Lower Extremity Tenosynovitis

WHAT YOU SHOULD KNOW:

  • Lower extremity tenosynovitis is a condition affecting the tendons, sheath, and synovium of the lower extremity (limb). Tendons are cords of tissue that connect muscles to the bones. The synovium is the lining of the sheath (covering) of the tendons. With lower extremity tenosynovitis, the sheath and the synovium of the flexor (bending) muscles become inflamed (swollen). The tendons may also become thickened and have a hard time moving through the swollen covering. This may cause pain and tenderness when moving the affected leg or foot, especially the ankle and heel areas. This condition usually affects athletes, ballet dancers, and people of middle age or older. Lower extremity tenosynovitis may be an acute or chronic (long-term) condition. It may also be caused by an infection.

  • You may have pain, redness, and swelling in your leg, thigh, ankle, or foot. This pain usually occurs when you move the affected limb up and down or while walking or running. Over time, the pain may become worse and may be present even at rest. You may also have weakness and limited movement of the affected part. Your caregiver will test your legs and feet by moving them in different positions. X-rays, an arthrogram, a biopsy, or magnetic resonance imaging (MRI) may be done to look for tendon injuries and other problems. Treatment will depend on your symptoms and the length of time you have had them. With treatment, such as medicines, a splint, rehabilitation, or surgery, you may be able to resume your normal daily activities.

INSTRUCTIONS:

Medicines:

  • Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.

  • Take your medicine as directed: Call your healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.

  • NSAIDs help decrease swelling and pain or fever. This medicine is available with or without a doctor's order. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.

Ask for information about where and when to go for follow-up visits:

For continuing care, treatments, or home services, ask for more information.

Activity:

  • Exercise: Exercise makes the heart stronger, lowers blood pressure, and helps keep you healthy. Begin to exercise slowly and do more as you get stronger. Talk with your healthcare provider before you start an exercise program.

  • Limit the activities of your affected part: Avoid too much leg and foot movement, such as walking or running, until your caregiver says it is OK. This may help decrease stress on the tendon and prevent further damage, relieve pain, and promote tendon healing.

  • Proper lower extremity position: It is important to always keep the affected part in a correct position so it will heal faster. The knees, ankles and feet should not be flexed (bent) or extended (straightened) for long periods of time. When sleeping, try not to lie on the same side as the affected part.

Cold or warm compress:

  • Ice pack: An ice pack may be applied on top of the swollen part to decrease swelling and pain. Put crushed ice in a plastic bag and wrap it with a towel. Place the ice bag on the area for 15 to 20 minutes every hour as long as you need it. Do not place the ice pack directly on the skin. If ice is put on the injured area for too long or if it is slept on, it may cause frostbite.

  • Warm pack: After applying an ice pack, apply a warm, wet washcloth, a heating pad (turned on low), or a hot water bottle. This will help to decrease pain. You may do this for 30 minutes, 3 to 4 times a day. Do not leave the warm pack on your skin for a long time. Leaving heat on for too long can burn your skin. Sitting in a warm water bath or whirlpool may also help.

Crutches:

Caregivers may have you use crutches to help you get around, and decrease stress and strain on your affected part. It is important to use crutches correctly. Ask your caregiver for more information about how to use crutches.

Home safety:

Remove loose carpeting from the floor to keep from falling. Using chairs with side arms and hard cushions will make it easier for you to get up or out of a chair.

Splint, brace, walking boot, or cast care:

Caregivers may put a splint, brace, walking boot, or cast on your affected lower extremity. This will keep the affected part from moving while it heals. It may also be used to decrease pain. Check the skin around the splint, brace, or cast everyday. You may put lotion on any red or sore areas. Make sure your splint, brace, or cast is not too tight or too loose. If it is too tight, your toes may feel numb or tingly. Gently loosen the tape so that your ankle, foot, and toes are comfortable. Do not push down or lean on any part of the splint because it may break.

Rehabilitation:

  • Occupational therapy: Occupational therapy (OT) uses work, self-care, and other normal daily activities to help you function better in your daily life. OT helps you develop skills to improve your ability to bathe, dress, cook, eat, and drive. You may learn to use special tools to help you with your daily activities. You may also learn new ways to keep your home or workplace safe.

  • Physical therapy: You may need to see a physical therapist to teach you special exercises. These exercises help improve movement and decrease pain. Physical therapy can also help improve strength and decrease your risk for loss of function.

Rest:

Rest when you feel it is needed. Slowly start to do more each day. Return to your daily activities as directed.

CONTACT A CAREGIVER IF:

  • You have a fever.

  • You have pain and swelling in your leg, ankle, or foot, even after taking your medicines.

  • Your skin is itchy, swollen, or has a rash.

  • You have questions or concerns about your condition, medicine, or care.

SEEK CARE IMMEDIATELY IF:

  • You have trouble breathing or chest pain all of a sudden.

  • Your leg, thigh, or toes feel numb, tingly, cool to the touch, or look blue or pale.

  • Your symptoms become worse, or have returned.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Lower Extremity Tenosynovitis (Aftercare Instructions)

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