Enthesitis is inflammation occurring at the attachment point of a tendon or ligament to bone. This condition commonly affects areas such as the shoulder, elbow, hand, wrist, knee, ankle, and foot.

Master, Doctor Diep Xuan Hoang from Tam Anh Cau Giay General Clinic explains that enthesitis often follows acute injuries, such as falls or direct impact to the tendon-bone attachment area. However, repetitive daily movements during work or sports like tennis or pickleball can also create micro-traumas that accumulate over time, leading to inflammation. Certain genetic conditions and autoimmune diseases, such as ankylosing spondylitis and psoriatic arthritis, may also cause enthesitis.

If left untreated, enthesitis can lead to persistent pain, joint stiffness, and difficulty with movement. The condition can progress to tendon tissue fibrosis, calcification, and the formation of new bone, which may cause severe pain.

Depending on the condition and its cause, Doctor Hoang outlines several effective treatment methods for enthesitis.

Conservative approaches begin with rest and cold compresses, especially during the acute inflammatory phase, to allow tendons time to recover and reduce inflammation. Patients should limit movement or activities that cause pain in the inflamed tendon area. Applying a cold compress for 15-20 minutes, three to four times a day, helps alleviate pain, swelling, and inflammation.

Physical therapy is crucial for managing enthesitis flare-ups. This includes strengthening exercises to target affected muscles, thereby improving mobility. Advanced therapies, such as laser and shockwave therapy, can also be employed to reduce pain and enhance tissue healing.

Treating lateral epicondylitis with a high-power laser machine. Photo: Tam Anh General Hospital

Treating lateral epicondylitis with a high-power laser machine. Photo: Tam Anh General Hospital

Local therapy involves applying nitroglycerin ointment to the painful tendon area. This method works by dilating blood vessels, which improves blood flow to the injured site and promotes tendon tissue recovery.

Medical treatment includes non-steroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and alleviate mild symptoms. Depending on the underlying cause, a doctor may prescribe biologics or disease-modifying antirheumatic drugs (DMARDs) to slow disease progression. Platelet-rich plasma (PRP) therapy is another option, using the patient's own plasma injected into the injured tendon area to stimulate cell regeneration, support healing, and restore tendon function.

Surgery is considered when conservative treatments prove ineffective. Surgeons perform either arthroscopic or open procedures to remove damaged or chronically inflamed tendon tissue and release impinged tendon attachments. The goal of surgery is to improve function and reduce persistent pain.

To prevent enthesitis or avoid its worsening and recurrence, Doctor Hoang advises individuals with underlying conditions such as ankylosing spondylitis or psoriatic arthritis to adhere to their treatment plans and manage their diseases effectively.

Healthy individuals should maintain regular exercise to improve overall health. However, it is important to choose appropriate exercises, reduce intensity, or rest if pain occurs.

If symptoms do not improve, patients should visit a multispecialty hospital for early examination, diagnosis, and treatment. A personalized, in-depth protocol is recommended, involving collaboration among imaging specialists, musculoskeletal doctors, physical therapy and rehabilitation specialists, and orthopedic trauma surgeons.

Thanh Long