Table of contents:
- What are the tasks of tendons and tendon sheaths?
- What are the causes of tendinitis?
- What are the symptoms?
- How is the diagnosis made?
- How is the treatment carried out?
- Whom can I ask?
- How are the costs going to be covered?
A tendon sheath is a fluid-filled “sheath” that surrounds one or more tendons. They occur in particularly stressed parts of the body and have the task of protecting the tendons running in them from mechanical damage.
Chronic overloading of the tendon or the tendon sheath can lead to inflammatory reactions. Tendovaginitis in the area of the wrist or ankle is particularly common.
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What are the tasks of tendons and tendon sheaths?
Tendons are the connection points between muscles and bones. They consist of connective tissue fibers and are used to transfer muscle strength to the bones: When moving, the muscle contracts (contraction). This creates a pull on the tendon, which in turn transfers the pull to the bone. This is the only way to move the bone.
In some parts of the body the tendons run over protruding bones or lie particularly superficially under the skin; at these points there is a risk that the tendon will be damaged as a result of friction or pressure. The tendons on such stressed parts of the body (e.g. fingers, wrist, shoulder, knee, Achilles tendon) are therefore surrounded by a protective covering of connective tissue, the so-called tendon sheath. Because the tendon sheaths are filled with fluid, the tendons can slide smoothly in them. More on the topic: tendons and ligaments
What are the causes of tendinitis?
If a tendon or the tendon sheath is stressed too much, it can become inflamed. Unusual or frequently repeated movements irritate the sliding tendon tissue and cause inflammatory reactions. Tendonitis is also known as tendovaginitis.
In athletes (e.g. runners) tendinitis often develops in the foot or lower leg area. Long walking distances can also cause tendinitis, especially in untrained people; unsuitable footwear also increases the risk. More on the topic: healthy exercise
Tendovaginitis also occurs particularly frequently in the wrist area as a result of chronic overload in stereotypical activities such as computer work ("mouse arm") or practicing a musical instrument.
In some diseases (e.g. rheumatoid arthritis, diabetes) and during pregnancy tendinitis is more common.
In rare cases, tendinitis is triggered by an infection when bacteria get to the tendon or tendon sheath through a small wound, for example. This type of tendonitis requires rapid treatment because the bacteria can spread through tendons and tendon sheaths and cause serious infections.
What are the symptoms?
Tendonitis leads to stabbing or pulling pains, which are particularly noticeable when moving. In addition, the affected area may be warm, red and swollen as a result of the inflammation. Pressure pain along the tendons and muscles is also typical. In pronounced cases there is pain at rest (especially at night). The symptoms usually develop slowly and increase over time.
The rare form of bacterial tendinitis manifests itself in sudden, severe pain with usually significant swelling, reddening and overheating. General symptoms such as fever can also occur; A quick medical evaluation is important in these cases.
Tendonitis in the area of the flexor muscles of the fingers is a special form. This leads to restricted mobility of the affected finger and is known as stenosal tendovaginitis. As a result of inflammatory reactions, the tendon sheath is so narrowed at one point that the tendon cannot slide smoothly through it. If the affected finger is stretched, the tendon has to overcome the narrow point. This usually happens jerkily after increased effort and is perceived as a "snap" or "snap" ("snap finger", the finger shoots into the extended position). If the extensor tendon of the thumb is affected, it is called tendovaginits de Quervain.
How is the diagnosis made?
The diagnosis of tendinitis is usually made on the basis of the symptoms and the physical examination findings. Sometimes you can feel a rubbing when moving the tendon (s) running in the corresponding tendon sheath or you can see soft tissue swelling. In rare cases, ultrasound or magnetic resonance imaging is necessary for further clarification.
How is the treatment carried out?
It is important to calm the affected muscle and to protect it. The movement that led to the inflammation should be temporarily avoided or at least severely restricted; a splint or a tight bandage may help. Anti-inflammatory drugs (ointments, tablets, etc.) can alleviate the symptoms; if the symptoms are severe, cortisone injections may be given. If mobility is restricted by the inflammation, physiotherapy or occupational therapy may be indicated. Pronounced constrictions within the tendon sheath that cannot be improved with conservative measures can be surgically removed.
Whom can I ask?
If you suspect tendinitis, you can contact the following offices:
- General practitioner
- Specialist in trauma surgery
- Specialist in orthopedics and traumatology
- Sports physician
How are the costs going to be covered?
The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:
- Right to treatment
- Visit to the doctor: costs and deductibles
- What does the hospital stay cost?
- Prescription fee: This is how drug costs are covered
- Rehabilitation & cure
- Health Professions AZ
and via the online guide to reimbursement of social insurance costs.