Acupuncture
W. John Diamond in The Clinical Practice of Complementary, Alternative, and Western Medicine, 2017
Tendinitis — This comes in many different manifestations. Chronic cases of one year or more duration may not respond to anything, in part due to the mineral deposits that occur at sites of chronic inflammation. More acute cases can be affected by microcurrent stimulation. A good technique for tendinitis is called “Threading the Tendon.” Closely insert your acupuncture needles parallel along both sides of the tendon to be treated. Run 80 Hz for 8 to 10 minutes, then 0.3 to 0.5 Hz for 5 to 10 minutes. This should help reduce inflammation. The patient may need five to six treatments. If there are no results by the 6th treatment, microcurrents probably will not help. Make sure you properly address all the muscles involved that may influence the site. This includes the muscle to which the tendon is attached as well as the opposing muscles on the opposite side of the limb (e.g., extensors and flexors). Ergonomie changes may have to be addressed as well.
Tendinopathy
Kohlstadt Ingrid, Cintron Kenneth in Metabolic Therapies in Orthopedics, Second Edition, 2018
Patients with tendinopathy and tendinitis will both present with the following symptoms: pain in the area of a tendon that is worse with use, palpation pressure and muscle testing. There may be visible tendon thickening in Achilles tendinopathy. In advanced cases, there may be muscle atrophy, but this is unusual. Both conditions are usually worse with eccentric loads. Patients with tendinopathy usually have had pain in a tendon that has gone on for more than 6–8 weeks. The tenderness in the tendon can become quite easily provoked with little pressure or use. The tendon area becomes sensitized and demonstrates low threshold characteristics in regard to pressure and pain with use. There is also a possibility of the development of secondary hyperalgesia, in which the receptive field for pain processing in the cord expands and the patient perceives a wider area of pain that is larger than the tendon itself. Patients with tendinopathy may have had strain injuries of the muscle or tendon that did not heal. Tendinopathy pain is usually not constant but is usually intermittent but easily set off or aggravated. Patients may also have pain, spasm or trigger points in the muscle belly of the tendon. Muscle testing of the muscle with the tendinopathy can show poor recruitment or breakaway weakness.
Musculoskeletal system
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha in Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
Heel pain – plantar fasciitis is inflammatory thickening of the plantar fascia, usually at the origin from the calcaneum and is a common cause of heel pain. The diagnosis is usually clinical but in refractory cases ultrasound can be used to confirm the diagnosis, exclude other conditions such as plantar fibroma or fibromatosis or to guide steroid injection. Achilles tendon pathology is another common cause of heel pain located posteriorly. Chronic tendinopathy is very common as the Achilles tendon also carries a major load during ambulation and is subject to acute inflammation or tears sometimes related to relatively trivial trauma. Ultrasound and MRI can establish the diagnosis of tendinopathy and assess the presence of tears. Partial or complete rupture can be assessed. Dynamic ultrasound can also assess the tendon gap in complete rupture.
The effects of pistol grip power tools on median nerve pressure and tendon strains
Published in International Journal of Occupational Safety and Ergonomics, 2022
Ryan Bakker, Mayank Kalra, Sebastian S. Tomescu, Robert Bahensky, Naveen Chandrashekar
CTS is caused by excessive pressure on the median nerve [10], which runs through the carpal tunnel. During pistol grip power tool operation, changes to the median nerve pressure (MNP) can be caused by gripping the handle [2,11–13] and deviating from a neutral wrist position [13–15]. Tendonitis is inflammation of a tendon caused by cumulative trauma through repetitive strain [16]. The tendons of the flexor digitorum profundus (FDP) and flexor digitorum superficialis (FDS) muscle groups travel through the carpal tunnel and are responsible for applying grip force and engaging the tool trigger during power tool operation. These tendons are commonly associated with tendonitis [17,18]. While muscular contractions cause these tendons to experience strain during hand-tool gripping tasks, the tendons may experience additional strain from a forceful tool handle rotary displacement due to a reaction torque at the end of a fastener’s travel.
Effectiveness of topical glyceryl trinitrate in treatment of tendinopathy – systematic review and meta-analysis
Published in Disability and Rehabilitation, 2022
Mikhail Saltychev, Jouni Johansson, Viljami Kemppi, Juhani Juhola
The MEDLINE defines tendinopathy as a “clinical syndrome describing overuse tendon injuries characterized by a combination of pain, diffuse or localized swelling, and impaired performance.” The syndrome is very common and affects different tendons. Pain is often the first clinical symptom causing motion restriction, disability, absence from work, and increased use of healthcare services [1,2]. The most common sites are shoulder rotator cuff, Achilles tendon, humeral lateral epicondyle, and patellar area. In addition to physiotherapy and operative methods, a diverse spectrum of topical agents has been used to treat this condition such as cortisone injections, shockwave therapy, platelet-rich plasma injections, topically applied nonsteroidal anti-inflammatory drugs, and many others [1,3,4].
Electromagnetic transduction therapy and shockwave therapy in 86 patients with rotator cuff tendinopathy: A prospective randomized controlled trial
Published in Electromagnetic Biology and Medicine, 2018
Tim Klüter, André Krath, Martin Stukenberg, Hans Gollwitzer, Norbert Harrasser, Karsten Knobloch, Nicola Maffulli, Jörg Hausdorf, Ludger Gerdesmeyer
Shoulder pain is one of the most common musculoskeletal disorders in patients over 40 years, with a prevalence between 4 and 36% (Murphy & Carr, 2010; Tekavec et al., 2012). Rotator cuff (RC) tendinopathy is the most common cause for shoulder pain and affects females in 70% of cases, typically during their 5th decade of life (Lewis, 2009). The pathogenesis of RC tendinopathies is unclear, and extrinsic and intrinsic factors, or a combination of both, are involved. Extrinsic factors include irritation or compression of the superior aspect of the tendons under the coraco-acromial arch, or of the articular side of the tendons from internal impingement onto the glenoid labrum (Harrison & Flatow, 2011). Tendinopathy is usually as a consequence of overuse or overload (Abate et al., 2009). Increase and change in collagen, proteoglycans, vascularity and tenocytes have been described (Abate et al., 2009). Intrinsic changes within the RC are the principal factors in the pathogenesis of RC tears (Hashimoto et al., 2003). RC tendinopathy persists or recurs in 40 to 50% of individuals within one year after initial presentation, and leads to marked functional loss and decreased quality of life (Chard et al., 1991; Van Der Windt et al., 1996).
Related Knowledge Centers
- Tendon
- Shoulder Problem
- Biceps
- Tennis Elbow
- Golfer'S Elbow
- Patellar Tendinitis
- Achilles Tendinitis
- Infection
- Arthritis
- Gout