What's the best way to treat chronic tenosynovitis?

Question

I obtained this condition above my left ankle about a couple of years ago playing soccer. It really hasn't gone away; when I poke at that area, it feels like a fresh painful bruise. I'm able to run and move around since the injury is above where my sneaker tops off.

I heard that acupuncture is helpful. Your suggestions are welcome.
Thanks.

Answer 1

Looks like applying heat for 4-6 weeks/corticosteroid injections or surgery is the basic treatments. Below is a good article on the subject.

ANKLE TENOSYNOVITIS
Inflammation of a tendon or the lining of a tendon sheath in the ankle. This lining secretes a fluid that lubricates the tendon. When the lining becomes inflamed, the tendon cannot glide smoothly in its covering.

BODY PARTS INVOLVED
Any ankle tendon and its lining.
Soft tissue in the surrounding area, including blood vessels, nerves, ligaments, periosteum (covering to bone) and connective tissue.

SIGNS & SYMPTOMS
Constant pain or pain with motion.
Limited motion of the ankle.
Crepitation (a "crackling" sound when the tendon moves or is touched).
Heat and redness over the inflamed tendon.

CAUSES
Strain from unusual use or overuse of muscles and tendons in the ankle.
Direct blow or injury to the ankle. Tenosynovitis becomes more likely with repeated ankle injury.
Infection introduced through broken skin at the time of injury or through a surgical incision after injury.

RISK INCREASES WITH
Contact sports, especially kicking sports such as football or soccer.
Skiing.
If surgery is needed, surgical risk increases with smoking, poor nutrition, alcoholism or drug abuse, and recent or chronic illness.

HOW TO PREVENT
Engage in a vigorous program of physical conditioning before beginning regular sports participation.
Warm up adequately before practice or competition.
Wear protective footgear appropriate for your sport.
Learn proper moves and techniques for your sport.

WHAT TO EXPECT APPROPRIATE HEALTH CARE
Doctor's examination and diagnosis.
Surgery (sometimes) to enlarge the tendon's covering and restore a smooth gliding motion. The surgical procedure under general anesthesia is performed in an outpatient surgical facility or hospital operating room.

DIAGNOSTIC MEASURES
Your own observations of symptoms and signs.
Medical history and physical examination by your doctor.
X-rays of the area to rule out other abnormalities.
Laboratory studies: Blood and urine studies before surgery. Tissue examination after surgery.

POSSIBLE COMPLICATIONS
Prolonged healing time if activity is resumed too soon.
Proneness to repeated injury.
Adhesive tenosynovitis: The tendon and its covering become bound together. Restriction of motion may be complete or partial. Surgery is necessary to remove the covering or transfer the tendon to a less constrictive area.
Constrictive tenosynovitis: The walls of the covering thicken and narrow, preventing the tendon from sliding through. Surgery is necessary to cut away part of the covering.

PROBABLE OUTCOME
Tenosynovitis of the ankle is usually curable in about 6 weeks with heat treatments, corticosteroid injections and rest of the inflamed area. Recovery is usually quicker if the inflammation is caused from a direct blow rather than from a sprain or strain.


HOW TO TREAT
Follow your doctor's instructions. These instructions are supplemental.

FIRST AID
None. This problem develops slowly.

CONTINUING CARE
If surgery is not necessary, you may need a walking-boot cast for 10 to 14 days. See Appendix 2 (Care of Casts). Then wrap the ankle with an elasticized bandage until healing is complete.
Apply heat frequently. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
Take whirlpool treatments, if available.

MEDICATION
You may use non-prescription drugs such as acetaminophen for minor pain. Your doctor may prescribe: Stronger pain relievers. Don't take prescription pain medication longer than 4 to 7 days. Use only as much as you need.
Injection of the tendon covering with a long-acting local anesthetic and a non-absorbable corticosteroid to relieve pain and inflammation.

ACTIVITY
Resume normal activity slowly.

DIET
During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.

REHABILITATION
Begin daily rehabilitation exercises when supportive wrapping is no longer needed.
Use ice massage for 10 minutes before and after exercise. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.

GOOD LUCK!

Answer 2

I badly sprained my ankle about 3 weeks ago. I was in a hurry going down the stairs, lost my balance and landed on a bad side of my left foot, causing my left ankle to be stretched going on the inside. The first 48 hours were excruciating and the pain was un-believable. I've never had a serious ankle injury before.

So I immediately treated it using the RICE method. The following day, the bruising and swelling were so horrible. I found out that I got a second degree sprain and immediately panicked after that. I had a football game on that week and it been looking forward to it because I've been training for rt. I had teammates that had similar injuries and it took them months to fully recover, some of them stopped playing altogether. So I kinda had a short-term depression because I can't imagine myself not being able to run and play sports anymore.

Because I was so desperate to recover again, I contacted a lot of people that I know who do sports and asked them if they had similar injuries. One friend of mine, from the boy's football team in my university, told me about H.E.M. Ankle Rehab. I got a copy 4 days after I got injured. I immediately read and followed what was instructed and felt improvement on the first day. I was able to walk a bit, but I was in pain.

A couple of days after that, the swelling and bruising were subsid-ing significantly and on the fourth day, I was walking comfortably again. Although I've had felt a bit of stiffness, I continued doing what was instructed. My sister was surprised that I have recovered this fast. I told her about this book and was shocked on how effective the procedures were. I'm just so happy that this book was shared to me and how effective it is.

Heal your ankle fully & fast?

Answer 3

Ankle Tenosynovitis

Answer 4

Tenosynovitis Ankle

Answer 5

i feel your pain! i had this when i played soccer my first year in college. i was also at a military school, so the combat boots we wore only made it worse. my injury did go away completely, but only after i spent about three weeks on crutches, giving the tendon TOTAL REST. it's possible that since your case doesn't sound as severe that accupuncture may help, but i really haven't heard anything about that. do you take anti-inflammatories for it too? possible that advil and rest might do the trick...

Answer 6

Take 2 aspirins to night, and see podiatrist tomorrow.