American Medical Association Family Medical Guide - American Medical Association [688]
Treatment
Mild cases of tenosynovitis can usually be treated by resting the affected area (such as by wearing a splint) and taking a nonsteroidal anti-inflammatory drug to reduce the swelling and relieve the pain. Your doctor may recommend ways to avoid overusing the tendon, such as changing your work habits. Noninfectious tenosynovitis can sometimes be treated with an injection of a corticosteroid drug to reduce the inflammation. Tenosynovitis caused by an infection requires prompt treatment with antibiotics to clear up the infection and possibly surgery to release pus from the affected area. If tenosynovitis persists, a simple surgical procedure to open the constricting tendon sheath will allow the tendon to move freely again.
Fibromyalgia
Fibromyalgia, also called fibrositis or myofascial pain, is chronic stiffness and pain in fibrous tissues, usually deep inside the muscles. The cause of fibromyalgia is unknown, but some doctors think it may result from an injury to the central nervous system or from a viral infection. The attacks of pain and stiffness seem to be associated with emotional stress. Although muscles knot up during an attack of fibromyalgia, the muscles themselves are not damaged in any way. Fibromyalgia is common, especially in people who are past middle age, and usually clears up on its own.
Symptoms
During attacks of fibromyalgia, you are likely to have localized pain and slight swelling in the affected muscles. The tenderness seems to occur in specific areas called tender points throughout the body. Backache is common. People who have fibromyalgia are often tired because the pain interrupts their sleep. They also may have other symptoms, including anxiety or digestive disturbances such as irritable bowel syndrome (see page 765).
Sensitive areas of fibromyalgia
A person is diagnosed with fibromyalgia if he or she has chronic pain in at least 11 of 18 specific sensitive areas, called tender points, on the body (dots). Some people with fibromyalgia also have pain elsewhere in their body.
Diagnosis and Treatment
Because symptoms of fibromyalgia are similar to those of other disorders, it is difficult to diagnose. Your doctor may make a diagnosis of fibromyalgia if you have had pain in at least 11 of the 18 sensitive areas in the body for longer than 3 months.
Soaking in a hot bath and massaging sore muscles can provide some relief. Exercise such as walking or swimming increases muscle strength and helps reduce pain and stiffness. Taking aspirin or another nonsteroidal anti-inflammatory drug can help relieve the pain. Your doctor may prescribe antidepressants, stronger pain relievers, or muscle-relaxant drugs to loosen muscles and help you sleep. A doctor may prescribe injections of a local anesthetic into the sensitive areas to relieve pain, sometimes with a corticosteroid drug to reduce inflammation.
Ganglion
A ganglion is a lump under the skin of the wrist or upper surface of the foot. A ganglion develops when a jellylike substance accumulates in a joint capsule or tendon sheath (the tissue surrounding a tendon) and causes it to balloon out.
Symptoms
The size of ganglia can vary. They may be soft or hard and are usually painless or only mildly painful. A ganglion on the wrist does not interfere with wrist movement, but a ganglion on the foot can make it difficult to wear some types of shoes. Although a ganglion is harmless, you should have your doctor look at it. A swelling of any kind could be a sign of a more serious condition.
Diagnosis and Treatment
A doctor can diagnose a ganglion by its appearance and feel. Your doctor may remove the jellylike substance from the ganglion with a syringe (aspiration) and inject the ganglion with a corticosteroid drug to reduce inflammation. Aspiration is effective only about half the time. In rare cases, ganglia that are especially painful are removed surgically. Do not try to eliminate a ganglion by smashing it with a book or other object; this folk remedy is ineffective and painful.
Ganglion
The wrist is one of the most common sites