Symptoms: Can Tendonitis Cause Nerve Compression?

Confused about the symptoms in my body?

Hello Doctor: In mid-April of this year, I visited an orthopedic clinic.
At that time, my symptoms included pain in my buttocks after sitting for too long, pain in my left leg after walking for extended periods (sometimes my calf would also hurt), difficulty straightening my left knee while sitting, and occasional numbness in the dorsum of my left foot.
The doctor performed a big toe test and noted that my left foot was weaker compared to my right foot, suggesting a muscle strain or a herniated disc (X-rays showed no issues with the bones).
However, during this period, I also experienced symptoms of autonomic nervous system dysfunction, which may have contributed to my decision to see a neurologist for an electromyography (EMG) test.
The neurologist diagnosed me with no issues in my right foot, but indicated that the nerves in my left foot were compressed, possibly due to a mild herniated disc.
After a month of medication, my left foot symptoms improved significantly, so the orthopedic doctor referred me to a rehabilitation specialist.
The rehabilitation doctor diagnosed me with tendinitis.
I would like to ask: since I have no lower back pain or lumbar pain, how can there be nerve compression in my left foot as indicated by the EMG? Is it possible for tendinitis to cause nerve compression? Thank you, Doctor.

Angela, 20~29 year old female. Ask Date: 2017/05/23

Dr. Yin Xinbei reply Rehabilitation

The symptoms indeed suggest a suspicion of sciatic nerve compression, but it is also possible that the compression is caused by a herniated disc affecting the lumbosacral nerves or by the piriformis muscle compressing the sciatic nerve (which originates from the lumbosacral nerves).
The electromyography (EMG) test previously conducted (especially if needle insertion was involved) should help determine the exact site of compression.
Please consult a neurologist again or obtain a copy of the EMG report.
Tendonitis in the lower extremities is unlikely to compress the nerve unless it is very close to the nerve, such as in the case of the piriformis muscle.

Reply Date: 2017/05/23

More Info

Tendonitis, or inflammation of a tendon, can indeed lead to symptoms that may mimic or contribute to nerve compression, although it is not a direct cause of nerve compression in the same way that conditions like herniated discs or bone spurs are. To understand this better, let’s delve into the anatomy and physiology involved.

Tendons are the fibrous connective tissues that attach muscles to bones. When a tendon becomes inflamed, it can swell and become painful, which may lead to changes in the surrounding structures. In some cases, this swelling can exert pressure on nearby nerves, leading to symptoms such as pain, numbness, or weakness in the affected area. This is particularly relevant in areas where tendons are in close proximity to nerves, such as the wrist (in carpal tunnel syndrome) or the elbow (in conditions like tennis elbow).

In your case, the symptoms you described—pain in the buttocks and calf, difficulty straightening the knee, and occasional numbness in the foot—suggest that there may be multiple factors at play. The diagnosis of possible nerve compression in your left leg, as indicated by the electromyography (EMG) results, points to a potential issue with the lumbar spine, such as a herniated disc, which can compress the nerves that exit the spine and travel down the leg.

The fact that you do not have lower back pain or lumbar pain does not rule out nerve compression. Some individuals with lumbar disc issues may not experience significant back pain but may have radicular symptoms (pain that radiates along the nerve pathway) in the legs. This can occur due to the way the body perceives pain and the specific pathways that are affected by the nerve compression.

Regarding the diagnosis of tendonitis, it is possible that the inflammation of the tendons in your leg could contribute to the overall discomfort and may even exacerbate the symptoms of nerve compression. For instance, if the tendons around the knee or ankle are inflamed, they could potentially cause mechanical irritation or additional swelling that might affect the nearby nerves.

To summarize, while tendonitis itself is not a direct cause of nerve compression, the inflammation and swelling associated with it can lead to symptoms that overlap with those caused by nerve compression. It is essential to address both the tendonitis and the underlying nerve compression to achieve optimal recovery. Treatment options may include physical therapy, anti-inflammatory medications, and possibly corticosteroid injections to reduce inflammation. In some cases, if conservative treatments do not provide relief, surgical intervention may be necessary to alleviate nerve compression.

It is crucial to follow up with your healthcare provider to discuss your symptoms and treatment options thoroughly. They may recommend imaging studies, such as an MRI, to better visualize the structures in your lower back and legs, which can help clarify the diagnosis and guide treatment. Additionally, addressing any underlying issues related to autonomic nervous system dysfunction may also be beneficial in managing your overall symptoms.

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