Enteopathy: Definition, Causes, Symptoms, Diagnosis, Treatment and Overview

It is a general term for a medical disorder that involves disorders of the musculoskeletal system.

Specifically those that affect the union of the ligaments and the tendons to the bone.

The area where a tendon joins the bone is called an enthesis (which is where the name comes from).

There are many areas in the body where the tendons attach to the bones, and as a result, there are many regions in the body where a patient can develop an enthesopathic condition.

Enthetosis can arise in the spine, knee, ankle, elbow, wrist, and other areas of the body.

This type of pain occurs when the joint or attachment point that is affected by enthesopathy is used.

Diseases like the ensofonía , that usually happens when one or more types of arthritis affect the articulation, the arthritis that happens when the cartilage or the bone of the joints is broken and the spondyloarthritis .

That is a term for the types of arthritis conditions that cause inflammation in the joints, sometimes they are related to enthesopathy.


Like many types of arthritis, enthesopathy can have many causes. These include:

  • Excessive use of the joint.
  • Obesity, which can put stress on your joints.
  • The conditions that cause your immune system to attack the tissue of your joint.
  • Present a family history of arthritis.


The most noticeable symptom of enthesopathy is pain in the area around a joint when using that joint.

You can also see that the area of ​​the tendon that joins the bones is sensitive to touch.

Hip Entesopathy:

Conditions that affect the spine can cause pain in the hip bones.

They can also cause general lower back pain, you may feel less able to move the spine, since enthesopathy can cause the vertebrae to fuse.

The enthesopathy of the hip may be related to intestinal conditions, such as inflammatory bowel disease, or a gene that is inherited.

Entelopathy of the knee:

Knee enthesopathy is usually related to overuse or stress placed on the knees.

This type of enthesopathy is often due to conditions such as patellar tendonitis .

Patellar tendinitis is also called runner’s knee.

Pain with this condition is usually worse when you exercise and put pressure on your knees.

You may also feel pain when performing certain daily tasks, such as getting up from a sitting position or climbing the stairs.

Foot Entesopathy:

The ensotopathy on your foot usually affects your plantar fascia, this is the tissue under the arch of your foot.

It can also affect the calcaneus bone or heel bone.

This pain usually occurs because the enthesis of your plantar fascia has become thickened.

This can cause pain in the heel and around the arch of the foot when walking or putting pressure on the foot.

Entelopathy of the ankle and tarsus:

Enthesopathy in the ankle and tarsus, or the Achilles tendon, usually affects the point where the Achilles tendon joins the heel bone.

When you suffer from enthesopathy in this area, you usually feel a lot of pain when your foot moves.

You may also feel pain when you lower and press the heel or forefoot.

For example, it may hurt when standing on the tips of the toes. The level of pain that you feel can vary widely.

With mild enthesopathy, pain can be only a nuisance. You can probably do everyday tasks without much discomfort.

With severe enthesopathy, pain can prevent you from doing daily activities.

Enthetosis can also be a symptom of an underlying condition. This includes:

  • At arthritis psoriasica.
  • Spondyl arthritis
  • The narrowing of the joint space.

Other symptoms associated with these potential underlying conditions include:

  • The inability to move a joint in the directions that normally move.
  • The stiffness of a joint, especially after sleeping or sitting for a prolonged period of time.
  • Swelling and pain in the area of ​​a joint.
  • The sound around a joint when it moves.
  • The ability to move various parts of the body depends on the tendons, ligaments and bones of our musculoskeletal system. Enthesopathy interrupts this system and can cause many problems.


The treatment of enthesopathy depends to a large extent on where the disease occurs in the body.

The treatment options for spinal enthesopathy differ from the appropriate treatments for enthesopathy of the ankle.

Therefore, the first step in the treatment is to identify the location and extent of the condition.

Once it is well defined, the doctor can offer you a treatment strategy that suits the patient’s needs.

When symptoms of enthesopathy are experienced, the doctor, after doing a physical examination, will recommend:

Laboratory studies such as:

  • Fluorescence test to detect antinuclear antibodies.
  • Rheumatoid factor test.
  • Tests to detect human leukocyte antigen B27.
  • Uric acid values.
  • General urine test.
  • Complete blood count (hemogram).
  • Synovial fluid analysis.

A differential diagnosis should be made of diseases such as gout or the presence of an infection.

Radiographs, MRI, and diagnostic ultrasound may be recommended to determine changes in the bones and if there is tissue swelling or swelling.


The treatment plan is based on the severity of your symptoms and the areas affected.

The treatment may also involve the treatment of any underlying condition that may be causing the enthesopathy.

Treatment options may include rest, therapies, analgesics, anti-inflammatory injections or surgery.

The therapies:

Over time, therapies or stretching techniques can help relieve some of the pressure on the affected joints.

For example, stretching of the calf muscles can help relieve the pain caused by the enthesopathy of the Achilles tendon.

To do this, place both hands on the wall, extend the leg back and bend the foot up.

This stretches the muscles attached to the Achilles tendon without pressing it.

Changes in lifestyle:

The doctor may recommend changes in lifestyle, avoiding the use or excessive activities that were responsible for the enthesopathy or the underlying condition.

If the area of ​​the affected joint is used frequently, for work or for any leisure activity, you should reduce the amount of work or activity, as it may worsen pain or inflammation.

If the patient exercises regularly and this type of exercise exerts pressure on some of the joints, the doctor may recommend a new exercise plan that allows the patient to continue exercising regularly and exert less pressure on the affected joint area.

The drugs:

To help the patient deal with the pain that accompanies enthesopathy, the doctor is likely to recommend a treatment based on non-steroidal anti-inflammatory drugs, which help relieve the pain and inflammation that enthesopathy causes.

These options may include:

  • Aspirin (Ecotrin).
  • Naproxen (Aleve).
  • Ibuprofeno (Advil).

If these medications do not help reduce pain, the doctor may recommend corticosteroid injections.

These medications can help control pain, since they reduce inflammation and therefore pressure on the tendon.

If a disorder of the immune system, as in the case of psoriatic arthritis , is what is causing the enthesopathy, it is likely that the doctor will recommend medications to reduce the response of the immune system that causes the pain.

An antirheumatic drug that modifies the disease can help in the treatment of the immune response. An immunosuppressant, such as cyclosporine (Neoral) or azathioprine (Imuran), may also help relieve symptoms.


Surgery is generally considered a last resort. When necessary, it is often due to enthesopathy caused by an underlying condition.

In these situations, the doctor may recommend a total joint replacement. In this procedure, the affected bone is surgically removed and a plastic or metal prosthesis is placed.


In most cases, enthesopathy can be treated through a combination of medications, treatment and lifestyle changes.

In some cases, it can be completely cured.

Mild cases caused by excessive use, stress or trauma can be resolved by addressing the cause.

If enthesopathy is caused by a condition of the immune system, such as psoriatic arthritis, the doctor will develop a treatment plan to relieve your symptoms. It will also try to treat the response of the immune system that causes pain.

It is possible that the discomfort caused by the symptoms can be reduced in the short term.

However, a long-term plan will be necessary to prevent the condition from getting worse and causing more damage to the enthesis and joint.