What is Tendinitis?

Tendons are flexible thick fibrous cords that join muscles to bones. Any irritation or inflammation of the tendons leads to a condition called tendinitis (also called tendonitis). It causes acute pain and tenderness, making it difficult to move the joint. The most commonly affected joints include those of hands, wrists, shoulders, biceps, thumbs, and calves.

Types of tendinitis based on the affected tendon:

  • Achilles tendinitis (the largest tendon that connects calf muscles to the heel bone)
  • Patellar tendinitis (connects the kneecap (i.e. patella) to shinbone)
  • Bicep tendinitis or Bicipital tendinitis (the tendon that is present around the long head of the biceps muscle)
  • Rotator cuff tendinitis (tendons that move the shoulder joint)

Symptoms of Tendinitis

Tendinitis symptoms may last for a few days to several weeks depending on the severity of tendinitis, and include:

  • Pain and tenderness along a tendon (mainly near a joint)
  • Mild swelling
  • Pain at night times
  • Pain that worsens with movement or activity

Causes Tendinitis

Tendinitis often results from repeated injury to an area such as the wrist or ankle which is common during sports or repetitive movements. Some of the tendinitis problems are named after the sports such as pitcher's shoulder, swimmer's shoulder, tennis elbow, golfer's elbow, and jumper's knee. The other causes are:

  • Bad posture or walking habits
  • Arthritis and related conditions (for example, osteoarthritis, rheumatoid arthritis, and gout)
  • Stress on soft tissues which results from a poorly positioned joint or bone
  • Diabetes
  • Side effects from certain medications

Risk factors

The most significant risk factor is playing certain sports that involve repetitive movements such as swimming, volleyball, and basketball. The other factors are:

  • Old age due to reduced flexibility of the joint.
  • Certain occupations involve awkward positions, forceful exertion, repetitive movement, frequent overhead reaching, etc.

Self-management

Self-management means taking a proactive role in treatment. The best measure to prevent the recurrence of tendinitis is to avoid or modify the activities which are causing the problem. Performing certain exercises within the range of motion of the affected joint can help to improve flexibility and reduce the stiffness of the joint.

Complications

Possible complications that may result from untreated tendinitis are:

  • Long-term inflammation increases the risk of further injuries, such as tendon rupture.
  • Recurrence of tendinitis symptoms.

Initially, your doctor reviews sports history and medical history which includes information regarding previous joint injuries, etc. Your doctor will perform a physical examination to look for the presence of swelling, redness, tenderness, muscle weakness and checks for a range of motion in the affected area. Further, one or more of the following tests are performed to confirm the diagnosis:

Test type Purpose of the test
Blood tests To look for other related causes of inflammation such as gout or rheumatoid arthritis
X-rays To confirm that there is no dislocation or fracture or bone disease
Ultrasound or Magnetic resonance imaging (MRI) scans To evaluate the extent of damage to the tendon

The treatment of tendinitis initially aims at reducing pain and swelling. Most of the types of tendinitis, such as tendinitis of the ankle, tendinitis in the shoulder relieve without medications. The following options are available for tendinitis treatment.

Rest and splints: The first choice of treatment includes resting the affected area and avoiding certain activities for a while. Splints, braces or slings may be used for this purpose.

Hot and cold therapy: Pain that lasts for long-term (i.e. even after 48 hours) may be relieved by dry or moist heat (such as a warm bath). A cold compress can help to relieve pain in the initial hours and also prevents further swelling.

Compression and elevation: The use of compression bandages and elevating the affected knee or leg above the level of the heart can help to minimize further swelling.

Physical therapy: This involves soft tissue or joint mobilization through manual therapy; a personalized exercise program; use of pressure-relieving devices; analysis of posture and walking; education and counselling regarding appropriate activities.

Medications: To relieve pain and inflammation, over the counter (OTC) and prescription medicines such as acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) are needed. If the symptoms are severe, corticosteroids injections which are powerful anti-inflammatory medications are injected directly into the affected joint. However, they are not used on a long-term basis due to side effects.

Surgery: Severe tendinitis can lead to tendon rupture which needs surgical repair. In the case of chronic tendinitis, a procedure called FAST is performed.

Focused Aspiration of Scar Tissue (FAST) – It is a minimally invasive procedure which uses ultrasound and some very small instruments to remove the affected tendon scar tissue. Most of the patients return to their normal activities within one or two months.

FAQ- Tendinitis

Tendinitis is often caused due to repeated injury to an area such as the wrist or ankle which is common during sports or repetitive movements other causes are: - Bad posture or walking habits, Arthritis and related conditions (for example, osteoarthritis, rheumatoid arthritis, and gout), Stress on soft tissues which results from a poorly positioned joint or bone, Diabetes, Side effects from certain medications.

FAST or Focused Aspiration of Scar Tissue is the best and effective treatment of tendinitis most of the patients return to their normal activities within one or two months. It is a minimally invasive procedure that uses ultrasound and some very small instruments to remove the affected tendon scar tissue.