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What are the Causes and Treatment Options for Tendonitis

Tendonitis

What are the Causes and Treatment Options for Tendonitis

Medically reviewed by Dr. Mavra Farrukh

Tendonitis is a severe condition occurring mostly in people above 45. Approximately 40% to 50% of adult athletes who play racquet sports suffer from this condition. Also, it is estimated that 2% to 5% of the population suffers from this condition. A report by the Bureau of Labor Statistics shows that more than 70,000 people miss work annually due to tendonitis. However, this condition can be avoided by exercising regularly and taking proper care. Hence, if you or your loved ones suffer from this condition, then read this article till the end to learn what this condition is about and how you can treat it.

What is Tendonitis?

Tendons are strong, fibrous cords of tissues that connect muscles and bones and help the body move. It is a condition where the connective tissues become inflamed. Tendonitis can happen to any tendon in the body, but the most common are shoulders, wrists, knees, and ankles. It can cause swelling, discomfort, and pain. 

Types of Tendonitis 

There are many types of tendinitis; the most common types are mentioned below. 

Achilles tendonitis:

The Achilles tendon is a thick tissue band located between the calf muscle and the heel. During walking, running, and jumping, this tendon endures great stress. It is a common sports injury. Additionally, people with rheumatoid are at a greater risk of Achilles tendonitis. It is most common in younger people. It occurs mostly in athletes or runners.

The symptoms of Achilles tendinitis include the following:

  • Pain and stiffness
  • Severe pain in the heel
  • Difficulty standing up
  • Swelling and warmth in the heel or along the tendon

Supraspinatus tendinitis:

In supraspinatus, the tendon at the top of the shoulder joint becomes inflamed. This causes pain when we move the arm. Some people may find lying on the affected shoulder uncomfortable and painful at night. Injuries to other tendons in the same area may result in rotator cuff syndrome.

Golfer’s elbow:

Lateral epicondylitis, commonly called golfer’s elbow, causes pain when someone bends their wrist outwards. This pain can also radiate down toward the wrist. Medial epicondylitis, or golfer’s elbow, causes pain and discomfort when a person bends the wrist towards the inside. You will feel more pain if you try to lift against a force.

Trigger thumb or finger:

It’s a common condition that happens when your finger clicks when it is straightened. A bent position is the only way to fix a thickened and inflamed tendon sheath in the palm. This restricts the tendon’s movement, so it cannot move smoothly. 

Tendinitis of the wrist:

It is the inflammation in the tendons that joins your lower arm to the bones in your fingers. It can cause pain or discomfort when you lift an object. Tendinitis is most common in people who do a lot of typing and writing work.

De Quervain’s stenosing tenosynovitis:

Inflammation of the sheath surrounding the tendons between the thumb and wrist causes this condition. It can cause severe pain in thumb movement. 

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Tendonitis Symptoms 

There are five main symptoms of tendinitis.

  • Difficulty while moving the joint
  • Swelling, sometimes with heat
  • Redness 
  • Feeling a crackling sensation when you move 
  • A lump on the tendon
  • Weakness in the affected area
  • Pain that gets worse when you move the tendon 

Causes of Tendonitis 

A common cause of tendinitis is an anatomical or bio-mechanical constraint to the tendon, such as supraspinatus tendon impingement by the coracoacromial arch. Other mechanisms include micro-trauma due to repeated overload, such as flexor tendons of the hand undergoing repeated contractions in a keyboard movement. Calcific tendinitis occurs when calcium deposits form in the tendon, resulting in decreased blood supply to the area. The most commonly affected tendons are the Achilles, rotator cuff, bicipital, patellar, common extensor group of the wrist, and posterior tibial. The clinical characteristics of tendonitis include pain, edema, redness, increased temperature, and loss of function at the joint. The use of the involved tendon typically worsens symptoms.

Moreover, people’s tendons become less flexible as they age. They are less able to tolerate stress, making them more vulnerable to injury. It is more common in adults over 45.

Besides this, tendinitis is most common in gardeners, manual laborers, and people whose job includes the following:

  • Vibrations 
  • Awkward positions
  • Repeated motions
  • Forced movements 

Difference Between Tendinitis and Arthritis

The main difference between arthritis and tendinitis depends on the type of tissues they impact. Although both involve inflammation, arthritis is inflammation within or around a joint. In contrast, tendonitis is the inflammation of a tendon. It can occur anywhere you have a tendon. 

Tendinosis vs. Tendinitis

Tendinitis is characterized by a swollen, acutely inflamed tendon without microscopic damage. Alternatively, tendinosis refers to a chronically damaged tendon with disorganized fibres and a hard, thick, and rubbery appearance. 

Tendinitis and tendinosis are the most common in these areas:

  • The tendon on the outside of the elbow (tennis elbow)
  • Tendons of the shoulder (rotator cuff)
  • The Achilles tendon
  • The patellar tendon that joins the knee cap to the shin bone
  • The gluteal tendon on the outside of the hip

How Long Does Tendonitis Last?

Mild tendon injuries can be treated at home within 2 to 3 weeks. In case of some serious injuries, it may take 6-8 weeks, months, or longer to heal. 

The estimated duration of the foot, wrist, and elbow tendonitis are at least six months or longer. 

Medical Conditions Associated with Tendonitis

  • Rheumatoid arthritis 

There is a possibility that rheumatoid arthritis can also cause pain in tendons and ligaments because the inflammatory process that damages the joints in rheumatoid arthritis can also affect the connective tissues, such as the tendons and ligaments in and around the joints.

  • Diabetes 

Patients having diabetes are much more likely to develop issues with tendons than those without diabetes. When you have diabetes, the extra sugar in the blood cranks up the speed that affects your tendons. 

  • Fibromyalgia 

Patients with soft tissue manifestations (FMS) have concurrent conditions, such as tendinitis, which lead to shoulder, arm, and leg pain but are likely symptoms of FMS.

How to Diagnose Tendonitis 

Tendonitis can be diagnosed directly by a physical examination. The doctor will also examine your range of motion and tenderness. Additional tests may include

  • X-rays
  • MRI scans
  • Ultrasounds 

It is also likely that your doctor will ask about your medical history.

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Treatment Options for Tendonitis

The treatment of tendonitis includes the following.

Platelet-rich plasma

Platelets in the blood release growth factors that promote recovery in injured tissue. Platelet-rich plasma (PRP) is the patient’s blood that has been centrifuged to have a higher-than-normal concentration of platelets. It’s then injected as a gel onto the damaged tendon to speed up the healing process of the tendon. Although commonly used in sports medicine, the results are mixed.

Shockwave therapy or sclerotherapy

Sclerosing, laser light therapy, and extracorporeal shockwave therapy are some of the treatments that orthopedic surgeons use to treat tendonitis. In ESWT, a high-energy sound wave is sent at the tendon, which may cause nerves to die. An LLLT works by applying a low-level laser beam to the skin above the tendon. As a final step, sclerotherapy kills the extra blood vessels and nerves in the damaged tendon by using drugs. All of these therapies can reduce pain in some patients but may not speed up the healing process.

Surgery:

A surgeon will remove injured or ruptured tissue from the damaged tendon and may graft collagen tissue on the tendon to protect it and help it recover. 

Medications for Tendonitis:

Medications are also used to treat tendonitis if you experience discomfort, pain, or swelling. Some common medicines are aspirin and ibuprofen.

Non-steroidal anti-inflammatory drugs

Non-steroidal anti-inflammatory drugs reduce the pain in the tendon. Medicines like trolamine and naproxen adequately manage the pain during the healing process. 

Corticosteroids

More severe or chronic pain can be treated with corticosteroid injections. Corticosteroids such as cortisone or methylprednisolone can reduce pain and swell rapidly. 

Some of the best medicines for the treatment of tendonitis are mentioned below:

  • Aleve 
  • Aspirin 
  • Motrin 
  • Myoflex 
  • Depo-Medrol

Surgical and other procedures:

In situations where physical therapy doesn’t work, your doctor might suggest 

  • Dry needling 

This procedure is usually performed with ultrasound to guide it. In dry needling, a fine needle makes small holes in the tendon to stimulate the healing process.

  • Surgery 

It depends on the severity of the tendon injury. Surgical repair is needed if the tendon is completely damaged and ruptured. 

Side effects of untreated tendonitis 

Untreated tendonitis can increase the risk of a tendon breaking down or rupturing completely. A ruptured tendon requires surgical treatment. If it is not treated on time, it can cause permanent disability in severe cases and can also become a long-term issue. 

When Should I See a Doctor?

If tendonitis symptoms worsen or you develop any additional symptoms, you should call your healthcare provider

Some warning signs may include:

  • Fever and chills (over 100 degrees Fahrenheit)
  • Continuous swelling and redness around the joint 
  • Increase in pain while moving joints 
  • No relief after a few days of self-care. 
  • Inability to move 

Preventing Tendonitis

Prevention programs should promote healthy workout habits by replacing bad habits with the following methods:

  • You should warm up thoroughly before working out, gradually increasing the intensity level. Whenever you finish a workout, cool down.
  • Train yourself for a new sport before you start it. Start building strength and flexibility in the muscles you will use a few weeks or months in advance.
  • Learn the proper method of using equipment for any exercise or activity. Work out regularly, not just once a week.
  • Avoid activities that cause stress on the tendons 
  • Stretch your body

Exercises to Strengthen Tendons:

Eccentric training:

It includes resistance training exercises with lighter weights, allowing your muscles and tendons to lengthen. Let’s take heel raises as an example; when you lower your heels back down after the raise slowly and deliberately, that’s an eccentric movement. 

Plyometrics:

Explosive movements are plyometrics, such as squat jumps, single-leg hops, depth jumps, and quick feet step-ups. Plyometrics use the tendon’s recoil response to executing the explosive movements.  

Isometric training:

Isometric contractions occur when the muscle is held in a constant or static position. For example, wall sits, calf holds, planks, or any other position you can maintain and hold for a long time. 

This training can provide short-term pain relief.   

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How to Get Rid of Tendonitis?

To get rid of tendonitis, use ice, compression, and elevation. This treatment can speed up the recovery process. 

Ice:

If you are experiencing pain, apply ice to the injured area for at least 30 minutes to alleviate it. Ice packs, slush baths, and ice massages can help reduce pain, muscles spasm, and swelling. 

Compression:

Swelling can cause a loss of motion in the injured joint. In order to speed up the recovery process, wrap that area tightly until the swelling subsides. You can use elastic bandages or wraps to protect your skin. 

Elevation:

Raise the affected knee above your heart to reduce swelling and pain in the area affected by tendinitis.

Rest:

It is best to avoid activities that increase swelling or pain. Please do not ignore the pain or attempt to work through it. While rest is necessary for healing, bed rest is not the only solution. There are other light exercises and activities you can do that won’t stress the injured tendon. Swimming and water exercise are suitable options.

FAQs About Tendonitis Answered By Your Doctors Online Team

Is it possible for tendons to heal on their own?

No! Tendons cannot heal on their own. Although minor tendon injuries can be recovered on their own, wounds that cause severe pain and swelling cannot be healed without any medical treatment.

Is heat good for tendonitis?

Heat can be helpful for chronic tendon pain. It is also known as tendinopathy. Heat can increase blood flow which helps in the healing process. Heat pads work best when used for at least 15-30 minutes.

Does tendonitis hurt all the time?

In most cases, the pain occurs when you move your body. It feels better when you rest. It s a sharper pain when you keep moving the joints. But the pain may eventually go away if it is treated on time. 

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