Aches and Pains Affecting Soft Tissue Near Joints
Aches and pains of soft tissue that are not due to joint abnormalities are sometimes referred to as nonarticular rheumatism. Tissues affected may include ligaments, tendons, bursae, and muscles. The following discussion focuses only on problems affecting tendons and bursae.
Tendons are cords consisting largely of fibrous tissue that connect muscles to bone. Therefore, tendons allow muscles to move joints. Tendons typically run inside tendon sheaths, which provide lubrication to the tendon, allowing it to move easily and with low friction.
A number of disorders can affect tendons (including tendon rupture). However, the typical rheumatic disorder that affects tendons is inflammation (tendinitis). The inflammation generally affects the tendon and its sheath. The result is pain and difficulty in moving the tendon—or even complete immobilization of the tendon. The cause is often unknown. However, the aches and pain are often caused by overuse. Other, less common, causes include a variety of body-wide disorders such as gout and diabetes. Treatment involves treating the underlying cause, such as trying to avoid further overuse, and resting the affected joint—using temporary splinting if necessary. Drugs that reduce inflammation, such as nonsteroidal anti-inflammatory drugs (NSAIDs), are often given. Sometimes, a corticosteroid is injected into the tendon sheath.
Bursae are fluid-filled sacs that lie between a tendon (and its sheath) and the underlying bone. Thus, bursae cushion movements between tendons, muscles, skin, and bones, allowing tendons to move easily in the vicinity of a joint.
Inflammation of a bursa (bursitis) results in pain and interferes with such movement. Bursitis is most often caused by overuse (like tendinitis). It may also be caused by injury, by disorders such as rheumatoid arthritis, or by infection of the bursa. Treatment depends on the underlying cause (such as antibiotics for infection). Treatment of the symptoms is virtually identical to that for tendinitis.
