What is Tendinitis?
Tendinitis is inflammation of a tendon – a thick cord that attaches muscle to bone. Tendons act as pulleys to help muscles move a joint. Tendinitis commonly affects the shoulders, biceps, hands, wrists, thumbs and calves.
Tendinitis often results from sports injuries or repetitive movements. But it can also be caused by:
- Bad posture or walking habits
- Stress on soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or joint deformities)
- Some types of arthritis and related conditions (rheumatoid arthritis, osteoarthritis and gout)
- Metabolic conditions, such as diabetes
- Side effects from certain medications
Since the pain occurs near a joint, these conditions are sometimes mistaken for arthritis.
This condition causes inflammation, tenderness and pain in areas around a joint, such as the tendons, ligaments and muscles. Some types can occur suddenly, last for days or longer and usually get better with rest or treatment. They can also happen again in the same body area.
A primary care doctor can diagnose most types of tendinitis with a medical history and physical examination. If there is persistent redness or swelling around the joints with fever or chills, see a doctor immediately to make certain there isn't an infection.
Tendinitis may go away over time. If not, the doctor will recommend treatments to reduce pain and inflammation and preserve mobility to prevent disability and recurrence. He may provide a referral to a rheumatologist, an orthopaedic surgeon or a physical therapist for specialized treatment. When properly treated, most tendinitis conditions don’t result in permanent joint damage or disability.
Common treatment options include:
- Rest and splints. Many soft tissue conditions are caused by muscle overuse, so the first treatment may include resting the painful area or avoiding a particular activity for a while. Splints, braces or slings allow a particular area to rest until the pain eases.
- Hot and cold therapy. A cold compress can help reduce initial swelling and pain. Cold therapy is usually most effective during the first 48 hours after overuse, injury or swelling begins. After 48 hours or for chronic (long-term) pain, dry or moist heat (like a warm bath) may be more helpful than cold compresses.
- Over-the-counter (OTC) and prescription medicines. The doctor may recommend medicines to help relieve pain and inflammation. They might include OTC pain relievers (analgesics), such as acetaminophen, or a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen or naproxen. Depending on the severity of the symptoms, a stronger version of an analgesic or NSAID may be needed.
- Corticosteroids injections. These powerful anti-inflammatory are injected directly into a joint at the doctor’s office.
- Physical therapy. A physical therapist can provide hot/cold treatments, ultrasound (sound wave), laser and water therapy; soft tissue or joint mobilization (manual therapy); orthotics or pressure-relieving devices; a personalized exercise program; analysis of posture and walking; and education regarding appropriate activities.
- Occupational therapy. An occupational therapist can recommend modifications for daily activities and work habits to prevent re-injury. He can create hand and wrist splints and suggest assistive devices to help make daily activities easier.
Tendinitis Self care
Taking a proactive role in treatment is called self management. Because tendinitis is mostly caused by overuse, the best way to prevent it from re-occuring is to avoid or modify activities that cause the problem. A doctor and physical or occupational therapists can provide suggestions on modifying daily activities. Range-of-motion exercises can help to improve flexibility and reduce stiffness.