Treatment of tendonitis is most often required by athletes, as well as other people whose field of activity leads to increased stress on muscle tissue and skeleton. With this lifestyle, a person regularly receives minor injuries of muscle tissue and joints. Normally, they should heal on their own in a short time, but with vitamin deficiency, significant health problems or under the influence of aggressive factors, this does not happen, therefore a chronic injury appears. It is in medicine that it is called tendonitis. Among athletes, such a chronic injury is the most common.
general information
Tendonitis is diagnosed when tendon elements have become an area of localization of degenerative processes. With increased load, for a long time affecting the tendons, the area swells, collagen breaks down, the integrity of the mucous membranes is violated. Over time, degeneration of these tissues is possible and the tendon center replaces a substance visually similar to jelly.
Tendonitis is sometimes accompanied by inflammatory processes. It is possible to generate trans, exudate, rich in inflammatory mediators.
What to do?
Conservative treatment of tendonitis involves the use of special orthopedic structures. For example, if areas of the lower extremities are affected, the doctor gives a prescription for the manufacture of specific shoes. She will have a reinforced back and foot arch support. This allows you to unload the muscle tendons of certain areas of the limbs, which means that the fascia of the sole will not stretch so much. To lower the shock load, use arch support. Such products are made from shock absorbing raw materials.
When the pathology is just beginning to develop, it is necessary to use funds to stop the activity of the focus of inflammation. It is also included in the conservative treatment of tendonitis. If possible, the diseased area is kept at rest, minimize stress, use treatment with cold, lasers, magnets, ultrasound radiation. Sometimes the doctor prescribes non-hormonal drugs to stop inflammation (for example, "Ibuprofen").
Acute stage: what to do?
Treatment of tendon tendonitis in the event that the symptoms are severe, the disease proceeds in an acute form, involves providing the patient with an optimal ratio of load and rest. The muscle is loaded under the control of a doctor, clearly following a rehabilitation program composed of specific exercises, the frequency of their repetitions. The greatest benefits are exercises that allow you to strengthen, stretch muscle tissue. Sometimes the patient is recommended to wear a bandage or bandage the damaged areas. If tendonitis has developed against the background of sports, the features of this area are taken into account, a decision is made in favor of using various simulators that allow the athlete to control the load on the affected areas.
Case features
With symptoms of tendonitis, treatment is chosen, taking into account the possibilities of MNR (magnetic nuclear resonance). To a greater extent this is characteristic of chronic patients. Identify areas that respond with normal impulses, determine the nature of degeneration, decide how justified the surgical intervention is. Perhaps excision of the area of hypertrophic tissue. After surgery, the patient is put on a recovery phase and a therapeutic program similar to that recommended for acute rupture.
An operation in the treatment of tendonitis of the brachial, Achilles or other tendon is indicated if physiotherapy does not give the desired result, conservative approaches are ineffective. The operation is justified with the pathology of Osgood-Schlatter, a stenotic form of tendonitis. With intervention, cicatricial sites, aponeuroses are excised. The recovery period takes up to a quarter of a year. During rehabilitation, it is necessary to regularly do exercises to increase muscle strength and ability to stretch.
The nuances of therapy
Sometimes treatment of tendonitis involves the use of painkillers. Widespread "Nise", "Ketorol." You can use painkillers ointments, anti-inflammatory injections and tablets. The optimal form of application is chosen by the doctor. The specialist will tell you how often you need to use medicines, what side effects can be, in which cases you need to stop treatment.
Often, treatment of tendonitis of the shoulder, Achilles tendon, knee or other area of localization involves the introduction of injections of hormonal drugs to stop the activity of foci of inflammation. Use "Hydrocortisone", "Betamethasone". Such drugs stop the pain syndrome and inhibit the release of inflammatory mediators, due to which the patient's condition becomes better. Hormonal, non-hormonal drugs are used for no more than two consecutive weeks. Sometimes the course is shorter if the symptomatology allows you to abandon the injection before the expiration of the specified period. The use of funds beyond this period is possible only when analyzing the condition of the patient by the doctor and evaluating the effectiveness of such a program.
Different approaches
Sometimes treatment of Achilles tendonitis tendonitis, knees, shoulders and other areas requires the use of antimicrobial agents. This is practiced if the inflammatory process is strong, the classic drug approach does not show a pronounced result. Before prescribing antibiotics, tissue samples are taken to determine the nature of the pathological microflora. Based on the information obtained from the analyzes, medications are selected that are effective in this case, and they also determine how their administration will show the best result - tablets, ointments, injections can be used.
Experts draw attention to the fact that treatment of tendonitis (supraspinatus, knee, shoulder and any other) will be effective only if the patient carefully follows the doctor’s instructions. Sick areas should be at rest, otherwise no drug therapy will stop the progress of the condition.
Available remedies: how to be treated at home?
Of course, treatment of tendonitis of the supraspinatus muscle, Achilles tendon and other parts of the body at home will not be effective, but some alternative recipes can be used to alleviate the condition and increase the effectiveness of the main course. The use of such techniques is important to coordinate with a specialist.
The easiest option is ice cubes. Sore areas are massaged for at least a third of an hour using them. It is recommended to add curcumin to food. Every day - at least half a gram. It is believed that walnut vodka tincture will benefit. On a glass of walnut partitions take half a liter of an alcoholic drink, let it brew for 18 days, then use a teaspoon three times a day for food.
Knee hurts: what to do?
Treatment of knee tendonitis involves an integrated approach. First, it is necessary to weaken the inflammatory process. To do this, use "Denebol", "Diclofenac" or similar means at the discretion of the doctor. Such drugs can alleviate the condition, eliminate hyperemia, cope with edema.
In order to rehabilitate the knee in a short time, it is necessary to immobilize this area. Put the tire or bandage the area with a special bandage. They choose the method of immobilization, focusing on the severity of damage to organic tissues, the activity of the focus of inflammation.
In order for the region to recover faster, treatment of knee tendonitis involves a course of physiotherapy. Use special dirt, electric current, magnets. With significant stretching, plastic surgery is required. Excision of the inflamed areas is possible if the approaches described above do not show the desired result.
Shoulder hurts: what to do?
Treatment of tendonitis of the shoulder joint in the first stage begins with a decrease in load, limiting the mobility of the affected area. Avoid movements that can provoke pain for at least three weeks. The doctor selects a set of strengthening exercises to increase the mobility of the zone. Gradually increase the load. Prolonged immobilization is associated with a risk of adhesive arthritis.
Up to five days, treatment of shoulder tendonitis is practiced with anti-inflammatory non-hormonal drugs. For another two weeks in the acute form, ointments with such components are used. With a prolonged course, blood-stimulating ointments containing capsaicin are indicated.
Disease progresses
At the second stage of development of tendonitis, it is necessary to inject "Lidocaine", "Bupivacaine", "Triamcinolone" into the joint cavity. Short-term analgesic drugs make it possible to clarify the case; substances with a lasting effect are used for therapy.
By injection, the administration of hormonal anti-inflammatory can cause a decrease in collagen generation, which leads to a decrease in tissue elasticity. Hormonal treatment for tendonitis is shown strictly in the acute phase of the disease. Between courses maintain three-week intervals. With biceps tendonitis, such drugs are not used at all.
At the third stage, a resection of the diseased part is indicated. During the operation, cicatricial sites are removed, aponeuroses are excised.
Achilles tendonitis: treatment
With this area of localization, the disease is accompanied by serious pain in the damaged area. Conservative therapy usually does not show a pronounced result, so the patient is sent for surgery. There are two main methods of operating - open and using an endoscope.
Open operations are currently practically not practiced, since such an intervention is associated with numerous complications. Using an endoscope is the preferred and popular option. Pain after surgery is milder than in case of open intervention, the rehabilitation period is relatively short, and the cosmetic effect is the best. Athletes who have undergone such an operation on the Achilles tendon can soon return to their main occupation.
If an arthroscope is used in the operation, the event involves the creation of several punctures in the skin through which a special device is inserted that transmits to the monitor the image of tissues inside the human body. The surgeon can examine the affected area, pinpoint where the inflammation is located in the joint bag, what are the osteophytes on the heel bones. Removing these elements, working with inflamed structures involves the use of a shaver.
To make the procedure as delicate as possible, tissue removal can be practiced through cold plasma. Immediately after the intervention, a person will be able to walk, loading his legs in normal mode. After a few days, the rehabilitation period is intensified by physical exercises, allowing to restore the mobility of the area. After a couple of weeks, the stitches are completely removed. In order for the recovery period to be more effective and short-term, physiotherapy is indicated.
Achilles tendon: features of therapy
As soon as pain occurs in this part of the body during training, the session is immediately stopped to give the tissues an opportunity to relax and recover. At the first stage of injury, a temporary cessation of stress is possible. To eliminate edema, skin hyperemia, ice is applied up to four times a day for 10 minutes. The weakening of the pain syndrome is possible if the site is bandaged with an elastic bandage. Tendon rupture can be suspected if the indicated measures do not help to completely restore the area, during exertion the soreness becomes stronger. In such a situation, it is necessary, if possible, to immediately see a doctor.
In the acute form of the disease, the Achilles tendon is bandaged, a compress is made with cold. The foot needs to be immobilized for two days, to provide rest, if possible to keep in a raised position. This will prevent the formation of a hematoma, due to which scars may appear in the future.
To minimize the load on the affected area, different methods of immobilization are used: teips, bandages, tires, orthoses, plaster. In severe cases, use crutches. Orthoses are especially useful at night, as they limit the mobility of the limbs.
Daily routine and diagnosis
With tendonitis of the Achilles tendon, you will have to reconsider the lifestyle, refuse to lift heavy objects. For everyday use, choose shoes with a small heel. Flats and high heels are prohibited. A small heel is the most effective way to relieve excessive strain on the tendon.
The doctor may recommend a compress with "Analgin", "Novocain", "Dexamethasone." The drugs are mixed in equal proportions and used externally. An alternative is injection into muscle tissue. This is especially true if severe pain disturbs you at night.
For stopping inflammatory processes in the Achilles tendon, Ibuprofen, Nimesil, and Naklofen are used. The duration of the program rarely exceeds 10 days due to the abundance of side effects. Such drugs contain compounds, with prolonged use of which a person experiences depressing recovery processes. The listed medicines are prohibited for impaired renal, hepatic functionality.
To improve the condition, the patient can be prescribed Kenalog, Diprospan, and Methylprednisolone. Substances are injected gently, scanning the affected areas with ultrasound. Proper administration helps reduce the activity of the inflammatory focus and slow down the reaction with the participation of enzymes that destroy the tendon. You can not enter these funds into the tendon and in the areas where it is attached to the skeletal system, as this can cause a rupture, which means that restoration will turn into an extremely difficult task, sometimes cure becomes impossible.
Of the methods of physiotherapy for the treatment of the Achilles tendon, magnets, ultrasound, shock-wave technique, ultraviolet, paraffin, therapeutic mud are used. You can do electrophoresis. As a rule, they use Lidazu. Ultrasound can be delivered to the diseased areas of Solcoseryl and Voltaren, which break up scar areas. When the pain is defeated, treatment is continued with massage, exercises to restore, strengthen the affected area.