tendinopathy
TENDINOPATHY

Tendinopathy is a clinical syndrome characterized by tendon thickening and localized tendon pain, swelling or impaired performance.
It usually is a temporary condition if treated early but may also be recurrent or chronic.
Principles of therapy include: ddentification & elimination of the cause of tendinopathy, behavior modification to minimize or eliminate sources of continuing irritation, specialist referral for appropriate follow up care and to reduce pain & to return function

 

Introduction

  • A clinical syndrome characterized by tendon thickening & localized tendon pain, swelling, or impaired performance
  • Usually a temporary condition if treated early but may also be recurrent or chronic
  • Result either from acute trauma (eg rupture, laceration) or repetitive overload/overuse

Definition

Tendinitis
  • An inflammatory response that occurs in tendons after vascular disruption, resulting from microscopic, partial, or complete rupture of the tendon
    • Although inflammatory reactions exist, most patients have prolonged symptoms before consulting a physician & the acute inflammation has already subsided & has been replaced by disordered collagen arrangement w/ increased proteoglycan & neovascularization
  • Occur during acute stage & is usually not long-lasting
Tendinosis
  • Refers to the histopathologic finding of tendon degeneration
Overuse Tendinopathy
  • Most common type of tendon problem
  • Characterized by chronic degenerative changes in the tendon tissue that reflect scarring &/or failed healing response
  • The classic inflammatory reaction is typically absent in overuse tendinopathy, or only minimally present in adjacent peritendinous or bursal tissue

Signs and Symptoms

  • Pain
  • Weakness in the joint
  • Tenderness
  • Swelling, erythema, warmth

Risk Factors

  • Often divided into intrinsic factors which refer to the properties of an individual’s tendon or healing capacity & extrinsic factors which refer to the load placed on the tendon
  • Age
    • Tendons become less flexible w/ age & become more prone to damage
    • Increasing age is also associated w/ increased risk of delayed recovery
  • Gender
    • May be caused by a combination of hormonal influences, biochemical variables, sporting or occupational behaviors
  • Obesity
    • In general, overweight or obese patients have increased risk of developing tendinitis
  • Medical conditions
    • Patients w/ preexisting illness such as tendon lesions, arthritis, gout, thyroid disease & diabetes
  • Fluoroquinolone treatment
    • Several case reports of tendinopathy, particularly Achilles tendinopathy, & some reports of tendon rupture in patients receiving fluoroquinolone treatment
  • Work-related factors
    • Physical factors: intense, repeated & sustained exertion; insufficient recovery time between activities; starting a new job or returning to work after an extended period of time away; poor environmental conditions; inadequate equipment
    • Psychosocial factors: monotonous work, time pressure, high work load
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Rheumatology digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Elvira Manzano, 5 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Tristan Manalac, 2 days ago
Statin use, particularly in smokers, obese patients and nondiabetics, has a strong and dose-dependent association with decreasing risk of pancreatic ductal adenocarcinoma (PDAC), according to a new study.
15 Oct 2017
Second eye cataract surgery provides greater improvement in visual function and quality of life compared with first eye cataract surgery alone, a recent study claims.