Боль в сухожилиях — распространенный симптом, который хотя бы раз беспокоил каждого человека. Чаще всего болезненные ощущения локализуются в бицепсе, сухожилии сгибателя руки и пятки, так как эти части тела наиболее подвижные и подвержённые перегрузкам и травмам.
Чаще всего боль в сухожилиях возникает из-за чрезмерных физических нагрузок, перенесённых травм, на фоне неправильной осанки и ряда заболеваний опорно-двигательного аппарата, например, подагры или псориатического артрита. Интенсивность болевых ощущений может быть различной: от незначительного дискомфорта, до выраженной изматывающей боли. Вне зависимости от интенсивности боли, при возникновении симптома стоит обратиться к врачу. Если не обеспечить повреждённым тканям отдых и соответствующее лечение, процесс восстановления не запустится, и повреждение перейдет в хроническую форму.
Содержание статьи
Причины и формы боли в сухожилиях
К предрасполагающим факторам болезненности сухожилий относятся:
- частые или чрезмерные физические нагрузки, характерные для профессиональных спортсменов;
- недостаточный разогрев и растяжение сухожилий перед интенсивной тренировкой;
- недавние или ранее перенесённые застарелые травмы сухожилий, которые не были залечены до конца и постоянно провоцируют повторное повреждение сухожилий;
- нарушения осанки, при которых нагрузка на опорно-двигательный аппарат распределяется неправильно и некоторые сухожильные волокна оказываются перегруженными;
- системные заболевания, например, подагра, ревматоидный и псориатический артрит.
Если перечисленные факторы действуют на организм в течение длительного времени, у пациента могут развиться следующие заболевания:
- тендиноз — дистрофические изменения сухожилия, при которых ткань в месте крепления к кости оказывается защемленной и постепенно замещается костью;
- тендовагинит — воспаление соединительнотканных оболочек, расположенных вокруг сухожилия;
- тендинит — воспалительный процесс и дегенеративные изменения сухожилия.
Типы боли в сухожилиях
Болезненные ощущения в сухожильных волокнах классифицируют по следующим критериям:
По длительности
- Острая боль — чаще всего следствие перенесённых травм, развивается сразу после повреждения сухожильных тканей и при условии своевременного лечения проходит в течение 2-3 дней;
- хроническая — следствие незалеченной травмы или хронического воспалительного или дегенеративного процесса, беспокоит от 1-2 недель и хуже поддается лечению.
По времени возникновения
- Боль в сухожилиях при ходьбе и других движениях — возникает только во время физической активности или сразу после нее;
- в состоянии покоя — беспокоит пациента постоянно, вне зависимости от физических нагрузок, может обостряться в утреннее или ночное время, под воздействием других факторов.
По причинам развития
Физиологическая боль возникает после интенсивных физических нагрузок или перегрузки, иногда после разовой травмы. Патологическая связана с воспалительными и дистрофическими процессами в тканях, которые чаще всего развиваются вследствие назалеченных травм и микротравм. Патологическая разделяется на следующие подвиды:
- травматическая — обусловлена одной серьёзной травмой или постоянно повторяющимися микротравмами на фоне перегрузок;
- опорно-двигательная — обусловлена нарушениями осанки;
- воспалительно-дистрофическая — носит стойкий характер, свидетельствует о воспалении сухожилий или дегенеративно-дистрофических процессах в тканях.
Методы диагностики
Чтобы выявить причину дискомфорта, травматолог записывает жалобы о локализации, характере боли, времени её возникновения и обострения, сопутствующих симптомах. Уточняет, какие заболевания или травмы предшествовали тому, что начали болеть сухожилия. Чтобы поставить точный диагноз, рекомендует сдать анализы крови и пройти аппаратную диагностику, например, рентген для исключения повреждения костей и суставов.
В клинике ЦМРТ пациентам, у которых болях сухожилия, рекомендуют пройти следующие методы диагностики:
Симптоматика может возникать как после травматического повреждения, таки и при наличии в анамнезе сопутствующих заболеваний.
Сухожилие представляет собой вид соединительной ткани, с помощью которой мышца присоединяется к кости сустава. Благодаря сухожилию человек может сгибать, разгибать и поворачивать конечности. По ряду причин в сухожилиях рук могут возникать воспалительные процессы. Согласно МКБ – 10 заболевания сухожильного аппарата на руках обозначаются кодами S – 66.0 – S – 66.9. Для того чтобы не допустить развитие необратимых последствий в сухожилиях верхних конечностей необходимо своевременно пройти осмотр у медицинского специалиста и выяснить причину, по которой болят сухожилия на руках.
Этиология [причины]
К заболеваниям, которые сопровождаются постоянными болевыми ощущениями в сухожилиях рук, относятся:
- артрит;
- остеоартроз;
- сахарный диабет;
- аутоиммунные болезни;
- красная волчанка;
- боррелиоз;
- склеродермия;
- хламидиоз;
- ангина;
- заболевания эндокринной системы;
- нейропатия.
Боль в сухожилиях рук может возникать и по иной этиологии. Неприятные ощущения в этой части руки могут возникать в следующих случаях:
- травматическое повреждение сухожилий рук;
- возрастные изменения в тканях верхних конечностей;
- гормональные изменения в организме (беременность, менопауза);
- индивидуальные особенности строений верхних конечностей;
- наличие бактериальной инфекции;
- состояние после инсульта.
К специфическим заболеваниям, которые связаны с патологическими изменениями в соединительной ткани верхних конечностей, относятся:
- Энтезопатия. При этой патологии возникает воспаление в месте прикрепления сухожилия к суставам и мышцам;
- Теносиновит – это воспалительный процесс, возникающий в соединительных оболочках сухожилия. Болевые ощущения возникают только при движении верхних конечностей.
- Тендинит. Развитию тендинита способствуют изменения в тканях сухожильного аппарата.
Симптоматика
За врачебной помощью необходимо обратиться в том случае, если воспалительный процесс в сухожилиях сопровождается следующими симптомами:
- болезненностью в поврежденной области;
- гиперемией кожных покровов;
- скованностью движений верхних конечностей;
- хрустом;
- возникновением узелков под кожей;
- одышкой;
- аритмией;
- искривлением пальцев рук. При этом кончики пальцев становятся синего цвета;
- повышением местной температуры.
Врачи и диагностика
В первую очередь нужно пройти осмотр у врача — терапевта. На приеме медицинский специалист будет действовать по следующему алгоритму:
- уточнит у пациента, когда возникло неприятное ощущение в руке. Полученная информация поможет составить анамнез;
- проведет пальпацию больного участка;
- выдаст направление на сдачу клинических анализов и на прохождение компьютерного обследования;
- посоветует пройти консультацию у узкопрофильных специалистов, к которым относятся травматолог, ортопед, ревматолог, хирург.
Если болит сухожилие на руке, то для уточнения диагноза могут быть назначены следующие виды аппаратных обследований:
- ультразвуковое исследование;
- рентген;
- МРТ.
Помимо компьютерных исследований, нужно будет сдать общий анализ крови и мочи. При возникновении воспалительного процесса в сухожилиях эти клинические исследования покажут следующие изменения:
- повышенную кислотность в моче;
- наличие С – реактивного белка;
- увеличение количества лейкоцитов в крови;
- повышенные показатели СОЭ.
После того как у лечащего врача будут на руках результаты всех назначенных обследований, он сможет поставить точный диагноз и назначить необходимые лечебные мероприятия.
Лечение
Для уменьшения болезненности в сухожилиях рук в первую очередь будет назначена медикаментозная терапия. Медицинский специалист может назначить следующие аптечные средства:
- антибиотики;
- вазодилататоры миотропного действия;
- нестероидные противовоспалительные препараты;
- гормональные средства;
- кортикостероиды;
- специальные мази и крема.
Вместе с медикаментозным лечением необходимо будет пройти физиопроцедуры. К процедурам, которые ускоряют регенерацию тканей сухожилий, относятся:
- лазеротерапия;
- магнитотерапия;
- ультразвуковое лечение;
- ударно-волновая терапия;
- электрофорез с лидазой.
Для расслабления мышечных волокон верхних конечностей будет назначен курс лечебного массажа. Такой вид терапии не проводится только в том случае, когда воспалительный процесс в сухожилиях имеет инфекционную природу.
Народные средства
При комплексном лечении болезней сухожилий верхних конечностей можно воспользоваться средствами народной медицины. Уменьшить воспаление и снизить болевой синдром в поврежденной области помогут следующие способы:
- Растирание поврежденного участка руки небольшим кусочком льда. Такую процедуру выполняют в течение 20 минут;
- Компресс из лука, картофеля и аптечной глины. Необходимо взять 1 луковицу, клубень картофеля и небольшое количество лечебной глины. Корнеплод нужно помыть и измельчить на терке. Луковицу очищают и мелко нарезают. Подготовленные ингредиенты смешивают друг с другом. Такой компресс необходимо приложить к больному участку руки и оставить на всю ночь;
- В 1-м стакане с кипяченой водой растворить столовую ложку соли. В полученном растворе смочить марлю. Смоченную марлю нужно положить в холодильник. Когда марля замерзнет, ее необходимо приложить к воспаленному месту и забинтовать. Держать такой компресс нужно до того момента пока марля станет сухой;
- Мазь из цветков календулы и детского крема. Для этого нужно измельчить цветки лекарственного растения и смешать его с детским кремом. Использовать такой лечебный крем можно каждый день;
- Компресс из чеснока. Для этого нужно взять несколько чесночных долек, очистить их от шелухи и тщательно размять. В полученную кашицу добавить 50 миллилитров кипяченой воды. Настаивают такой раствор в течение 2 – 3 часов. После того, как отвар настоится в нем нужно смочить марлевую повязку и положить ее на поврежденное место. Длительность процедуры не должна превышать 15 минут. Проводить такое лечение можно до 3 раз в день;
- Мазь из полыни. Для приготовления необходимо взять 50 граммов измельченной полыни и небольшое количество свиного жира. Все ингредиенты нужно тщательно перемешать. Такую лечебную мазь нужно охладить и смазывать ей поврежденный участок руки.
Необходимость хирургического вмешательства возникает только тогда, когда иные лечебные мероприятия не приносят положительного эффекта. Операция будет назначаться при наличии следующих показаний:
- травмы сухожильного аппарата верхних конечностей;
- скопление гноя;
- образование фиброзного кольца;
- болевой синдром не удается купировать иными лечебными мероприятиями.
Профилактика
Для того чтобы не возникало дискомфорта в сухожилиях на руках, необходимо придерживаться следующих профилактических правил:
- Необходимо чередовать работу и отдых. Благодаря таким действиям сухожилия рук не будут перенапрягаться, и в них не будет возникать воспалительный процесс;
- Ежедневно выполнять специальные упражнения лечебной физкультуры;
- Делать массаж поврежденной области;
- По возможности исключить ситуации, при которых может возникнуть травматическое повреждение сухожильного аппарата верхних конечностей;
- Необходимо принимать курсом витаминные препараты, богатые аскорбиновой кислотой и витаминами группы В;
- В рацион можно добавить куркумин. Такая приправа помогает уменьшить болевой синдром.
Благодаря рукам человек может себя обслуживать и заниматься различным физическим трудом. Возникновение болезненных ощущений в этой части тела всегда вызывает дискомфорт. Необходимо сразу же выяснить этиологию такого неприятного ощущения. Такие ощущения могут возникать как после травматического повреждения, таки и при наличии в анамнезе сопутствующих заболеваний.
Как только человек почувствовал болезненность в сухожилиях рук необходимо пройти осмотр у квалифицированного специалиста. По рекомендации врача нужно будет пройти необходимый комплекс диагностических мероприятий, на основании которых будет установлена истинная причина недуга и назначена лечебная терапия. Своевременное проведение лечебных мероприятий поможет избежать возможных осложнений.
Список литературы
При написании статьи врач-ревматолог использовал следующие материалы:
- Заболотных, Инга Ивановна Болезни суставов : рук. для врачей / И. И. Заболотных. — СПб. : СпецЛит, 2005 (ГУП Тип. Наука). — 220 с. ISBN 5-299-00293-9
- Евдокименко, Павел Валериевич Артрит [Текст] : избавляемся от болей в суставах : [причины, симптомы, диагностика, методы лечения, лекарственные препараты, лечебная гимнастика, фитотерапия, диета : рекомендации опытного специалиста : 16+] / [Евдокименко П. В.]. — 3-е изд., перераб. — М : Мир и Образование, 2015. — 255с. ISBN 978-5-94666-632-9
- Полный справочник травматолога / [О.В. Ананьева и др.]. — М : Эксмо, 2006 — 733 с. ISBN 5-699-16187-2
- Борщенко Игорь Как избавиться от боли в суставах рук [Борщенко И.]. — М : Астрель: Метафора, 2012, -130с ISBN: 978-5-271-38841-5
Активная и здоровая жизнь человека напрямую зависит от опорно-двигательного аппарата организма. Поэтому боль в сухожилиях мешает не только нормальному передвижению, но и свидетельствует о травмах или серьезных патологических процессах, которые могут распространиться на здоровые суставы. Рекомендуется не откладывать визит к специалисту и вовремя начать терапевтический комплекс, чтобы предотвратить развитие осложнений в костном аппарате.
Почему воспалилось и ощущается боль в сухожилии?
Как травмы влияют на патологический процесс?
В процессе тренировок, частым явлением считается растяжение сухожилия на стопе, коленях, руках. В этот момент происходит образование микронадрыва коллагеновых волокон, который развивается в местах креплениях сухожилия к мышечному аппарату. А также к факторам, провоцирующим разрыв, относят повышенную плотность сухожильных нитей, что делает их менее эластичными и не приспособленными к сильному растяжению.
Инфекционное воздействие на сустав
В человеческий организм проникает бесчисленное количество патогенных микроорганизмов, которые провоцируют развитие инфекционных недугов. Проникая в систему кровотока, они быстро внедряются в суставы на ногах, руках и по всему организму, поражают сухожильный и мышечный аппарат. При этом иммунитет активирует выработку специальных антител, которые начинают бороться с чужеродными агентами, что приводит к развитию серьезного воспалительного процесса. К инфекционным патогенам, которые могут спровоцировать такую реакцию, относят:
- хламидиоз;
- гонорею;
- стрептококковую инфекцию;
- вирусное влияние.
Вернуться к оглавлению
Как воспалительные процессы влияют на появление боли?
Проблемы с сухожилиями на руке и нижних конечностях могут вызвать микроорганизмы, которые проникают в костные соединения через царапины или ранки, что были некачественно обработаны обеззараживающим средством. Внедряясь в суставную полость, патогены инфицируют сухожилия, ткани из-за чего постоянно болят суставы. Дискомфорт в пораженном месте сохраняется даже после полного заживления полученной ранее раны.
Могут ли интенсивные нагрузки спровоцировать недуг?
Если тянет, болят сухожилия на руках и ногах, то это может быть следствием неправильного распределения нагрузки. К причине такого влияния относят физические упражнения, проведенные при неподготовленном и должным образом не разогретом мышечном аппарате. Это приводит к микротравмам сухожильных соединений, болевым ощущениям и последующему воспалительному процессу.
Влияние, оказанное дегенеративными процессами
Недуг характеризуется некрозом мягких тканей, который может затрагивать сухожилия. К основным факторам, провоцирующим болезнь, относят:
- нехватку кальция и фосфора;
- травмы костных соединений и окружающего их мышечного аппарата;
- недостаточное питание тканей, вследствие возрастных изменений в коленях;
- гормональную дисфункцию;
- продолжительный медикаментозный курс.
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Другие причины, вызывающие боль в сухожилии
Могут ли повлиять отклонения в иммунной системе?
Воспалительный процесс, поражающий сухожилия на стопе, а также на руках и коленях, может быть спровоцирован дисфункцией иммунной системы организма, так как основной ее задачей является борьба с вредоносными агентами, которые проникают во внутреннюю структуру всех систем человеческого тела. В противном случае патогены быстро размножаются и распространяются. К нарушениям приводят:
- продолжительный прием лекарственных средств;
- онкологические патологии;
- обычные простуды;
- заболевания кровеносной системы.
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Какие симптомы характерны для патологического процесса?
В медицине выделяются клинические проявления, которые свойственны этому виду болезни. Однако они тесно переплетаются с другими заболеваниями, поэтому самостоятельно установить повреждение сухожильного аппарата затруднительно. К главным проявлениям относят:
- боль в суставе и окружающей его области;
- скованность передвижения;
- формирование нехарактерных образований под кожей;
- воспалительный процесс;
- изменение цвета кожного покрова.
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Какая диагностика проводятся для постановки диагноза?
После проявления неприятных ощущений в области сухожилий ног или рук, рекомендуется незамедлительно посетить медицинское учреждение. Лечение начинается с первичного осмотра и выяснения всех обстоятельств, которые могли спровоцировать заболевание. Больному также назначается прохождение:
- ультразвукового обследования (УЗИ);
- рентгенографии;
- магнитно-резонансной томографии (МРТ);
- общего анализа крови.
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Как проводиться лечение боли в сухожилиях?
Особенности терапии при непатологическом влиянии
Как лечить недугом напрямую зависит от причин его спровоцировавших. Если боль в сухожилии проявилась вследствие травматического воздействия, то помочь можно в домашних условиях. В первый час после травмы к поврежденному месту прикладывается холод, чтобы предотвратить развитие отечности и снять болевые проявления. А также запрещается нагружать конечность с поврежденным сухожилием.
Как справиться с недугом при патологическом воздействии?
Если развитие тендинита вызывает болезненность, то снятия воспаления недостаточно. Требуется устранить сам провоцирующий фактор. В такой ситуации прикладывание холодных примочек нежелательно и может усугубить основное заболевание. Больному прописывается полный покой с приемом курса противовоспалительных препаратов, среди которых эффективными считаются:
Нужно ли делать физиотерапевтические процедуры?
Чтобы устранить боль и воспаление сухожилия также прибегают к помощи специализированных методов, которые включают:
- Терапию при помощи лазера. Воздействует непосредственно на поврежденные ткани и сухожильные соединения, тем самым улучшая в них процессы обмена.
- Воздействие магнитными волнами. Обладает таким же лечебным влиянием, что и лазерное воздействие.
- Ультразвуковое лечение. Помогает улучшить кровоток и лимфатический отток, а также влияет на восстановление поврежденных клеток.
- Применение электрофореза. В травмированное место вводиться препарат под воздействием электромагнитного поля, что позволяет ускорить заживление сухожилия.
- Облучение ультрафиолетом. Облучение кожного покрова ускоряет процесс кровотока в тканях и позволяет быстрее доставлять полезные вещества к поврежденным участкам.
Терапия подбирается лечащим врачом с учетом причин, спровоцировавших боль в сухожилии.
Заключение
Сухожилия очень прочные и неэластичные структуры, которые легко поддаются травматизму или атакам патогенных организмов. Причины, провоцирующие этот процесс, бывают безобидными, а иногда способны причинить вред организму и активизировать развитие серьезных патологических процессов, которые затрагивают не только сухожилие, но и костные ткани организма.
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