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Tendomyopathy: Causes, Symptoms and Treatment

Tendomyopathy refers to pain syndromes affecting muscles, tendons, and their attachment points. It is often caused by overuse or poor posture.

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Things worth knowing about "Tendomyopathy"

Tendomyopathy refers to pain syndromes affecting muscles, tendons, and their attachment points. It is often caused by overuse or poor posture.

What is Tendomyopathy?

Tendomyopathy is a term derived from the Latin and Greek words for tendon (tendo), muscle (myo), and disease (pathy). It describes a group of painful conditions involving both muscles and tendons, including the points where tendons attach to bone. Symptoms most commonly occur in the shoulder, neck, back, elbow, hip, or knee and may follow either an acute or chronic course.

Tendomyopathy is not a single diagnosis in the strict sense but rather an umbrella term for various musculoskeletal pain syndromes in which muscles and tendons are jointly affected. It is one of the most common causes of musculoskeletal pain and is frequently encountered in general practice and orthopedics.

Causes

Tendomyopathy most commonly develops as a result of sustained mechanical stress or improper use of the musculoskeletal system. The most frequent causes include:

Chronic overuse: Repetitive, one-sided movements in occupational or sporting activities lead to micro-trauma in muscles and tendons.
Poor posture and ergonomic deficiencies: Prolonged sitting in an unfavorable position, such as at a desk or while driving, places persistent strain on certain muscle groups.
Muscular imbalances: Imbalances between shortened and weakened muscle groups promote overuse reactions.
Psychosocial factors: Stress, psychological strain, and insufficient recovery can intensify muscle tension and pain.
Degenerative changes: With advancing age, the load-bearing capacity of tendons and muscle tissue decreases, raising the risk of tendomyopathy.
Acute injuries: Strains or sprains can serve as a starting point for chronic tendomyopathy.

Symptoms

The symptoms of tendomyopathy are varied and can differ depending on the affected area of the body. Typical symptoms include:

Dull, pulling, or burning pain in the affected muscle and tendon regions
Tenderness on pressure at tendon attachment points and along tendons
Restricted movement and a feeling of stiffness, especially in the morning or after prolonged rest
Swelling or local warmth in the affected area
Muscle weakness and rapid fatigue of the affected muscles
Chronic cases can significantly reduce quality of life

Diagnosis

The diagnosis of tendomyopathy is primarily clinical. The physician takes a detailed medical history and performs a physical examination to assess tender points, range of motion, and muscle strength. The following diagnostic measures may also be used:

Ultrasound: To evaluate tendons, muscle structures, and possible signs of inflammation
Magnetic Resonance Imaging (MRI): For unclear findings or suspected structural damage
X-ray: To rule out bony changes or calcifications
Laboratory tests: To exclude inflammatory rheumatic diseases

Differential diagnosis is important to distinguish tendomyopathy from conditions such as fibromyalgia, osteoarthritis, rheumatoid arthritis, or other inflammatory diseases, in order to initiate the correct therapy.

Treatment

Treatment of tendomyopathy depends on the cause, severity, and affected body region. A multimodal approach is generally recommended:

Conservative Therapy

Physiotherapy: Targeted exercises for stretching, strengthening, and improving posture form the cornerstone of treatment.
Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac may be used short-term to relieve pain.
Local measures: Heat or cold applications, ultrasound therapy, electrotherapy, and massage can alleviate symptoms.
Ergonomic adjustments: Changes to the workplace or daily routine help to prevent overloading.
Corticosteroid injections: Targeted injections may be considered in cases of localized inflammatory reactions.

Multimodal Pain Therapy

For chronic cases, a multimodal pain therapy approach is recommended. This includes not only physical measures but also psychological support, stress management, and relaxation techniques such as progressive muscle relaxation or biofeedback.

Surgical Intervention

Surgical intervention is rarely necessary for tendomyopathy and is only considered in cases of confirmed structural damage (e.g., tendon tears) when conservative measures have not provided sufficient relief over an extended period.

Prevention

Tendomyopathy can be effectively prevented through regular physical activity, ergonomic design of the workplace and daily environment, adequate recovery, and stress management. A balanced ratio of exertion and regeneration is essential for the long-term health of muscles and tendons.

References

Siebert, U. et al.: Guidelines on Fibromyalgia Syndrome and Soft Tissue Rheumatism. German Society for Rheumatology (DGRh), 2022.
Breivik, H. et al.: Assessment of pain. British Journal of Anaesthesia, 2008; 101(1): 17-24.
World Health Organization (WHO): Musculoskeletal conditions. WHO Fact Sheet, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions

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