Tendinitis or bursitis usually affects the shoulder, elbow, wrist, hip, knee and ankle. It usually occurs suddenly and can cause severe pain. Tendinitis usually develops as a result of repetitive (overuse and contempt) abuse. It often heals in a short time, especially when treated early; in some people it may recur or become (long-term) chronic.
Quick Notes:
Tendonitis and bursitis is inflammation (non-germ) or degeneration of soft tissue around muscles and bones.
Emergency treatment: Consists of rest, ice application, wrapping (compression) and elevation.
Rapid worsening of pain, redness and swelling, or sudden inability to move the joint; are danger signs.
What is tendinitis?
The green area in the picture is the region of the knee called the ‘anserine bursa’; Inflammation is called bursitis. Tendons (white) are the thinning of the muscles (red) and becoming a ligament and the inflammation in the area where they are attached to the bone (without germs). These attachment areas become painful and tender to touch when tendinitis develops.
What is bursitis?
Bursitis is inflammation of the bursa (usually germ-free). Bursa is a small sac-shaped tissue that acts as a cushion between moving structures (bone, muscle, tendon or skin). It distributes the load on the bone that is pulled aside by the muscle or tendon. When the bursa becomes inflamed, it is very painful, even causing pain at rest.
What is the cause of tendinitis and bursitis?
Tendinitis can occur with sudden severe injury. It most commonly occurs with repeated, minor injuries to the tendon. For example:
Prolonged typing while using a keyboard can result in tendinitis or bursitis after hours of ceiling painting, chopping and cutting.
Clamping tight—when using hand tools (such as scissors, pliers) or during extended driving.
Playing one-handed “backhand” while playing tennis; causes tennis elbow.
Wearing inappropriate running shoes or not receiving proper training prior to sports.
People with gout, pseudogout, blood or kidney disease often develop bursitis as part of this disease. The elderly are more prone to tendinitis and bursitis.
Rarely, certain medications can cause tendinitis and tendon rupture (spontaneous tearing). These are fluoroquinolone antibiotics and statins (cholesterol-lowering drugs).
How are tendinitis and bursitis diagnosed?
To determine the cause of these problems, first your medical history (anamnesis) and a careful physical examination are performed. Tenderness at a particular point along the tendon or tendon sheath indicates tendinitis. Pain occurs when the muscle to which the tendon is attached moves against a resistance.
Most patients do not require imaging tests such as X-rays, magnetic resonance imaging, or ultrasound scans at early return. Imaging and blood tests may be done to examine for infection or an underlying disease (such as rheumatoid arthritis, gout) only if the problem persists despite treatment. If bursitis developed as a result of infection; Inflammation from the bursa must be resisted.
How are tendinitis and bursitis treated?
Treatment depends on the cause. If the cause is overuse or injury, measures can be taken to reduce it. You can work safely with appropriate ergonomics. Some patients may need to protect the joint and support the affected area. For therapeutic purposes, ultrasonic waves may be beneficial in some patients. But the general treatment principle is as follows.
-Rest: The affected joint should be rested, at least for a short time. If the problem is in the hip, leg or foot, weight bearing should be avoided for a short time.
-Ice: Ice can help reduce inflammation and pain. Ice can be applied to the painful area for 10-15 minutes twice a day.
-Medication: If pain persists, non-steroidal anti-inflammatory drugs (NSAIDs), usually aspirin, ibuprofen or drugs such as naproxen may be required. NSAIDs are available in topical (applied to the skin) forms and can reduce pain and inflammation. Acetaminophen can also help relieve pain.
Corticosteroid injections may provide short-term benefit in some tendinitis. If there is an infection, it is necessary to use an appropriate antibiotic and drain with a needle.
-Supports: A walking stick or suitable orthoses can be used to reduce the pressure on the joint.
-Physical therapy: Some tendon problems may not improve despite standard treatment. If the tendinitis lasts for more than a few weeks, you may need to see a physical therapist. The physiotherapist can give you strengthening and stretching exercises. If tendonitis or bursitis limited joint movement for a long time; the range of motion of the joint may not be the same as before. For example, you may not be able to extend your arm up-down, forward-backward as before, due to the development of “frozen shoulder” in the shoulder; With early treatment, this problem can be avoided.
-Surgery: If the problem still persists a few months after treatment, you may consider surgery. Some patients with infections or adhesions in the tendon or bursa may require a cortisone injection or surgery.
Tendon rupture due to tendonitis is a serious problem. The most common rupture is the Achilles tendon, in the lower calf region of the lower leg; condition requiring surgery.
Prevention:
Tips for all joints to prevent the development of tendonitis or bursitis:
– Warm up and stretching exercise should be done before intense exercise.
-Start slowly and gradually increase the degree of exercise.
– Take care to do exercise and sports daily, not just on weekends.
-Learn and maintain proper posture and body mechanics.
-Use sports equipment suitable for you and your sport.
-Avoid staying in the same position for too long. Take rest breaks or change your position every 20-40 minutes.
-When pain occurs, stop the activity, do not force yourself to do it.
-“Even if it kills me, I will finish this job!” Avoid compulsive behaviors such as
Tips to protect the joints:
Shoulder: – Lie facing the object you want to reach.
-Get up from the chair with your thigh muscles, not by pushing with your shoulders or hands.
-Push from the sides, not from the bottom.
-When carrying a heavy object, hold the load at eye level and use both hands.
Elbow and wrist:
-If you have difficulty in gripping and squeezing movements that require power; auxiliary tool-use aids such as jar opener, car steering wheel pad.
-Use your abs while getting out of bed.
-Do not carry anything heavy in one hand or on one side of your body. Carry balancing on both arms and reducing the load.
Knee and ankle
-Avoid sitting with your leg bent (folded).
-Wear comfortable shoes to expand the weight bearing area; put the weight on the heel, not the toes.
-Replace your worn shoes.
-If you are walking or standing for long periods of time, wear shoes that support the soles of your feet.
-Keep your leg muscles strong. You can do leg lifts by placing weights (2-10 kg) on the ankle while sitting
