Tendon Entrapment - Causes, Symptoms, Diagnosis, and Treatment

Introduction

The tendon is a band of fibrous connective tissue that connects a muscle to bone and other structures. Tendons hold the structures together and help transmit the mechanical forces from the muscles to the bones. Tendon entrapment, or tendon compression or impingement, is common in any body part.

What Is Tendon Entrapment?

Tendon entrapment is a condition in which the tendon gets squeezed, compressed, or entrapped due to various reasons, resulting in pain, inflammation, or damage to the tendon. It may be caused by overuse of muscles, trauma, or structural abnormalities that affect the space around the tendon, making it compressed.

What Are the Causes of Tendon Entrapment?

Tendon entrapment may occur due to a variety of reasons.

• Overuse or Repetitive Use - Repetitive motions that use a particular muscle group or joint can cause inflammation and compression of the tendons.

• Direct trauma or injury to the tendon may result in its entrapment.

• Structural anomalies, like bone spurs or narrow joint spaces, may compress the tendons.

• Systemic diseases like diabetes, rheumatoid arthritis, and gout may cause tendon swelling and entrapment.

• Improper posture or mechanics causes unnecessary strain in the tendons.

• Tenosynovitis denotes the condition in which the lining of the tendon becomes inflamed. This can cause tendon entrapment, resulting in pain and stiffness in the joint.

• Old age is also a contributing factor, as the flexibility and strength of the tendons reduce with age, making them easier to injure.

• Previous injuries associated with sprain or strain in the joints and muscles may increase the risk of tendon entrapment.

• Hormonal changes due to pregnancy may increase swelling and inflammation, thus increasing the risk of tendon entrapment.

• Obesity - Being obese can increase the load on the joints and the muscles, increase the pressure on the tendons and nerves, and increase the risk of tendon entrapment.

What Are Some Conditions Associated With Tendon Entrapment?

Tendon entrapment occurs in any part of the body. Commonly affected parts include the shoulders, hips, wrists, knees, ankles, and feet. Tendon entrapment also occurs along with other conditions, such as:

• Carpal Tunnel Syndrome - A condition that causes compression of nerves in the wrist.

• De Quervain’s Tenosynovitis - In this condition, the tendons responsible for the movement of the thumb get compressed.

• Rotator cuff impingement occurs when the rotator cuff's tendons and muscles get entrapped in the bone and the shoulder joint.

• Tennis Elbow - Tendons in the elbow are overused by repetitive motions, causing pain and tendon entrapment.

• Stenosing Tenosynovitis - Flexor tendon entrapment, also known as the trigger finger, affects the flexor tendon.

What Are the Symptoms of Tendon Entrapment?

Some of the common symptoms of tendon entrapment are listed below.

• Dull or sharp pain is felt in the affected muscle or joint. Pain is worsened with activity or movement.

• Swelling or inflammation of the affected area is seen. The skin over the affected tendon appears red or warm to the touch.

• Stiffness or limited range of motion is present in the affected joint.

• Tingling or numbness may occur if the nerves get compressed along with the tendon.

• A weakness in the affected muscle makes it difficult to perform certain movements.

• Clicking or popping sounds may be present if the affected joint is moved.

• Catch or snap sensation when the fingers affected by tendon entrapment are moved.

• Tendon entrapment can lock the fingers in flexion when occurring in fingers and progressing. That is, the patient may lose the ability to extend the finger actively.

What Are the Diagnostic Methods for Tendon Entrapment?

• Diagnosis of tendon entrapment is usually made through clinical assessment, medical history, and imaging tests.

• A physical examination of the patient is done to assess the affected areas. The doctor checks the range of motion, areas of tenderness, and muscle strength.

• A thorough medical history, including previous injuries, surgeries, or any other chronic conditions of the patient, is considered to diagnose tendon entrapment.

• Structural abnormalities or damage caused by trauma can be identified by imaging tests such as X-rays, MRIs, or ultrasounds.

• Nerve conduction studies may be done if there is nerve compression. Nerve conduction studies are used to assess nerve function.

• Diagnostic injections are local anesthetic or corticosteroid injections given in the affected areas to assist in better diagnosis and treatment.

What Are the Treatment Options for Tendon Entrapment?

Treatment of tendon entrapment depends on the severity of the condition, the underlying causes, and the location of the entrapment.

• Rest - Rest or immobilization of the affected muscle or joint helps improve inflammation and other symptoms. The doctor may recommend a brace or a splint to immobilize the affected area.

• Medications - Nonsteroidal anti-inflammatory drugs like Ibuprofen or Naproxen are prescribed to manage pain and inflammation.

• Physical Therapy - Physiotherapy helps by improving the affected joint or muscle group's flexibility, strength, and range of motion. Physiotherapy includes stretches, exercises, and other treatment options that help reduce inflammation and promote healing.

• Steroid injections help in reducing symptoms.

• Surgery - If conservative treatment options do not improve the condition, surgery may be required. Surgery involves releasing the affected tendon or decompressing the affected nerve surgically.

Certain lifestyle modifications to improve tendon entrapment include:

• Proper posture.

• Avoid repetitive motions.

• Use proper body mechanics.

• Maintain healthy body weight.

• Practice good ergonomics.

What Are the Complications of Tendon Entrapment?

Complications are rare and often occur only when the condition is severe or left untreated.

• Chronic pain may be present, which is difficult to manage and interferes with daily activities.

• Muscle weakness occurs if the tendon entrapment is left untreated for a long time.

• In rare cases, nerve compression caused by tendon entrapment may result in nerve damage.

• Tendinitis is inflammation in the affected tendon; this may be caused by tendon entrapment.

• Over time, tendon entrapment may cause damage to the affected joint, leading to arthritis or other joint-related conditions.

Conclusion

Tendon entrapment is a common condition that can be completely treated if properly diagnosed. Following certain basic lifestyle changes and maintaining a healthy weight also contributes to a better prognosis for the condition. Doctors and patients need to work together to have good results. More learning and studying how to manage things helps people feel better and improve their health. With hard work and taking action early, tendon entrapment can be treated effectively so people can go back to living a fulfilling life.