Read More »
Read More »
Read More »
Read More »
What is it?
Inflammation of tendons or joint capsules.
Symptoms
Localised pain, swelling, and sometimes redness. The inflamed joint is frequently tender to the touch with there being pain on moving the joint. The inflamed (or torn) tendon is tender to touch with there being increased pain on using the associated muscle. Prolonged loss of use can result in loss of movement of the affected joint, or loss or weakness of the affected muscle.
Incidence
This is a common condition in the physically active population. Most cases are relatively mild resolving within a matter of weeks. A small proportion of these injuries can be severe and a small proportion may become chronic.
Key Points (from ACC Treatment Profiles, 2001)
Inflammation is involved with tenosinivitis of the tendon and tendon sheath
Overuse, poor technique or continuation from an acute injury are frequent causes of tenosinivitis
Rest is important in recovery
Infection may be a risk
Synovitis/Tenosinivitis is rare in patients less than 18 years of age
Identify and then modify the precipitating activity
Differential Diagnosis (From ACC Treatment Profiles, 2001)
Carpal tunnel syndrome
Mixoedema/pregnancy
Inflammatory arthritis
Joint sprain/fracture
Nerve entrapment
Old carpal injury
Gout/pseudo-gout
Soft tissue infections
Recommended Treatments
Resting night splints (for nocturnal symptoms) (Mills R, 2003)
Physiotherapy (Mills R, 2003)
Reduced stressors (ACC Treatment Profiles, 2001)
Other options suggested by the ACC include:
Physiotherapy
Joint aspiration
Local anaesthetic sterile injections
Occupational Therapist to assess the workplace
Red flag conditions (Dr R Mills):
Muscle atrophy
Significant impairment of activities in daily living
Altered finger/hand profusion
Systemic signs/symptoms
Sudden onset of symptoms
Yellow flag conditions:
Attitudes and beliefs about pain
Emotions
Behaviour
Family
Compensation issues
Work
Diagnostic and treatment issues
Workplace conflict
When to Consider Referral for a Specialist Opinion:
The presence of any red flag conditions
The worker has had more than two weeks certified unfit for duties, or more than one month on selected duties
The worker has had more than three weeks off work, or on selected duties and has significant yellow flag conditions
Not back at pre-injury duties within six weeks of the injury