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Tendonitis, also tendinitis, is a condition that arises when there is an inflammation or irritation of a tendon – a thick, fibrous cord through which muscles act on bones to bring about movement. Tendonitis causes pain and discomfort in and around the affected joint. It can occur in the tendon of any part of the body, however, tendons around the shoulder, elbow, wrist, knee and heel are most commonly affected.
Some common types of tendonitis include:
Rotator cuff tendonitis: this is the inflammation of the tendon around the top of the shoulder joint, particularly the supraspinatus tendon, causing tenderness around the shoulder joint when the arm is moved, especially upwards.
Achilles tendonitis: this is the inflammation of the Achilles tendon that extends between the calf muscles and the heel bone. It is common in people who play sports, like tennis, that require constant use of the tendon and more likely among people with rheumatoid arthritis.
Tendonitis of the wrist: this one is also common among people who play sports like badminton due to repeated motion made over and over.
Trigger finger or thumb: the finger or thumb is bent in a fixed position as though one is trying to pull a trigger, hence the name. This is usually due to thickening and inflammation of the tendon sheath in the palm of the hand which prevents the tendon from moving smoothly. A nodule may occasionally form along the tendon.
Tennis or golfer’s elbow: tennis elbow or lateral epicondylitis is inflammation of tendon in the outer or lateral side of the elbow. Occasionally, this pain may radiate to the forearm and elbow. Golfer’s elbow is inflammation of tendon in the medial or inner side of the elbow. It is also called medial epicondylitis, and pain may also extend down into the wrist.
De Quervain’s stenosing tenosynovitis: the tendon sheath that surrounds the thumb, at the base of the wrist becomes inflamed, causing swelling and pain.
Jumper’s knee: also called patellar tendonitis, is an inflammation of the patellar tendon connecting the kneecap to the shin bone, usually due to injury.
Tendonitis generally can occur to anyone, at any age, however it is more common in adults who play sports a lot. Also, people over the age of 40 are more susceptible to developing it, because as tendons age, they are less able to withstand stress, have less elasticity, and therefore more prone to tearing.
Tendonitis may develop in individuals whose jobs or hobbies involve repeated movements, eventually wearing out the tendons. Risk factors predisposing one to developing tendonitis include the following:
Symptoms usually occur at the point of where the tendon attaches to a bone and generally include:
If there is a rupture or tearing of a tendon due to sudden injury, a gap may be felt in the course of the tendon, and movement of affected part will be extremely difficult.
Symptoms may last from a few days to several weeks or months depending on the location and extent of tendonitis.
To make a diagnosis, a doctor will generally ask questions about the symptoms and physically examine you. The doctor will also review your medical history, to know if you have had any previous joint injuries. Questions that may be asked by the doctor include the following:
In the course of examining you physically, the doctor may ask you to move the affected area in certain ways. These movements, although may be hurtful, are very essential so that the doctor can accurately pinpoint which tendon is really affected. Doctors are usually able to accurately diagnose tendonitis based on your symptoms and medical history along with the outcome of your physical examination.
People with Achilles and rotator cuff tendonitis may need MRI scans to help assess the extent of the tendon damage. Also, blood tests may be carried out to help check for other underlying conditions, such as rheumatoid arthritis or gout, that may cause inflammation.
Treatment of tendonitis focuses on alleviating pain and reducing inflammation. The following treatment options when meticulously followed will usually heal the affected area.
Rest: Disuse of the affected area will cause the inflammation to reduce gradually. Particularly if tendonitis is caused by a sporting activity or exercise, rest from that activity or exercise is important for recovery, otherwise complications can arise from continued use of affected area. A brace or bandage may be required to restrict movement.
Heat and cold treatment: Applying ice to the affected area may help reduce pain and swelling. This can be done for 10 to 15 minutes, once or twice daily. When applying ice to the affected area, it is important to not apply the ice directly onto the skin. You should either wrap it in a towel or make use of a specially designed ice-pack device. For injuries that have occurred within the last 48 hours, ice is normally the best option, but after this, heat may be a better option.
Pain relievers: these include over-the-counter drugs such as ibuprofen and other non-steroidal anti-inflammatory drugs (NSAIDs). Corticosteroid injections around the affected tendon may help make symptoms better. However, these injections should be controlled as repeated injections may considerably increase the likelihood of a rupture. Physical therapy, involving massaging the affecting area may render relief and speed up the healing process. Also, specific stretching exercises recommended by the physiotherapist may help strengthen the affected tendon and muscle.
Shock wave therapy or surgery: Tendonitis, if left untreated can cause tendon rupture, which usually requires surgery to be corrected. Shock wave therapy is done by passing a shock wave through the skin to break up calcium deposits.