From pain to recovery: a guide to treating tendon injuries

Tendons, those resilient cords connecting muscles to bone, play an indispensable role in our movement. A sudden twist, overuse, or an unfortunate accident can lead to an injury, causing not just pain but also significant impairment of our daily activities. If you’ve ever felt this jarring discomfort, you will understand the immediate desire to seek relief. Here’s a comprehensive guide to help you navigate from that initial pain back to recovery.

Immediate actions post-injury: first aid

It’s essential to initiate immediate first aid procedures, as the initial hours post-injury are pivotal in determining the speed and quality of recovery. The commonly advocated RICE method remains the cornerstone:

1. Rest: Refrain from using the injured area. If it’s a hand tendon, for instance, try to refrain from using it. Giving your body this crucial downtime can significantly expedite the natural healing process.

2. Ice: Apply cold packs to the injured site, using a cloth barrier to prevent frostbite. This helps in reducing inflammation and numbing the area. Remember, it’s best to ice in intervals, typically 20 minutes on followed by 20 minutes off, to avoid tissue damage. Avoid direct application of ice to the skin!

3. Compression: Use elastic bandages to wrap the injured region, not too tightly, to minimise swelling. Ensure it’s snug, but not cutting off circulation, and check the skin’s colour and temperature to ensure adequate blood flow.

4. Elevation: Prop up the injured limb higher than the level of the heart to reduce swelling and facilitate fluid drainage. Employing pillows or cushions can make this position more comfortable and sustainable during rest periods.

Non-surgical treatment avenues

In many instances, tendon injuries don’t necessitate surgical intervention. Several non-invasive treatments can stimulate recovery, alleviate pain, and restore function.

• Hand therapy: This is the bedrock of non-surgical treatment. A competent hand therapist can provide exercises tailored to your injury, aiming to restore strength and flexibility. Initially, gentle movements help in maintaining range of motion. As healing progresses, more intensive exercises come into play to regain full function.
• Corticosteroid and local anaesthetic (CSI) injections.
• PRP (Platelet-Rich Plasma) injections: A relatively new yet promising procedure, PRP involves drawing a small volume of the patient’s blood, processing it to concentrate the platelets, and then injecting it into the injured site. These platelets release growth factors that can accelerate tissue repair and reduce inflammation.

Considering surgery: when and what to anticipate

When non-surgical interventions fail to produce the desired outcomes, or the severity of the tendon injury is beyond conservative management, surgery may be the next logical step. Venturing down this path can be daunting, but with the right information, you’ll be better prepared for the journey.

Factors necessitating surgery

Apart from complete ruptures, some other scenarios might make surgery the most viable option:

• Chronic tendinopathy: Sometimes, tendons can undergo degenerative changes. These chronic conditions, resistant to most conservative treatments, might benefit from surgical debridement, where damaged tissues are removed to promote healthier tissue regeneration.
• Recurrent injuries: If you’ve experienced multiple injuries in the same tendon region, it could indicate underlying structural issues that surgery might address, providing a more long-term solution.

Here’s what to expect:

Pre-surgery:

Comprehensive evaluations, including Ultrasound or MRI scans, may be performed. Your specialist, such as a hand and wrist surgeon, will discuss the procedure, potential risks and expected outcomes.

During surgery:

While the specifics of tendon surgeries vary based on the injury’s location and complexity, some general aspects are worth noting:

• Anaesthesia: Depending on the surgery’s invasiveness and duration, you might be given general anaesthesia, where you’ll be unconscious, or local or regional anaesthesia, numbing only a part of the body.
• Arthroscopy: In many tendon surgeries, especially around joints, a minimally invasive technique called arthroscopy might be used. This involves small incisions through which a camera and surgical tools are inserted, allowing for a clearer view and precise intervention.
• Tendon transfer: In cases where the injured tendon can’t be repaired, a nearby tendon might be redirected to take over its function, ensuring continuity in movement.

Navigating the post-operative phase:

• Pain management: Post-surgery, it’s natural to experience some discomfort. Your medical team will provide pain management solutions, often starting with stronger pain relievers before transitioning to over-the-counter analgesics. Elevation of the arm is key to minimising pain.
• Protecting the operative site: Depending on the surgery, you might need to wear protective equipment, like slings or splints, to shield the operated area from undue stress and accidental impacts; your hand therapist will guide this.
• Follow-up Visits: Consistently touching base with your medical expert post-surgery is essential. These sessions not only assess how well the operated area is healing but also spot any after-surgery complications and recalibrate the recovery plan when required.

Navigating the aftermath of tendon injuries requires patience. Hastening the recovery stages might jeopardise healing or induce enduring ailments. Engage in regular communication with your surgeon, such as an orthopaedic hand specialist, to pave the way for the best possible outcome.

In summary, while tendon injuries pose their challenges, with the right blend of knowledge and strategy, the road from discomfort to healing becomes less formidable. By mastering the preliminary phases, weighing the pros and cons of non-invasive measures and recognising when to opt for surgical routes, you’re equipping yourself for optimal healing.