Soft Tissue Rheumatism

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Category: Soft Tissue Rheumatism Articles Published on Wednesday, 25 June 2008 Written by Yong Tsai, MD
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WHERE IS YOUR PAIN?

Almost all of us over the age of 50 have experienced some musculoskeletal pain. The term “arthritis” has been a common label put on the elderly. The fact is not all the pain is from arthritis. Tendinitis, bursitis and myofascial pain are common cause of musculoskeletal pain then arthritis.

Tendons are made up of tough, fibrous, ropelike materials that link muscles to bones. Tendons are one of the most commonly injured structures in the body. Tendons have very little blood supply and can take a long time to heal after injury. When a tendon is injured, some of its fibers tear. The more severe injury, the more amount of fibers torn and pain.Tendinitis means the tendon is partially torn. Inflammed or torn tendons take a long tinme to heal because they do not have a large blood supply, and when the tendon is restressed, it frequently retears and heals badly with a lot of scar tissue. Inflammed tendons due to minor trauma without tears are a less serious type of tendon injury, This type of injury is usually self-healing within a short period of time.

ROTATOR CUFF TENDONITIS

Four muscles make up the rotator cuff. These muscles move the shoulder from the side and turn it inward and outward. Rotator cuff tendonitis occurs tendons to become pinched between structures that are involved in shoulder motion. Patients will experience severe pain in the upper shoulder or upper third of your arm, difficulty sleeping on the shoulders or pain when lifting the arm overheaded.

LATERAL EPICONDITIS

The epicondyle is the region where muscles of your forearm attach to the outside bone of your elbow. Over use of these muscles occurs in tennis and other sports that require forced extension of the wrist or hand. Gardening, using tools or clenching your hand excessively, such as when carrying suitcases, also may cause epicondylitis. Patients will experience aching pain on then outside of your elbow that can travel down your forearm. Pain with handskakes, movement of your fingers, lifting with your wrists.

DEQUERVAIN'S TENDONITIS

This is a condition involving the overuse of your thumb tendons, often caused by repeated pinching with your thumb while moving your wrist. This can occur with writing, gardening or fine handiwork. Patients will experience pain over the wrist on the side of your thumb, especially with thumb motion.

A bursa is a fluid-filled fibrous sac that lies between a tendon and a bone A bursa acts as a small cushion between muscles and bone and allows the tendon to glide smoothly under the bone without becoming irritated or torn. An irritated bursa can produce pain and swelling. It causes pain as the bone moves and the tendon rides over the bursa.

TROCHANTERIC BURSITIS

This bursa is located over the prominent bone on the side of your hip. Females and middle-to older-aged people are more often affected. Injury, degeneration and calcification of the bursa region is common cause. In addition, walking abnormally due to leg length differences, arthritis in your hip, knee, ankle, foot or back can stress this region. Patient occurring over the side of your hip, pain when sleep on the side, pain upon rising from a deep chair, sitting in a car or climbing stairs: occasionally pain when walking.

MYOFASCIAL PAIN

The myofascial tissue is a connective tissue which surrounds muscle sheaths, ligaments, joint capsules, and nerve sheath. The myofascial acts like a tent, covering and protecting other body parts. Myofascial pain syndrome is pain in areas of muscle, often in the buttocks, back, neck and shoulders. Myofascial pain is the most cause of neck and back pain. It often is associated with tender, hard areas called trigger points. When pressed, these trigger points are painful, and the pain can spread away from them. Myofascial back pain is a dull, aching pain located in the muscles of your lower back and buttocks. The pain can travel down your buttocks and into your thigh. It is very frequent patients with myofascial back pain is misdiagnosed with sciatica.

Mechanical stresses can perpetuate trigger points in most patients with persistent myofascial pain syndrome. The most common source of such physical stress is skeletal asymmetry and disproportion. Other sources of muscular stress, such as misfitting furniture, poor posture, abuse of muscles, and prolonged immobility, are frequently significant and nearly always correctable.

Trigger point injections, muscle massage, and muscle stretching exercise are the core treatment for pain reduction and restoration of normal function. Keeping good posture and properly practicing regular home stretching of the affected myofascia help alleviate recurrence of this problem.

Because the treatment and prevent of arthritis, is quite different from the treatment and prevention of tendonitis, bursitis and myofascial pain are quite different, it is important to make a correct diagnosis. In general, the pain of arthritis is limited in the joints. Tendonitis and bursitis are usually confined to one area of the body such as the shoulder, elbow, wrist, and hip. Myofascial pain can affect any portion of the body. The chief symptoms of tendonitis, bursitis and myofascial pain is pain in the affected area. The diagnosis depends on the exclusion of arthritis and the identification of the inflamed tendon or bursa or trigger points. Your ability to relay your medical history into the skillful hands of the doctor is important to make a correct diagnosis.

Treatment may vary, depending on the conditon. Treatment can include a nonsteroidal inflammatory drug, corticosteroid injections, local heat or cold pack applications, appropriate rest, therapeutic exercise, and physical therapy. Tendinitis and bursitis are often subsided with treatment once you stop the activity that lead up to it. Prevention of re-injury is the best treatment of all.

If tendonitis, bursitis and myofascial pain are treated properly and early, pain can be minimized and recurrence can be prevented. If you have local musculoskeletal pain such as shoulders, elbows, or wrists, do not accept "your pain must be from arthritis". You just need to live with it.

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