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Tendinitis - Symptoms, Causes, Prevention, Diagnoses and Treatments

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Tendinitis - Symptoms, Causes, Prevention, Diagnoses and Treatments

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Tendinitis results from overusing a tendon or injury to a tendon, which is commonly seen in athletes. Learn about its symptoms, causes, and treatment.

Medically reviewed by

Dr. Anuj Gupta

Published At September 19, 2019
Reviewed AtAugust 3, 2023

What Is Tendinitis?

Tendon is a thick fibrous structure in the body, which connects muscle to bone. Inflammation of the tendon is known as tendinitis or tendonitis. The exact cause is still debatable, but the most common theory excepted is it occurs due to overuse, which causes microtrauma to the tendon. It commonly affects the shoulder, elbow, wrist, knee, thigh, ankle, etc. Tendinitis is common in athletes though it can occur at any age. Older people are more susceptible as tendons become weaker and less elastic with age. When the sheath around the tendon is inflamed, it is called tenosynovitis. Tendinosis is a similar condition, but it is a chronic degenerative condition, which causes long-term pain. Depending on the location, the common tendinitis problems are:

What Are the types of tendinitis?

Depending on the parts of the body affected, the different types of tendinitis are:

  • Achilles tendinitis - The Achilles tendon attaches the calf muscles to the heel. Inflammation of this tendon is commonly seen in athletes and rheumatoid arthritis patients. It can also be caused by wearing ill-fitted shoes.

  • Supraspinatus tendinitis - Inflammation of the tendon around the top of the shoulder joint. It results in shoulder pain while lifting the arm upwards.

  • Tennis elbow - Otherwise called lateral epicondylitis, is the inflammation of the extensor muscles of the elbow. It causes pain on the outer side of the elbow and the wrist.

  • Golfer’s elbow - Otherwise called medial epicondylitis, is the inflammation of the flexor muscles of the elbow. It causes pain on the inner side of the elbow and wrist. Pain is severe when the person tries to lift something heavy.

  • De Quervain's tenosynovitis - Here, the patient finds it difficult to move the thumb as the sheath covering the tendons responsible for its movement become inflamed and painful.

  • Trigger finger - Here, the finger movements, most commonly ring finger, are not smooth. There is an obstruction while straightening of the finger at a point and then suddenly it straightens upon applying some force. Hence it is known as trigger finger. A clicking sound can be heard while straightening out the fingers. It is due to inflammation and swelling of tendon responsible for straightening of the finger and due to swelling there are interrupted movements when it passes below the pulley covering the tendon.

What Are the Symptoms of Tendinitis?

The symptoms of tendinitis include:

  • Dull ache or pain on moving the joint or limb.

  • Swelling.

  • Redness.

  • Tenderness.

  • Formation of a lump along the tendon.

  • The feeling of the tendon crackling on movement.

What Causes Tendinitis?

The common causes of tendinitis are:

  • Repetitive action.

  • Sudden injury.

  • Conditions like rheumatoid arthritis and diabetes.

  • Aging.

  • Tennis, golf, bowling, or basketball players are at a higher risk of developing tendinitis.

What Are the Risk Factors for Tendinitis?

The factors that increase the risk of tendonitis are:

  • Old age, as the tendons become less flexible.

  • Work that involves repetitive motions, sitting in awkward positions, and forceful exertion.

  • Athletes who play baseball, golf, bowling, tennis, or running.

What Are the Complications Associated With Tendinitis?

If left untreated, tendinitis can lead to:

  • Tendon Rupture - It is a serious condition, which might need surgery. Rupture occurs because the tendon becomes weak in the inflamed part.

  • Tendinosis - It causes degenerative changes in the tendon, which results in pain lasting for several weeks to months.

How to Diagnose Tendinitis?

A doctor will take medical history and perform a physical examination. The doctor will check your range of motion and will ask you about any recent injury, work type, previously diagnosed medical condition, and the medicines consumed by the affected individual. Diagnosis of tendinitis is usually clinical, but to confirm the diagnosis, a doctor might refer to get X-rays, MRI (magnetic resonance imaging) scans, or ultrasounds.

What Are the Treatment Options for Tendinitis?

The treatment helps relieve pain and reduce inflammation. Some of the treatment options include:

Home Remedies:

Most of the time, RICE (rest, ice, compression, and elevation) protocol is all the treatment that is needed to treat tendinitis. The home remedies include:

  • Rest - Do not work and move with pain as it will worsen the pain and swelling. For the tissues to heal, it is important to take rest. Bed rest is not necessary, just avoiding the activities that strain the injured joint or limb is good enough. The individual can still go for a swim or do water aerobics.

  • Ice - Apply ice to the injured area, several times for 20 minutes, to decrease pain and swelling. Wrap ice cubes in a towel or freeze a cup full of water to apply cold directly to the skin.

  • Compression - Compressing the area with the help of wraps and elastic bandages help to alleviate the swelling.

  • Elevation - The affected part should be raised above the level of the heart to reduce swelling.

One has to rest to for healing the tissues, but avoid prolonged inactivity, as it can result in joint stiffness. After some days, move the joint gently to maintain flexibility.

Physiotherapy:

Manipulating, massaging, and exercise designed to stretch and strengthen the affected tendon and muscle might help reduce chronic pain. For example, eccentric strengthening. Also, ultrasonic or laser therapy is also one of the options in physiotherapy.

Medications:

Always consult a doctor before taking any medication. Some of the medicines used are:

  • Painkillers - Aspirin, Naproxen sodium, or Ibuprofen tablets or topical creams.

  • Corticosteroids - To reduce inflammation, corticosteroids can be used. It is not recommended to use steroids for tendinitis that lasts for more than three months, as steroids can weaken the tendon and can rupture it. Steroids can also be injected locally at the inflamed part, which is safe and more effective than any other oral or intravenous medications.

  • Platelet-Rich plasma (PRP) - One's platelets are injected into the area of tendon irritation. This treatment method is still under research.

Surgery:

The surgical options include:

  • Dry needling - Here, small holes are made in the tendon with a fine needle to stimulate factors that help in the healing of the tendon.

  • Extracorporeal Shock Wave Therapy (ESWT) - A small incision is made through which a special device that removes tendon scar tissues are inserted.

  • Surgical Repair - In cases where the tendon has torn from the bone, surgical repair might be needed.

Can Tendinitis Be Prevented?

Follow these tips to reduce the chance of developing tendinitis:

  • Avoid performing activities that stretch the tendons excessively. If there is any pain while doing an exercise, then rest and start over.

  • Avoid doing one type of exercise, instead, mix it up.

  • Take time to stretch and warm-up.

  • Maintain proper posture.

  • Adjust the chair, keyboard, and desktop to make it as comfortable as possible. This will avoid excessive strain on the shoulder and joints.

  • Strengthening exercises can help strengthen the tendons and muscles.

Conclusion

As tendinitis is typically associated with overuse, the most effective approach to prevent it from recurring is to avoid activities that cause the issue. Seeking guidance from a physical or occupational therapist can offer valuable insights into the modification of daily activities. Additionally, incorporating range-of-motion exercises into the routine can alleviate stiffness and enhance flexibility.

Frequently Asked Questions

1.

What Is the Treatment for Tendonitis?

The best treatment option for tendonitis is to follow the RICE formula. R stands for rest, I indicates an application of ice, C stands for compression, and E emphasizes the importance of elevation of the tendon region that has been injured. Anti-inflammatory drugs are known to be beneficial. Aspirin and Ibuprofen are most commonly used.

2.

Will Tendonitis Ever Go Away?

Tendonitis is the inflammation of the tendons. It is known to subside soon in most of the cases. Immobilization is an essential part of the treatment procedure. The pain will gradually reduce after the healing of the swelling in the tendon. In severe cases, the patient must visit a rheumatologist or orthopedic surgeon.

3.

How Does Tendonitis Pain Feel Like?

The pain will be severe only if there is excessive swelling. Otherwise, it is usually a dull ache. It is not known to be continuous and is generally relieved at rest. There will be a pain when trying to move the injured limb. If you are experiencing severe pain, you should consult your doctor immediately.

4.

How Long Does Tendonitis Take to Heal?

Most patients heal within a month, but in chronic cases, the tendonitis takes more than six weeks to heal. In chronic cases, there will be an inability to move the joints. The sheath surrounding the tendons will be narrowed in chronic conditions of tendonitis.

5.

Is Cold Heat or Better for Tendonitis?

In the initial stages of tendonitis, cold treatment is the best option. Applying ice to the injured area will help in the reduction of swelling. This happens due to the constriction of the vessels. Ice is also known to reduce the level of pain. After one week, the patient can go for heat treatment.

6.

What Cures Tendonitis Pain?

For long-lasting pain, anti-inflammatory agents are the right choice. You should get recommendations from your doctor and also ask for an appropriate dosage. Aspirin and Ibuprofen are given for a short period to relieve pain.

7.

How to Heal Tendonitis Faster?

Follow Rest, Ice, Compression, and Elevation- RICE concept. Cold packs should be applied in the affected area for nearly 15 minutes. It is necessary to apply ice in circular motions. It can be done every two hours. This can be repeated for three days.

8.

Which Foods Trigger Tendonitis?

The foods that are rich in uric acid are known to aggravate the condition of tendonitis. The foods that increase uric acid levels are meat, processed foods, caffeine, potatoes, tomatoes, citrus fruits, dairy products, eggs, tomatoes, pepper, alcohol, peppers, and salt.

9.

Is Massage Helpful for Tendonitis?

Massage can increase friction. This will stimulate the production of collagen. It can repair the damaged tendon and help in the healing of the affected area quickly. Massage therapy is known to improve the circulatory flow. It can restore the ability of the joints.

10.

Can Stretching My Muscles Make Tendonitis Worse?

Stretching is known to provide only temporary relief to the joints. Sometimes, it is known to have a negative influence on the bones and tendons. But stretching can provide short-term relief to the tendons. It is not recommended for a complete healing procedure.

11.

What Do Doctors Prescribe for Tendonitis?

The doctor may recommend below medications to cure tendonitis, the medicines are:
- Platelet-rich plasma (PRP).
- Pain relievers. Taking Aspirin, Ibuprofen, or Naproxen sodium may relieve discomfort associated with tendonitis.
- Corticosteroids.

12.

Is Walking Good for Tendonitis?

Walking could be good for tendonitis. Switching from high impact activities like swimming, cycling, intense exercises to easy walk is good. While observing one’s own breathing during the walk can be an excellent mindful exercise. Do not prefer to go for long walks. Walking short-distance would be sufficient.

13.

Should I Go to the Hospital for Tendonitis?

Yes, it is recommended to consult a doctor if the following signs are noticed.
- The tendonitis pain does not relieve in seven to ten days.
- The tendonitis pain is exceptionally severe, and also if swelling is noticed, there will be a marked loss of motion.
- If there is a ruptured tendon, you need medical care right away.

14.

What Happens If You Ignore Tendonitis?

If the tendonitis is kept untreated, it might develop into chronic tendonitis and result in permanent degradation of your tendons. In some other cases, the untreated tendonitis may lead to tendon rupture, for which surgical treatment is required to fix it.

15.

Which Cream Is Good for Tendonitis?

The topical application creams can treat tendonitis. Anti-inflammatory agents such as Diclofenac sodium gels are highly beneficial. Applying these gels twice a day would provide sufficient relief. It is known to be more effective than the intake of painkiller medications.

16.

How Bad Does Tendonitis Hurt?

In the majority of the cases, it has dull pain only. You will experience pain only when you try to move your limbs. There will be a certain degree of tightness when you walk or move. It hurts very badly when you try to move.

17.

Does Stretching Help With Tendonitis?

No, stretching does not improve the condition of tendonitis. It is known to provide relief for a short duration. In some cases, doing stretching exercises can end up in negative results. It is better to get advice from your doctor.

18.

How Much Rest Do You Need for Tendonitis?

You would require additional rest for the healing of tendonitis. It is necessary to make changes in the long-term habits you are having. It is necessary to apply ice packs in the affected region.

19.

Can Tendonitis Come on Suddenly?

Tendonitis is known to affect a few patients suddenly, but it will gradually develop into complicated conditions over time. Some patients experience pain and tenderness while touching. If it tends to increase, then consult a doctor immediately.

20.

How Can You Tell the Difference Between Tendonitis and Arthritis?

Arthritis is the inflammation of joints. It will be accompanied by pain in the joints. Cartilages connect the joints. If there is inflammation in the tendon or cartilages, then it is known to be tendonitis. Arthritis is known to heal after an extended period, whereas tendonitis can heal faster.

21.

Can an X-Ray Show Tendonitis?

An X-ray cannot show tendons, so this diagnostic procedure will not help detect tendonitis. The doctor will recommend another diagnostic procedure called selective tissue tension test. This will be beneficial in detecting tendonitis.

22.

Why Is Tendonitis Pain Worse at Night?

The reason for excessive pain at night is gravity. When the person is lying down, there will be a change in the position of the muscles and tendons. The effects of gravity will decrease the blood flow to tissues like tendons. A reduction in the blood flow might increase the level of pain at night.

23.

Will Tendonitis Become Inflamed?

Yes, tendonitis will have inflammation. Untreated cases of tendonitis will tend to worsen the condition. The repetitive motion is also known to damage the tendon. In some cases, tendonitis can happen due to trauma.
Dr. Anuj Gupta
Dr. Anuj Gupta

Spine Surgery

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