompanied by pain in the upper-anterior divisions of the shoulder girdle. Typically, such pains occur due to overexertion of the biceps muscle after lifting weights. In this case, the removal and rotation of the shoulder is not broken. In the process of diagnosis, a resistance test of the active supination of the hand is carried out. Patients with chronic tendinitis, as a rule, are examined using the method of magnetic nuclear resonance. In the course of this study, areas with abnormal impulses are revealed, indicating degenerative changes in the tendons.

At rest, pain is usually absent

Treatment

Treatment of tendonitis of the shoulder joint, first of all, provides for complete resting of the affected area. Special straps, tires or bandages are used for this. Primary therapy for damage to the ligament of the shoulder includes:

  • Protection of the shoulder joint from the load.
  • Immobilization.

The main methods of secondary therapy include:

  • Physiotherapy.
  • exercise therapy.
  • Anesthesia and anti-inflammatory therapy.

Clinicians note a positive trend in the treatment of tendinitis by injections of corticosteroids directly into the lesion. These drugs quickly eliminate soreness and contribute to the attenuation of the inflammatory process.

Note: In addition, injections of corticosteroids do not provide a complete cure, and they are able to increase the rate of collagen degradation and reduce its synthesis, which reduces the tensile strength of the tendon and leads to its rupture. Therefore, this treatment of tendinitis of the shoulder is justified only in the acute period( once every 2-3 weeks).

Not bad non-steroidal anti-inflammatory drugs( for internal reception).However, their long-term use is recommended only for chronic overstrain conditions. Also for pain relief in the shoulder area patients are prescribed simple analgesics and muscle relaxants. With the development of muscle-tonic syndrome, it is recommended to use muscle relaxants, which reduce the pathological muscle tension and reduce the severity of the pain syndrome. An effective method of treatment is local therapy with the use of gels and ointments, which include NSAIDs. If necessary, these drugs can replace systemic non-steroidal anti-inflammatory drugs. As a supplement to the main course of treatment, physiotherapeutic procedures are prescribed to the patient. Well-proven ultrasound treatment, as well as laser and magnetic therapy. In the case of the development of a strong inflammatory process and with the ineffectiveness of standard treatment, patients are treated with antibiotics. Operative intervention is recommended only when all conservative methods and the program of physiotherapeutic procedures have failed, and also if the patient shows signs of stenosing tendinitis( which is characterized by constriction of blood vessels) or Osgood-Schlatter disease. In the course of surgical intervention, dissection or partial excision of tendon aponeuroses and scar tissue is performed. Such an operation requires two or three months of rehabilitation, including the gradual use of exercise exercise for stretching and development of strength.

Note: Treatment of tendonitis of the shoulder joint will be effective only if the patient complies with all the expert's recommendations regarding the resting of the inflamed extremity without exception. If you continue to do the usual work, the disease will only progress in the future.

Prevention of

In order to prevent the development of the pathological process, whenever possible it is necessary to avoid work that requires keeping hands in the raised position for a long time, as well as avoiding monotonous movements in the joint for a long time. Before performing any physical exertion, it is recommended to perform a small warm-up beforehand. The rate of loading should increase gradually.

Warning! Categorically it is not recommended to work at the limit of your strengths and capabilities. When the slightest signs of pain occur, a short rest is required.

If the pain sensations appear constantly, it is wiser to abandon the work or movements that cause them.

znak-zdorovya.ru

Tendonitis: what it is and what tendons are susceptible to this disease

Inflammation of tendons is a fairly common cause of pain and stiffness in the joints. Tendonitis: what is it, what is it and where does it come from? This disease has an inflammatory nature, but usually it does not appear on level ground. Most tendonitis is preceded by pathological processes in the constitution, and the catalyst is in most cases a trauma, an infection or a stressful situation.

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The human body has its own wear limit .When the load is too high, microtraumas are formed, which have the property of regenerating during rest. If the joint overload becomes critical, the recovery mechanisms do not have time to fully work, and the muscles - adapt to the super-action. As a result degenerative processes begin in the place of defeat.

Causes of

The most obvious and frequent reason for the formation of inflammation in the tendons is excessive and prolonged stress on the joint, as a result of which the places of attachment of muscles to the bone most suffer.

This is confirmed by the fact that this pathology is most often observed in athletes, gardeners and builders. Prerequisites for the development of tendonitis can be such factors:

  • single or frequent injuries of the joints;
  • bacterial infections that spread through the bloodstream and affect the most vulnerable places - in this case, the elements of bone joints;
  • already available rheumatic or degenerative joint disease;
  • problems with the spine, posture disorders;
  • anatomical disorders in the joints resulting from degenerative processes( for example, limb shortening);
  • immune and endocrine diseases;
  • congenital and acquired joint dysplasia;
  • neuropathies that cause muscle spasm and other disorders.

Symptoms of

The inflammatory process that occurs when a tendonitis of the tendon of the muscle is a normal response of the body to the stimulus.

As a result of exposure to harmful agents, the immune system reacts in a special way, and certain changes occur in the focus. The purpose of complex complex work of the human body at this time is to restore the functions of the affected organ.

Symptoms of tendonitis:

  • pain. Usually it is persistent and prolonged, occurs either suddenly or increases with the development of inflammation, during movement and immediately after the strain of the limb. When you feel the affected tendon by the nature of unpleasant sensations, you can determine the boundaries of the pathological process;
  • edema. Formed in the focus of inflammation, trans- and exudate are secreted into the tissue, because of which the lesion site increases in size and loses its shape;
  • function violation. Limitation of mobility( contracture) is due to the filling of the joint with liquid, hardening and tightening of the tendon as a result of inflammation. The limb can not fully bend-unbend or make other habitual movements up to complete immobility( ankylosis);
  • creaking sound( crementation).Occurs during movement can be heard both by the patient himself and from the outside;
  • local redness and fever. Observed with examination and palpation of the limb.

Diagnosis of

Tendonitis does not actually have specific specific symptoms that would distinguish it from many other pathologies of the joint or surrounding tissues.

With hardware examinations, you can trace only certain characteristic signs of tendon inflammation. Therefore, differential diagnosis is very important. Methods for determining the disease:

  • examination by a physician. As a result of this simple method, you can detect the presence of edema and asymmetry in the tendon area, feel the boundaries of the lesion, determine the nature and cause of the pain( active or passive movements) and restrict mobility in the joint;
  • laboratory tests. Are indicative only if there is a bacterial infection or rheumatoid process;
  • radiography. It is always prescribed when the above symptoms appear, both to exclude a fracture, and to determine some obvious signs: salt deposits with calcifying tendinitis, the presence of calcaneal spurs in inflammation of the Achilles tendon, as well as aseptic necrosis with tendonitis of the patellar ligament;
  • computer or magnetic resonance imaging. Assigned to differential diagnosis, in case of doubt, to avoid rupture of tendons, as well as some degenerative changes;
  • ultrasound examination. It can be informative to detect changes in the structure of the tendon.

Because the diagnosis of tendonitis is sometimes difficult, orthopedics use specially designed tests that can be informative only if the tendon is inflamed. For example, with differential detection of tendonitis of the shoulder, the disease is confirmed when pain is discontinued after the short-acting anesthetic is injected into the focus of the anesthetic.

The most frequent lesions of tendonitis

Inflammatory process can affect any tendon .But there are places in the human body, features of location and functional overload which cause the most frequent development of tendonitis.

In addition, the localization of the pathological focus introduces its own characteristics in the symptoms and course of the disease. Consequently, to some extent, the therapeutic measures that will be most useful for this type of pathology also differ.

Lateral and medial epicondylitis

Lateral tendonitis of the muscles, which unbend wrists( long and short radius extensors, and also the brachial muscle), often occurs in professional athletes. The disease begins with weakness in the hand and difficulties in performing simple familiar actions.

When testing by movement, you can identify a clear focus of soreness from the outside of the elbow. Unpleasant sensations can give up - in the shoulder, or down - to the outside of the forearm.

Medial tendinitis of the tendons involved in flexion of the forearm, most often occurs in sports, under which there is a load on these muscles: golf, baseball, gymnastics. In contrast to lateral tendonitis, pain concentrates on the inside of the elbow. In the treatment of injections requires special care because of the close location of the ulnar nerve.

Inflammation of the Achilles tendon and posterior tibialis muscle

Tendonitis of the foot is a common name for inflammatory lesions of the tendons of the thumb, arch of the foot, posterior tibial muscle, and Achilles tendon.

With the help of the last muscle, the calves are attached to the heel bone. His inflammation is characterized by severe pain when trying to stand on your toes, and when you break - it is impossible to do it.

Tendonitis of the Achilles tendon is characterized by pain along its location closer to the heel. This ailment often occurs in athletes( because of overloads when running or jumping) and women who usually wear high-heeled shoes, and then abruptly move to a flat sole.

Tendonitis of the posterior tibial muscle, or post-tibial tendonitis, is a common disease that can lead to flatfoot, as this muscle supports the arch of the foot in the right position when walking. Accordingly, with the reverse process - the presence of flat feet - the tendon of the muscle is affected in the first place. This pathology is characterized by the appearance and intensification of pain during running and because of weight lifting.

In tendonitis of the Achilles tendon, a frequent complication is the appearance of calcaneal spurs - osteophytes, extending from the heel bone to the sole with a sharp edge. When walking, they press on soft tissues, resulting in severe pain.

Tendonitis of the joints of the shoulder

Tendonitis of the shoulder joint is a collective name for the inflammation of the tendons of this joint, which includes several muscles.

Tendonitis of the shoulder develops most often after the rupture of the muscular capsule, which can occur as a result of external trauma, and because of muscle damage with the bones of the joint.

The most common first is tendinitis of the supraspinatus. If it is damaged, the tendons gradually become thinner, break down and break. The main feature of this pathology location is that the volume of joint movements is not disturbed.

Normally contracture( restriction of motor activity) is caused by capsulites, synovitis and adhesive arthritis. Peritendinitis occurs when the inflammatory process involves the tendon sheath( tendon sheath) and the synovial membrane.

Wrist Tendonitis

Wrist tendonitis is a "favorite" inflammatory disease of pianists and PC operators. It is diagnosed on the basis of tests that detect the presence of characteristic symptoms.

For example, if you try to bring together the tips of the little finger, forefinger and thumb, a sharp pain will appear in your wrist;when the fist is bent-unbending on both hands, the affected arm will lag far behind.

In inflammatory processes in the area of ​​the forearm tendons, the most common symptom is the difficulty in performing the usual actions, in particular, problems arise in holding objects in hands.

Tendonitis of the hips of the hip joint

Tendonitis of the hip joint is a collective name for the inflammatory process in tendons of the congenital joint, the different localization of which, with other common signs of the disease, may give different pain symptoms. Species and signs of lesion:

  • tendonitis of the tendon of the long adductor muscle is characterized by unpleasant sensations when the leg is withdrawn and the limb is severely limb;
  • tendonitis of the tendons of the abducens muscles manifests itself in a severe pain syndrome in the external part of the thigh;
  • tendonitis of the tendon of the ilio-lumbar muscle manifests itself unpleasant sensations throughout the thigh that can give to the lower abdomen. Diagnosis is somewhat difficult due to the similarity of symptoms with other diseases in this area of ​​the human body.

Tendonitis of the knee joint

Tendonitis of the knee is most often provoked by jumping, severe overload of the joint or uneven development of its muscles. Pain with inflammation of the tendon of the knee occurs when walking, especially when you descend or climb the stairs.

Symptoms of this disease resemble signs of ligament or tendon lengthening, so differential diagnostics is needed to identify the true problem. Complication with tendonitis of the patellar ligament can be aseptic necrosis of tuberosity of the tibia.

With timely treatment of tendonitis, the patient's condition improves after 3 days of , and complete recovery is observed after 1-1,5 months. The most frequent complications of the disease are the rupture of the tendon and the formation of chronic fibrosis( nodes).However, the overall outlook is favorable. Treatment is conducted conservatively, surgical intervention is required in very rare cases.

mirsustava.ru

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