Author: Foot Doc
Date: 4/27/2007 4:54 am PDT
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DISCLAIMER:
THE FOLLOWING IS OFFERED GRATIS AS GENERAL INFORMATION ONLY, AND, AS SUCH, MAY NOT BE APPLICABLE TO THE SPECIFIC QUESTIONER AND/OR HIS/HER PROBLEM. IT IS CLEARLY NOT BASED ON ACTUAL KNOWLEDGE AND/OR EXAMINATION OF THE QUESTIONER OR HIS/HER MEDICAL HISTORY, AND IT CAN NOT AND SHOULD NOT BE RELIED UPON AS DEFINITIVE MEDICAL OPINION OR ADVICE. ONLY THROUGH HANDS- ON PHYSICAL CONTACT WITH THE ACTUAL PATIENT CAN ACCURATE MEDICAL DIAGNOSIS BE ESTABLISHED AND SPECIFIC ADVICE BE GIVEN. NO DOCTOR/PATIENT RELATIONSHIP IS CREATED OR ESTABLISHED OR MAY BE INFERRED. THE QUESTIONER AND/OR READER IS INSTRUCTED TO CONSULT HIS OR HER OWN DOCTOR BEFORE PROCEEDING WITH ANY SUGGESTIONS CONTAINED HEREIN, AND TO ACT ONLY UPON HIS/HER OWN DOCTOR’S ORDERS AND RECOMMENDATIONS. BY THE READING OF MY POSTING WHICH FOLLOWS, THE READER STIPULATES AND CONFIRMS THAT HE/SHE FULLY UNDERSTANDS THIS DISCLAIMER AND HOLDS HARMLESS THIS WRITER. IF THIS IS NOT FULLY AGREEABLE TO YOU, THE READER, AND/OR YOU HAVE NOT ATTAINED THE AGE OF 18 YEARS, YOU HEREBY ARE ADMONISHED TO READ NO FURTHER.
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Allowing that you have related your story completely accurately, I find it complete unacceptable that a doctor would make a diagnosis and then offer the patient absolutely no treatment, advice or referral regarding that diagnosis. Accordingly, lacking confidence in a diagnosis from that doctor, I am reluctant to give you any advice specific to your current status based on a diagnosis of which I am uncertain. But I will discuss the diagnosis and treatment of tendonitis with the admonishment that none of what I will offer should necessarily be thought of as applicable to your situation, and any treatment attempted should be based on a real hands-on diagnosis which should be professionally tailored to the specifics of your case by your own attending doctor.
Tendonitis is consider by most to be an inflammatory process involving the tendon or its sheath covering, although a few discount it as an actual inflammatory condition. I personally subscribe to the inflammatory theory. A tendon is the business end of a muscle. It attaches to the bone upon which that muscle applies its force. The tendon slides within a sleeve folded back on itself which facilitates movement. Tendons are collagenous soft tissue structures which are not well vascularized and thus injuries to tendons generally heal slowly.
The diagnosis of tendonitis is often made on a clinic basis and may reflect a default thought when more specifics do not come to mind. The main treatment of tendonitis in an otherwise intact tendon is supportive and palliative. Generally, rest is initially essential, along with the use of NSAIDS and sometimes the judicious use of local corticosteroids injected close to but not into the tendon. Corticosteroids can weaken tissue and care must be taken when such medications are employed that over-stressing of the tendon is avoided. Ruptures can result, even from normal use. Physical therapy in which the affected joint is put through its normal range of motion is also frequently useful, but such therapy is best supervised by a competent professional to avoid further injury to the tendon. Properly controlled heat prior to the PT and controlled cold afterwards is frequently employed. Other modalities such as ultrasound may be helpful. But this is not a do-it-yourself project and treatment and therapy should be directed by a professional.
I would suggest another opinion from a doctor who will be willing and able to treat based on his/her diagnosis. Again, do not rely on my discussion to reflect advice which is necessarily applicable your particular case. |
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