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Elbow tendonitis
Last reviewed: 23.04.2024
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Very often the focus of inflammation becomes a tendon in the elbow joint zone, and then the doctors diagnose such a disease as ulnar tendonitis.
In the musculoskeletal system of man, especially dense connective tissue - tendons (in Latin "tendo") - performs two major functions. Tendons attach the muscles to the bones, and also transmit them to the bone levers of muscle contraction, that is, they provide the biomechanics of the entire musculoskeletal system. And although the tendons due to the predominance of fibrous collagen elements in their structure are characterized by high strength, they also tend to have inflammation - tendonitis. The most vulnerable to the onset of inflammatory processes are the tendons in the knee, hip and shoulder joints.
[Causes of elbow tendonitis
Among the causes of ulnar tendonitis, there are a variety of factors. First of all, this is a prolonged overstrain of the elbow joint (for example, in athletes) or a constant physical load, associated with repeated repetition of the same movements (in some professions).
Due to constant overloads, the collagen fibers of the tendons begin to deform until partial destruction of the tissues and their tearing. At the site of tendon tearing, necrotic areas can appear - inflammation foci, as well as deposits of calcium salts, traumatizing adjacent tissues.
The cause of elbow tendonitis in many cases is trauma, especially in older people, when due to age-related changes in the body, collagen production decreases and elasticity of tendons decreases.
The development of tendonitis of the elbow joint is promoted by infections, rheumatoid processes in joints (arthritis), metabolic disorders (with diabetes mellitus), a general decrease in the level of immunity of the body.
Symptoms of elbow tendonitis
Symptoms of elbow tendonitis can appear suddenly, but can develop slowly - for a long time.
The most typical and most common sign of tendonitis of the elbow joint is a sensation of pain, which is of different intensity and character (aching, acute, pulsating). Pain occurs when you move your hand, sometimes the pain gets worse towards the night, not allowing you to fall asleep.
Due to the defeat of the tendon tissues and their inflammation, contracture (restriction of mobility) of the joint and crunch during movements is noted. With a large area affected by inflammation, the skin in the area of the aching joint turns red and becomes hot to the touch.
Where does it hurt?
Diagnosis of elbow tendonitis
The diagnosis of this pathology of the musculoskeletal system is based on a medical examination of the patient with palpation of the elbow joint. In order to determine the degree of mobility of the affected limb and the localization of pain, the doctor also conducts special tests: hyperflexia, supinatory, varus and valgus stress test, compression syndrome, etc.
Since the clinical picture of elbow tendonitis is largely similar to other inflammatory processes of this localization, it is necessary to differentiate tendonitis from such diseases as osteochondritis, arthritis, osteoarthritis, synovial chondromatosis, fasciitis, etc.
To exclude arthritis and osteoarthritis, a laboratory blood test is performed. To clarify the diagnosis also helps to picture the distribution of temperature fields in the tissues of the tendon and muscle (using thermography), the definition of pathological changes in tissues and inflammatory foci in them (ultrasonography). In addition, an examination of a sick hand using an X-ray can be performed.
What do need to examine?
How to examine?
Who to contact?
Treatment of elbow tendonitis
The primary therapeutic task of treating elbow tendonitis is to relieve the patient of pain and relieve tendon inflammation.
Treatment begins with resting the patient's hand, for which medical bandages, elastic bandages, immobilizing bandages, which ensure the immobility of the limb, are used. It is recommended to apply cold to the sick place (wrapped in ice napkin).
To anesthetize and relieve inflammation in the treatment of elbow tendonitis, non-steroidal anti-inflammatory drugs are widely used. For example, Nimesulid (synonyms - actasulide, aulin, mesulide, nise, nimesil, nimulide, etc.) is available in the form of tablets of 100 mg for internal use and 0.1% of the gel for topical therapy. This drug is prescribed by doctors for arthritis, arthrosis, osteoarthritis, bursitis, enthesopathy, fever and pain of various etiologies.
Nimesulide is taken orally by one tablet twice a day - after eating, squeezed with enough liquid. The maximum daily dose of this drug is 400 mg (ie 4 tablets). The duration of treatment is determined by the doctor individually.
Normally, Nimesulide is tolerated well by patients, but can also cause side effects in the form of drowsiness, dizziness, headache, nausea, vomiting, diarrhea, skin rash and swelling. There are also possible changes in the blood: anemia, leukopenia, agranulocytosis, a decrease in the level of platelets.
The use of this drug is contraindicated in hypersensitivity to other anti-inflammatory non-steroid drugs, with ulcer of the stomach and duodenum, hepatic and renal insufficiency, heart failure, high blood pressure. Nimesulide is absolutely contraindicated in pregnant and lactating women, as well as in children under 12 years of age.
The drug in the form of a gel is applied externally by applying (without rubbing and applying bandages) to the skin of the sore spot three times during the day.
It should be noted that in the case of a particularly painful inflammation, parenteral administration of anesthetics in combination with steroid hormones can be prescribed.
Treatment of ulnar tendinitis associated with infection is performed with the use of antibacterial drugs, appointed by the attending physician.
A good therapeutic effect on the removal of acute manifestations of tendonitis of the elbow joint is given by physiotherapy, and after the cessation of pain, exercise therapy (in particular stretching exercises).
In those rare cases when conservative therapy does not give the desired results, surgical treatment in the form of excision (excision) of the inflamed tendon can be applied.
Prophylaxis of elbow tendonitis
The main thing in the prevention of elbow tendonitis is to avoid excessive stress on the joints and long-lasting monotonous movements, and also not to make sudden movements and not to lift weights by standing on your straightened legs.
To replenish the body with collagen, that is, to increase the elasticity of the tendons, experts recommend eating beef and beef liver, chicken eggs, vegetable oils, dairy products, sea fish, citrus fruits, apricots, bell peppers, nuts.
It should be borne in mind that fatty foods, black tea, coffee, chocolate, oatmeal, sorrel and radish block the absorption of calcium and its entry into the tissues of the tendons and bones. The same hormonal contraceptives are sinful.
Prognosis of elbow tendonitis
If acute ulnar tendonitis is not cured in time, the disease will take a chronic form with persistent pain and a significant limitation of the mobility of the hand. In addition, the inflammatory process can go further and capture the entire joint and the joint bag.
Without adequate complex therapy, the prognosis of elbow tendonitis is not optimistic, since there is a real threat of irreversible dystrophy of the tendon tissues, its weakening and rupture, even with moderate physical exertion.