An inflammation in the connective tissue can have different causes and therefore present with different symptoms.
In general, inflammation in connective tissue occurs as a response of the tissue to an internal or external stimulus. For example, this can be an injury, an infection or an autoimmune disease. The connective tissue then reacts with the inflammation, the ultimate goal of which is to remove the disturbing stimulus and, as a result, to heal the tissue. The inflammation is intended to create conditions for repair processes to take place.
The inflammation of the connective tissue is classically associated with the so-called cardinal signs of inflammation. These are the swelling (tumor), the redness (Rubor), the overheating (Calor), the pain (Dolor) and the functional impairment (Functio laesa). Not all signs of inflammation have to appear at the same time. For example, with deeper inflammations, reddening is not always visible.
Inflammation of the connective tissue can be accompanied by very different symptoms, which depend on the cause and type of inflammation as well as on the location. Not all connective tissue inflammation manifests itself in the same way.
Signs of inflammation in the connective tissue are sudden swelling that is accompanied by redness and pain. Accompanying fever and a general feeling of illness also suggest inflammation. Furthermore, the swelling can be warmer than the rest of the skin.
A rather painless and slowly growing swelling without reddening usually has other causes, such as a lipoma. However, inflammation can also be of a chronic nature; in this case, however, occasional pain or discomfort would be typical.
Inflammation that occurs as part of autoimmune diseases can be associated with a wide variety of symptoms. In this case it is often not easy to see directly where the inflammation is located. However, typical symptoms are creeping in, such as unwanted weight loss, fever or night sweats.
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Further information on this: Connective tissue pain
The causes of inflammation of the connective tissue are very diverse.
A possible cause of inflammation is a mechanical stimulus or trauma. Typically, injuries that happen during sports or in everyday life, for example, can lead to an inflammatory stimulus in the affected connective tissue. Such inflammation is abacterial. In this case, it can be both superficial and deeper-lying inflammations. As part of the inflammation, various structures of the connective tissue can be affected, such as ligaments and tendon attachments.
Another cause of inflammation of the connective tissue is pathogens, especially bacteria. A special form of this inflammation is the phlegmon. This is a deep inflammation of the connective tissue, the skin and the subcutaneous fatty tissue that can penetrate to the muscle fascia. Usually the bacteria Staphylococcus aureus and / or streptococci of group A are involved in the development of this connective tissue inflammation. They can penetrate the connective tissue through a small injury in the nail bed or the skin and cause the inflammation there. Other pathogens, such as tuberculosis or gas fire, can also cause inflammation of the connective tissue.
Apart from such traumatic or infectious inflammations, there are also connective tissue inflammations in the context of autoimmune diseases. A common example that is mentioned in this context is scleroderma. This rare disease leads to a lot of inflammation in connective tissue and organs, which is associated with cell proliferation. So-called fibroses develop, which make the connective tissue coarse and inelastic and lead to hardening. Lupus erythematosus, poly- and dermatomyositis and Sjögren's syndrome also belong to this type of autoimmune disease, which is also known as collagenosis and affects various parts of the connective tissue.
The diagnosis of inflammation in the connective tissue can be made by different doctors. The family doctor is often the first point of contact for complaints. This may determine signs of inflammation, such as swelling, reddening, overheating or pain. Fever and a general feeling of illness are also possible accompanying symptoms. These occur, for example, with bacterial inflammation, including phlegmon.
The anamnesis can also contain important information for the correct diagnosis. For example, injuries, previous illnesses or other accompanying symptoms can be queried. A blood test may show an increase in the inflammation levels CRP, ESR and white blood cells. For the diagnosis of autoimmune connective tissue inflammation, special antibodies are determined in the blood and further rheumatological examinations are initiated. Deeper inflammation of the connective tissue can also be diagnosed with the help of imaging, such as an MRI.
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Read more about this: Increased levels of inflammation in the blood
Treatment of inflammation in connective tissue depends on the underlying cause and the location of the inflammation.
So there is no universal therapeutic approach. In the case of inflammatory pain in the connective tissue, anti-inflammatory painkillers such as ibuprofen or diclofenac are used because they combine two important active principles. If there is an acute inflammation in the connective tissue, for example due to an injury, the affected area should be kept calm and cooled.
Bacterial inflammation is also treated with antipyretic and antibiotic drugs. Chronic inflammatory processes in particular, as they often play a role in connective tissue inflammation of the back, are also treated with physical methods and physiotherapy. Massages also help treat inflammation and relieve pain.
In autoimmune diseases such as scleroderma or lupus erythematosus, special drugs can be used that suppress the immune system. Here too, however, various treatment methods, consisting of painkillers, physiotherapy and physical therapy, are usually combined with one another.
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Connective tissue inflammation can also develop in the eye. Different parts of the eye can be affected. One possible location is the eyelids. So-called blepharitis is an inflammation of the connective tissue on the edge of the eyelid. It is triggered by bacteria (staphylococci). Typical symptoms are thickened eyelids, redness, and itching. A foreign body sensation in the eye and greasy deposits are also typical.
Endocrine orbitopathy is an inflammation of the fat, muscle and connective tissue in the eye socket, which leads to a structural change and ultimately to an increase in size. A typical cause for this is the autoimmune-related Graves' disease (autoimmune overactive thyroid). Typically the eyes protrude (exophthalmos). This can lead to impaired vision.
Orbital phlegmon is another cause of inflammation of the connective tissue in the eye. Pathogens cause an infectious inflammation of the connective tissue. The pathogens get into the tissue of the eye socket through injuries or through propagation from neighboring inflammations, such as sinus or tooth inflammation. With orbital phlegmon, the eye is severely swollen, red and painful.
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Read more on the subject at: Inflammation of the upper eyelid
Inflammation in the connective tissue of the leg is often traumatic. Sports injuries and strains in particular can lead to local inflammation of the ligaments and tendons, which are noticeable in the form of pain, redness and swelling.
However, non-traumatic causes are also possible. For example, pathogens can get into the connective tissue through small wounds on the toes or skin and cause infectious inflammation. However, this is more common on the lower leg and less often on the thigh. In both cases, overheating of the leg and fever would be typical.
Also read: Adhesion of the connective tissue
The foot can be affected by connective tissue inflammation for a variety of reasons. The feet of diabetics are particularly susceptible to such inflammation, which is why the examination of the feet is an integral part of the care in diabetes.
In diabetes mellitus, the sugar deposits in the vascular walls cause circulatory disorders that manifest themselves particularly early in the feet. The wound healing is disturbed by the poor blood circulation. Inflammation there can quickly develop into a chronic course. Small injuries to the toes and skin encourage the entry of bacteria, which in turn cause bacterial inflammation in the feet.
Non-diabetics can also be affected. Inflammation in the connective tissue can also occur in the context of gout or rheumatic disease.
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Back pain can also be attributed to inflammation of the connective tissue around the spine.
One possible cause is a degenerative change and loss of elasticity in the connective tissue. Lack of exercise and advancing age promote these remodeling processes in the connective tissue and are a cause of persistent movement pain.
Connective tissue on the spine is also usually affected in the context of what is known as Bechterew's disease. Above all, the bone-tendon junctions are inflamed. This is known as enthesopathy. The pain is particularly evident at the transition between the lumbar spine and the pelvis. Bechterew's disease is a chronic inflammatory disease that mainly affects the spine and can lead to severe back pain.
Inflammation of the connective tissue in the thigh is usually caused by excessive or insufficient use of the muscles, tendons and the surrounding connective tissue.
That may sound like a contradiction at first, but it can be explained as follows: If you overstrain, for example through frequent or too intensive training, small injuries occur in the muscle tissue, but also in the surrounding connective tissue and in the tendons. These small injuries lead to inflammatory processes that help the tissue to heal and cause pain. In contrast, insufficient stress can also lead to inflammatory processes. The connective tissue loses its elasticity and the friction between bones, muscles, tendons and nerves increases. This also leads to constant stimuli, which also cause small inflammations.
The duration of inflammation in connective tissue depends on various factors.The cause of the inflammation plays an important role in this.
Bacterial inflammation is usually very acute. They appear within a few hours or days. With adequate therapy, depending on the inflammation, healing can be achieved within several days or a few weeks. However, some connective tissue inflammations also show a chronic or chronic recurrent course. This is especially the case with autoimmune diseases such as scleroderma or lupus erythematosus. In this case, even under therapy, it is not uncommon for years to go through.
