Tendonitis in rheumatism
The Latin term for tendinitis is Tendonitis. This becomes the inflammatory process on the tendons in the course of a rheumatic disease described. A distinction must be made between tendinitis (tendinitis) Tendinopathy (Tendon problems). Tendinopathy is a chronic overstressing and incorrect loading of a corresponding tendon. Basically, it should be noted that the Tendonitis can affect people of all ages. The rheumatic disease is not an exclusive disease of the elderly, but mainly occurs in different forms in children and adolescents.
The The cause of the inflammation of the tendons lies in the immune system the data subject. The diseases of the rheumatic type are Autoimmune diseases. This means that the immune system, which normally recognizes foreign structures as foreign and fights them, and recognizes the body's own structures as the body's own and does not fight them, no longer differentiates properly and now also the body's own tissue attacked.
All cells in the human body are covered with so-called surface antigens (small anchors that sit on the outer surface and have a very specific structure) - on the basis of these, the cells of the human immune system recognize that this cell is a cell that is also in belongs to the body. Cells and structures that do not belong in the body, such as Viruses, bacteria and foreign bodies (splinters, threads) do not have these surface antigens. The immune system therefore recognizes that these structures need to be fought, and the immune system becomes active on various levels. If you have an autoimmune disease such as rheumatism, the immune system incorrectly recognizes some of the body's own surface antigens (anchors) as foreign and activates itself to fight them. Antibodies are formed against the actually good surface antigens, which dock onto them and mark them so that the antigens are killed.
In rheumatism, one's own cells in joints, muscles, tendons and other soft tissue structures are very often attacked. It should be noted, however, that this attack can vary from patient to patient. Therefore, tendinitis does not develop in every patient with rheumatic disease.
The patients suffer from Pain, redness, overheating in various places in the body. In theory, any tendon on any muscle in the body can be affected. There In addition to the tendons (tendinitis), the muscles (myositis) and joints are also often affected patients complain of decreased strength, restricted mobility and pain during physical activity.
The symptoms can appear briefly in an acute flare-up and also regress. But they can also exist chronically (long-term and permanent).
Synovitis in rheumatism
The synovium is the innermost layer of the joint capsule. It is a thin membrane that forms the synovial fluid (grease). With synovitis or Synovitis is this Membrane inflamed. This inflammation manifests itself in a deposition of inflammatory cells, increased blood flow to the tissue, the vessel walls become leaky and allow more fluid to pass through and water is stored. That leads to a Joint effusion arises. In the long term, i.e. when the inflammation becomes chronic, as is often the case with rheumatoid diseases, the cells of the synovia grow into the joint. That leads to Movement restrictions and pain in the patients. Often only an arthroscopy can help (Joint endoscopy) in which the villi or the entire synovia are removed with a kind of electric razor.
The degree of synovitis can be classified using a score (degree of classification to determine the severity of the disease). This assigns the classification low and high-grade. The removed villi are examined by the pathologist and assessed according to certain criteria. Together with the rheumatologist or the orthopedic surgeon, the severity is then classified. If there is high-grade synovitis, rheumatic disease is very likely.
In the diagnosis of rheumatic diseases includes the anamnese (i.e. the patient's medical history) is a very relevant part, since the treating doctor uses the description of the symptoms and the course of them, as well as e.g. Diseases of blood relatives, can draw decisive conclusions about the possible disease. Furthermore, the physical examination important, since other causes of pain in the joint apparatus can be excluded or classified as unlikely.
The Blood test allows to find out if Markers of inflammation (certain proteins in the blood that are increased during inflammatory processes in the body) are present. In addition, antibodies or the Rheumatoid factors determined become. It is important to note here that there are known antibodies that can be looked for. But there is also the possibility that no antibody is increased, although a rheumatic disease is present. Or that antibodies are elevated even though the patient is healthy. Therefore, the evaluation of the antibody results can only work in connection with a good medical history, physical examination and further diagnostics.
In addition to the studies mentioned, this also takes place roentgen its application. Changes in the joints, but also gross abnormalities in the soft tissue, such as calcifications, can be made visible here.
In addition, further information can be obtained with examinations such as computed tomography, MRI (magnetic resonance) and ultrasound (sonography).
Treatment of tendinitis in rheumatism
The treatment of rheumatic diseases and also rheumatic tendinitis should definitely be carried out by a trained rheumatologist, as the therapy has to be adjusted differently depending on the patient and side effects are to be expected. In addition to various pain medication, immunosuppressants, cortisone and biologicals are part of the drug therapy.
Especially for pain in joints, muscles and tendons due to inflammation caused by rheumatism, the patient should receive physiotherapy therapy or exercise therapy in general. The general rule is that those affected should not stop moving as this will make the problems worse in the long term. Because of the pain, many patients avoid certain movements - as a result, muscles and tendons atrophy and weaken. At the beginning of sports activities, the pain may increase as the muscles, tendons and the entire musculoskeletal system are not used to the new movements.
Various organizations offer programs for independent or group training.
However, care should be taken not to overwork the body as tendons and muscles are damaged due to the inflammation.
Exercises and sports such as swimming, yoga, cycling and also shadow boxing strengthen and train the whole body.
In the most severe cases, the symptoms can be resolved by cutting the tendon (tenotomy), which is a surgical procedure.
The Appearance of symptoms in diseases of the rheumatic type, such as tendinitis, can happen in the short or long term.
In the case of short-term occurrences, one speaks of Spurts. The problems worsen within a short time to a degree that would otherwise not be perceived by those affected. This condition can last for weeks to months. Appropriate drug and non-drug therapy is used to try to subside this surge. In principle, the rheumatic disease remains present throughout life. With appropriate therapy, however, the goal is that fewer or no relapses occur and the patient remains as pain-free as possible. This does not work equally well for every patient. Therefore, therapy (with medication and exercise therapy) to reduce tendinitis must be tailored to the individual patient.
Tendonitis in rheumatism on the foot
Changes to the foot in the course of a rheumatic disease are very often. It often arise in the process bony misalignments, like for example Claw toes, of the hallux valgus. This means that tendons that run along the foot are also affected tendinitis can occur. The tendinitis on the foot and leg can be very bothersome, as moving around no longer works without pain. Many patients work in self-therapy with ointments and bandages. However, these only have a limited effectiveness. If the inflammation is severe, a doctor should be consulted.
Especially the inflammation of the Achilles tendon can be dangerous here the high stress on this tendon poses a risk of tearing. If many approaches do not help and the entire foot (including joints and bones) is affected by rheumatism, a Stiffening (Arthrodesis) of the ankle may be necessary, whereby at best the tendinitis is reduced by reducing the overload. It is important to continue the drug therapy at all times and to regularly check the feet for wounds and injuries, as the incorrect posture creates pressure points that can become inflamed if not cared for and can provide a gateway for bacteria.
Please also read our page Tendinitis in the foot.
Tendonitis in rheumatism on the shoulder
Tendonitis is not uncommon in rheumatism on the shoulder. As in all other places in the body, the immune system attacks the body's own structures. The joint itself is often attacked and the synovial membrane destroyed. As a result, structures that pull through the joint, such as the tendons of the biceps (flexor arm muscles) and the rotator cuff (a group of four small muscles that lie in front of (ventral) and behind (dorsal) of the shoulder blade, and the Ensure mobility and stability of the shoulder). The Tendons can swell, calcify and also tear as a result of the rubbing in the joint. This leads to crackling and rubbing noises, pain and, very often, to restricted mobility. You can start here with syringes containing cortisone to be worked. It is important to have adequate rheumatoid therapy at all times. Regular exercise of the shoulder is also important, since permanent immobilization of the shoulder leads to long-term immobility in the shoulder (frozen shoulder).
In addition to medicinal conservative treatment can also be treated surgically. Smaller arthroscopic interventions such as the removal of mucous membranes and bone splinters are possible. Major interventions are z. B. the Removal of inflamed bursa or the correction of the position of bone parts. In later stages (if the shoulders are severely changed and damaged) the installation of prostheses may be necessarywhen the bone is no longer stable and, for example, the rotator cuff tendons are no longer able to hold the shoulder. In these cases, the installation of a so-called inverse prosthesis can be indicated, for example.
Also read: Shoulder pain