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I've just come to the realization that what I thought was joint pain from arthritis may actually be tendinitis. Nothing in particular seems to bring it on (e.g., overuse). The pain starts off gently in a very specific location near a joint (I can use my fingertip to isolate it), but increases with time and ends up affecting the nearby joint in terms of pain and mobility. After a couple of days, it's completely gone but then reappears somewhere else. Is this a sign of tendinitis?
 

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Hi GCCH,

I looked up tendinitis and this is what I found.

Tendinitis is inflammation or irritation of a tendon — any one of the thick fibrous cords that attach muscles to bones. The condition, which causes pain and tenderness just outside a joint, can occur in any of your body's tendons. Tendinitis is common around your shoulders, elbows, wrists and heels.
It came from this web page.

http://www.mayoclinic.com/health/tendinitis/DS00153

I hope this helps.
love,
Lyn
 

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Thanks, Lyn. Does anyone here get tendinitis as part of their lupus? I'm just wondering if it differs from the generic version.
 

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Hi,

I used to get trigger finger (tenosynovitis) a lot pre diagnosis and meds
 

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Hi GCCH,

It could be tendinitis or synovitis. Synovitis can be caused by the same inflammatory process involved in lupus as well as other connective tissue disorders. When that is the case, it's different from overuse injuries and can come and go over many areas of the body or stay fixed for a very long time. I have been diagnosed with tendinitis and carpel tunnel for approximately 26 years. I was diagnosed with tenosynovitis May of last year. Dubois' Lupus Erythematosus, Seventh Edition, c. 2007 thoroughly explains the inflammatory process involved and its relevance.

Some internet resources:
http://en.wikipedia.org/wiki/Synovitis
http://www.merck.com/mmhe/sec05/ch074/ch074e.html
http://emedicine.medscape.com/article/1239040-overview

Barb
 

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Thanks, Lily and Barb. How did your doctor finally make the differential diagnosis? Do you take NSAIDs for the pain? I am unable to take NSAIDs (due to kidney problems) but other pain relief only takes the edge off, at best.
 

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Many doctors have been involved in sorting out my diagnosis. My GP diagnosed and treated the tendinitis and carpal tunnel. A pain specialist recognized the tenosynovitis and referred me to an orthopedist who diagnosed and is treating the tenosynovitis. I have to wear splints at times, avoid all use of an affected body part at times, do rehabilitative exercises on my own or via physical therapy, use moist heat, get cortisone injections, etc., etc. I take NSAIDS to address inflammation but they do nothing for the pain. Only heat, cortisone, protection or immobilization and rehabilitative exercises ease the pain. I'm currently taking oral steroids to see if that will ease my current problem with tenosynovitis. If the steroids don't help, I will have to have surgery.

I have been seeing a rheumatologist for at least 15 years. First one then another. Both refused to acknowledge the synovitis because they were stuck on the diagnosis of fibromyalgia. If my current rheumatologist continues to refuse to acknowledge it, given the seriousness and length of the current flare (1 year), he's fired.

Synovitis can be very disabling. When I had it in my sacroiliac joints, I couldn't bend my body including to sit, couldn't walk around the block, couldn't roll over in bed, had a hard time dressing myself, etc. It lasted over a year as well. Should have seen an orthopedist or the pain specialist then. A trigger point injection of cortisone would have resolved that problem quickly but I didn't know that such things existed then and my rheumatologist didn't inform me of that option.

Barb
 

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Yes achilles tendonitis.

It took me a while to realise that the stiffness in my muscles caused by lupus meant that my tendons reacted , thus tendonitus.

There are so many layers with lupus and peeling them back and trying to sort out what is what.
Lupus?, tendonitis, arthritus, plantar faciatus.......I could go on.

Typically lupus can cause stiffness and that has a knock on effect.

Did I mention Fibromyalgia:rolleyes:
:)
 

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just to mention.

A doctor recommended not having cortisone injections in the achillies tendons as they tend to rupture.

Just for the record
 

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Hello there :)

Yes tendinitis is a big part of my lupus symptoms - Apparently I have "weak" tendons (docs words), only they were far from weak before I had lupus (and they were fine during a remission period too). All my tendons are affected so shoulders, hips (a lot), knees, wrists (a lot), hands, ankles....

Due to the state of my tendons I get calcium forming on them too which doesn't help pain-wise and, like Nicky, have both Achilles affected (near the insertion).

I have found that, generally, taking extra Vit B supplements (mine is a mix of B6, B9 and B12) has helped quite a lot, otherwise I try and support the tendon, if it's in a place where that's possible, and that eases the pain which then vanishes for a while - as you say, it comes and goes a lot. Vitamin B also helps ease any nerve pain you have as well. I stopped it for a while and after a couple of months saw a big difference. For my wrists, I wear wrist braces at night (even though I don't have carpal tunnel problems) as the position I put them in was causing extreme pain.

I am also careful not to "overbend" or "overstraighten" knees and put other joints in odd positions as that tends to bring on quite a bit of pain.

Katharine
 

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Discussion Starter #11
Katharine, it's interesting that Vitamin B works for you. Is this over-the-counter or by prescription? And to those of you who are suffering from this, how does the pain usually start?
 

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Hi,

The vitamins are OTC but first given to me by the rheumy who said that they were well worth trying (both for tendon and nerve pain) and that in any case if there is too much Vitamin B the body eliminates it.

At first I wasn't convinced that they did much but my nerve pain reduced considerably and so did tendon pain - I thought it was because things were better disease activity wise but when I stopped I really saw the difference and it suddenly clicked that that might have been helping. I asked the chemist who confirmed and so went back on them.

My pain starts relatively suddenly - unless I've put myself in a funny position and is quite sharp (not as sharp or shooting as nerve pain). Some days I'll wake up with it, some days I'll first notice it on a walk. It can also come on in my wrists (which are very bad) and Achilles through too much strain - driving the car does it for me with the wrists. I also find I can't work at a desktop PC as I can't "pose" the heels of my hand and having my arms "in the air" does it. I don't think that is its "on/off" nature, more a question of the tendons being in that state for so long that certain things have become rather difficult and revive the problem pretty quickly.

So, some of my tendons it's pretty constant, others it comes and goes. I don't know if that's what you are experiencing at all.

Katharine
 

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Hi Katharine. My pain seems to be a little different. It comes gradually (usually late in the day) and then progresses, sometimes to the point of extreme pain. Lately (touch wood), it's been manageable though (use of acetaminophen generally dulls the pain). It's also very unpredictable and not related to overuse, poor positioning, etc. I guess that's why it's so frustrating. I just can't predict when it will appear, and when it will go away!
 

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I would ask the doctor what you have so he could order the right tests to find out and treat better. I do hope that you feel better soon.
 

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onetay;546590 said:
I would ask the doctor what you have so he could order the right tests to find out and treat better. I do hope that you feel better soon.
Thanks, onetay. Actually, I've been complaining about this pain for a few years now. My doctor just takes my complaints at face values and prescribes pain medication or decides not to further reduce my prednisone. He just says that my arthritis is migratory. :umm:
 

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Tendons!

Hi GCCH,

Tendonitis, Tenosynovitis and synovitis HURT!! The more you complain about it the more they ignore you and say you should be thankful because it could be worse! Of course everything could be worse but it still doesn’t take away the pain.

I suffer from all 3 problems in both hands, both knees, both shoulders, all toes, both feet and both ankles and Achilles tendons . I’ve had, ct scans, MRI’s and x –rays and the rheumatologist says no one can help me nor can they fix it, it is one of those things and I need to get use to the pain, inability to get up and out of a chair, up the stairs and in the shower and so on and so forth. I have asked many times to refer me to orthopaedic and I am told time after time they can’t help me so of course no referral.

I was diagnosed with carpel tunnel syndrome and the MRI revealed it is not from an inflammatory process so then my referral to orthopaedics was done. He looked at my hands and at the MRI and told me that this can not be ignored because the tendons are so inflamed along with the synovial linings and if it is not cleaned out and continues to stay inflamed then the risk of tendon ruptures are very high. He was shocked to hear that the rheumatologist had refused to send me to ortho and stated they can’t help. That is ridiculous. On Wednesday I go in for tendon realignment, synovectomy of my fingers and carpel tunnel release on the right hand when it heals I will have the left hand done.

Now I though the rheumatologist was here to help me. She suggested that I had carpel tunnel releases on both hands at the same time. The orthopaedic read this in her referral letter and said to me with the tendonitis and so on in your knees and feet can you get out of a chair without using your hands and can you get up and down the stairs without holding on to something. Of course the answers were no and he then asked me how would I be able to function with both hands done at the same time? He also said the stress to the tendons in the knees and feet would become so inflamed and I could risk ruptures. He was shocked to even think that a rheumatologist would suggest such a ludicrous idea.

It is my opinion that rheumatologists are helpful and knowledgeable but really don’t want other specialists involved. I understand that treatment options are limited due to the disease process but it is disheartening to be told nothing can help and to learn to live with the everyday pain. I feel all doctors should have the conditions they are treating so they can truly understand what we are going through.

As far as the problems with my hands, the ortho doctor said I should get immediate relief from the surgical procedure I am having on Wednesday but it is only a temporary intervention. It could last a few months or years but since I have had cortisone injection and no more should be done this is my only option at this time. If and when it returns then we will need to look at possible joint replacements or fusion of the bones. To me, fusion of the bones means no more range of motion in my fingers. If tendons rupture the chance of repair is limited as the tendons really can’t hold sutures because to the disease process in the tendons. So I have a few options and in my personal opinion some pain relief no matter how long is better then none and a few moths or years of being able to use my fingers is better then not having the ability to use them at all. If I was told the pain would not go away with this procedure then I wouldn’t have it done but to finally get some relief is better then what I am going through now.

Tendon problems with Lupus, the ones it affects can definitely sympathise with you. It hurts and there is no way one can say that tomorrow I should feel better because when tomorrow comes you may hurt worse. I have come to realization that on a good day it is AS GOOD AS IT GETS and believe me, good days are few and far between and you still hurt!

I hope you get the help you need and remember you are not alone. Many of us suffer with tendon problems and pain and we can sympathise with you 100%!

Stacie
 

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(((Stacie))) Thanks for sharing that.

The problem is that my pain comes and goes so much that by the time I get to the doctor, it's gone. The only time he was able to see me in extreme pain was when I ended up in the hospital with an extremely inflammed ankle. I was hospitalized for 5 days with X-rays and biopsies performed. They even suspected a joint infection, but fortunately tests were negative.

I just want someone to figure out what this is! Whether arthritis, tendintis or synovitis, this thing is no fun! :eek:hno:
 

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Before I was diagnosed with lupus I went to my family doctor for all my issues before I had a very serious flare. Things I would tell him that would bother me he wrote off which I found out later were minor symptoms. He referred me to rheumatologist I see now. She is an O.D. and I love her. She will identify problems before I speak them because she can feel them. I am typically a negative person and don't believe things will help the pain but everything she has had me do has worked. I see a massage therapist for my tendonitis to avoid taking drugs and it works great. I no longer have issues in my wrists. I still have pain in my shoulder but it comes and goes. I would recommend an O.D. to anyone and search until you find the right doctor there is no reason to settle.
 
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