Tendonitis

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Classification according to ICD-10
M77.9 Enthesopathy, unspecified
ICD-10 online (WHO version 2019)

A tendinitis (derived from the Latin tendo , tendon 'and Greek -itis (-ίτις), inflammatory (s disease)'; German, tendonitis') is the medical term for an inflammatory disease of the tendons in the context of tissue damage (micro lesions) of the affected Tendon structure. This can lead to an inflammatory reaction which, according to Galen, can classically lead to certain perceptible changes (reddening, overheating, swelling, pain, functional restrictions).

Causes and Description

A clear cause can rarely be identified. The most common inflammation occurs on the tendons that are connected to the shoulder joint ( rotator cuff ). However, tendinitis is also observed on the wrists and heel, which is caused and promoted by constant stress and incorrect posture ( tendon sheath and Achilles tendinitis )

Pathophysiologically, after the tissue damage (often due to overuse of the tendon), small tendon tears or shortened blood supply to the tendon tissue occur. The acute decrease in the wall tension of the small arteries and the constriction of the small veins with subsequent increased blood flow lead to the classic signs of inflammation with reddening and overheating . Because of the high pressure within the blood vessels, blood plasma escapes into the surrounding tissue: an edematous swelling develops . In the further course, the pain reactions can even intensify , especially due to proinflammatory cytokines and interleukins . The tendon damage develops slowly, usually over several years, but usually an acute trigger can be assigned to the problem.

In rare cases, tendonitis can also be attributed to prior treatment with a fluoroquinolone antibiotic such as B. Levofloxacin be recycled .

Chronic inflammation can lead to a pathological change in the structure of the tendon, which in some cases is associated with calcium deposits (e.g. tendinitis calcarea or also called calcified shoulder). The pathological change in the tendons is also called tendopathy or enthesopathy at the tendon insertion if there is no accompanying acute inflammatory reaction.

Treatment options

Anti-inflammatory measures are the main focus of therapy . First of all, it is essential to reduce the load on the affected tendon in order to avoid further irritation or even damage to the tissue. In addition, local cooling ( cryotherapy ) is required to stop the inflammatory process. Injections with corticosteroids are often helpful , as they allow the pain to subside.

In addition, the posture should be improved or changed. Measures to change the supply of nutrients to the affected areas of the body should be considered.

See also

Sources and individual references

  • Roche Lexicon Medicine [Electronic Resource] 5th edition; Elsevier GmbH, Urban & Fischer Verlag; Munich / Jena 2003; ISBN 3-437-15072-3
  1. ↑ Alphabetical directory for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 866
  2. ↑ a b c Tendinitis and Tendosynovitis. Retrieved October 8, 2019 .
  3. ^ T. Lewis, J. Cook: Fluoroquinolones and tendinopathy: a guide for athletes and sports clinicians and a systematic review of the literature. In: Journal of athletic training. Volume 49, number 3, 2014 May-Jun, pp. 422-427, doi : 10.4085 / 1062-6050-49.2.09 , PMID 24762232 , PMC 4080593 (free full text) (review).