Tendinitis in the metatarsus

definition

Tendinitis in the metatarsus is an acute or chronic inflammatory change of the tendons belonging to the foot muscles. For various reasons, these inflammations can impair the movement of the toes of the affected foot.

In addition to the conservative treatment methods, emergency treatment is also available for exceptional cases.

causes

The causes of tendinitis in the metatarsus are divided into acute and chronic causes.

Acute tendinitis of the metatarsus occurs mainly due to congestion of the feet. So it may happen that after a long walk the pain in the metatarsus begin.

Even if, for example, heavy loads are worn, it can lead to tendinitis of the metatarsus. The unfamiliar load causes strong friction in the area of ​​the tendon insertion points on the bone, with the result that the tendons become inflamed.
Mostly, inflammation of the foot is painful when moving, and painless at rest. With very strong and advanced tendinitis it can come even to a resting pain in the area of ​​the metatarsus.

Among the chronic causes leading to tendinitis of the midfoot is the long-term overload of the midfoot. If the footwear is improperly adjusted and the full weight is applied at the same time, this can lead to chronic tendinitis of the midfoot. Again, the symptoms start at first only under stress, but then in advanced inflammation may be present in peace.

symptoms

The first symptoms of midfoot tendonitis are pain in the movement of the foot and toes. As the tendons belonging to the muscles move, calcifications cause painful friction, which can lead to inflammation and thus further severe pain. The pain is initially felt only in motion, because it causes the greatest friction due to the muscle and tendon movement.

In advanced inflammation, there is already pain in peace. It can also lead to partial painful swelling of the foot or toe. Restrictions of mobility also sometimes occur due to the swelling of the soft tissue.

diagnosis

The diagnosis of a tendinitis of the foot is made by the patient survey and the examination by the doctor. First, it asks when the pain has occurred and how long it has lasted.
Also previously performed movements or loads are inquired and examined exactly the severity and type of complaints.

The study refers to the flexibility in the toe and ankle, which the examiner actively and passively tests.
If, in particular, pulling the toes towards the body is painful, this indicates a tendon problem in the area of ​​the foot.
The reason is that the toe movement of the tendons of the associated muscles in the area of ​​the foot move back and forth and it comes in the case of inflammation in this area to strong friction.

During the examination, the patient is also asked to stand on tiptoe and on the heel. If this succeeds only in pain, this may also indicate a tendinitis of the midfoot.
In case of doubt, a diagnostic imaging can be performed. In this case, the ultrasound examination, which can represent calcification and thickening of the muscle tendons, is used.

If this examination does not provide clear evidence of tendinitis, an MRI scan of the foot can also be performed.

In this study, soft tissues can be represented very well. Inflamed tendons of the foot would become thickened or calcified, which would substantiate the suspicion of tendinitis.

duration

Tendinitis often begins insidiously. Due to heavy exercise during exercise without warming up or repetitive one-sided movements, swelling, redness and pain in the affected area occur.

Lime deposits can also occur after a long untreated course, which is noticeable by a crunching sound during movements. The duration of a tendinitis depends very much on the immobilization of the affected tendon or the affected joint.

If this is consistently spared, the inflammation can subside again after a few days.

If this is not the case, it can also develop into a chronic course. It is important to avoid the triggering movements, or to correct erroneous movements, for example during sports.

Preventive measures, such as physiotherapy exercises, help to shorten or prevent tendinitis.

therapy

Mostly a conservative treatment is used. The immobilization and cooling of the foot for a few days and the anti-inflammatory treatment leads in the vast majority of cases to a speedy recovery of the symptoms. The anti-inflammatory drug is Ibuprofen or Diclofenac. Chronic and severe inflammation lead to tendon adhesions and severe mobility restrictions. In this case, it may be necessary for an operative solution of the tendons to restore mobility.

taping

Taping can help accelerate the regeneration of the inflamed tendon.

Through the tape, the stability of the affected area is increased, which in turn means that secondary injuries are prevented and also incorrect loads are avoided.

The blood vessel dilating effect helps to promote the decay of the inflammatory process. Similarly, the tape can ensure that the affected tendon is relieved of pressure and thus not further irritated.

home remedies

Even with tendonitis, there are some home remedies that can reduce the inflammatory reaction faster, or at least alleviate the symptoms.

  • On the one hand, the Quark wrap has proven to be pleasantly soothing on the affected area with its cooling effect. For this, it is sufficient to give quark on a cloth, which is placed on the inflamed area and replaced after a few minutes.
  • Also, cold compresses are useful to apply to inflammation. It is important to note that the cooling element should never be placed directly on the skin, but always keep a cloth in between to prevent frostbite on the skin.
  • Tapes and bandages or splints are always useful in order to immobilize the affected area of ​​the body in order to maintain the protection and prevent further irritation of the tendon.
  • Anti-inflammatory gels or creams also help to speed up the healing process and reduce excess body reactions.

forecast

Depending on the severity of the inflammation, it may take a necessary treatment time of a few days to 4 weeks until the symptoms have subsided completely. It is also important to what extent the patient pays attention to the immobilization of the foot.

When overloaded during the healing phase, the inflammation may worsen or take a chronic course despite drug administration.

When can you do sports again?

Tendinitis should be spared rather than trained. Sport should be avoided for a few weeks.

In time, the affected tendon should be absolutely spared - and rested, for example, with a special rail.

Individual exercises can then slowly be performed after some time to strengthen the surrounding muscles. However, the re-entry into the sport, especially if the sport has triggered the tendonitis, should be carefully and carefully observed.

How can I differentiate a tendonitis on the metatarsus from a fatigue fracture?

Fatigue fractures are so-called stress fractures, which occur especially in people who engage in high-intensity sports and / or have a congenital malposition and thus incorrect loading of individual skeletal elements.

The bones are worn down by intensive stress and then usually spontaneously break. Since the fragments are usually relatively cheap to each other, surgery is usually not necessary and immobilization is on the treatment plan.

It is dangerous that a fatigue fracture with pain, redness and swelling of the affected area involves symptoms similar to tendinitis.
Here you have to pay attention to whether the symptoms related to sports activity in time and how long it lasts.

From a duration of more than one week, a diagnostic imaging should be performed to exclude one of the two clinical pictures.


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