Tendonitis, tendinitis, or “overuse tendinopathy,” is a medical diagnosis that describes inflamed, irritated or torn tendons. These are the hundreds of thick, rope-like ends of muscles connected to bone. Tendons are constantly in use as they move with muscles and bones during activity, and as such can more easily become irritated or injured.
Tendonitis is often considered a repetitive stress injury (RSI) coming from overuse or overload at work or play. Tendonitis particularly strikes elbows, heels, hips, shoulder, and wrist areas, as these joints are constantly in motion. Reduced blood flow that provides oxygen and nutrients to these areas can accelerate tissue damage and inflammation.
Tendonitis commonly affects adults 40 and over. Aging can actually reduce tendon elasticity, strength and stress resistance – thus making damage more likely. Whether trying to prevent or treat tendonitis, it’s important to stick to the medical advice of a musculoskeletal specialist if you don’t want to deal with the long-term pain and discomfort.
Symptoms of Tendonitis
Tendonitis causes discomfort, pain, weakness, stiffness, and instability of the affected joint. Swelling can indicate a thickened tendon. Increased activity aggravates the symptoms, and can ultimately lead to a tear.
Sometimes the inflammation subsides and symptoms resolve with basic home treatment and care. In other cases, tendonitis can become chronic and require medical care to restore mobility and reduce pain. It depends on the age, severity, and extent of inflammation.
Different forms of tendonitis, often named after the triggering activity, present different symptoms:
Achilles tendonitis – Pain just above the back of the heel.
De Quervain’s tenosynovitis – Pain behind the wrist, at the bottom of the thumb.
Golfer’s elbow – Pain in inner elbow.
Jumper’s knee – Pain in and around the kneecap.
Pitcher’s shoulder – similar to rotator cuff tendonitis below.
Rotator cuff tendonitis dull, widespread pain in shoulder joint, often traveling into the upper arm and thorax. It can also be aggravated during sleep.
Swimmer’s shoulder – similar to above
Tennis elbow – pain in outer elbow, and along lower arm and wrist.
If tendonitis is caused by infections such as gonorrhea (less common than repetitive injuries), symptoms, may include discharge from the vagina or penis, a fever, or rash.
Causes of Tendonitis
Any every day, repetitive movement, whether domestic, social, professional or sporting can cause tendonitis to develop. This gets aggravated if there is no warm-up, activities start too abruptly, or continue for too long.
Tendonitis commonly results from chronic poor posture while sitting or standing at home or work, or with vigorous exercising before getting properly conditioned.
Physiological factors like abnormal bone or joint placement or attachment can cause tissue stress. Medical causes like infection, reactions to medications (especially certain antibiotics), diabetes, gonorrhea, gout, thyroid disorders, or rheumatoid arthritis are some of the other causes of tendonitis. Trauma or injuries to the affected joint can result in tendonitis.
Prevention is the best cure for tendonitis.
Start activity slowly, with low-impact and build up resistance gradually. Restrict repetitions and listen to your body and its warning signals. If pain strikes, stop! If it recurs, take a break.
To avoid an RSI, vary your activity, including stretches, warm-up and cool-down sessions. Avoid overusing the same muscles and bones constantly. Take frequent rest breaks and stay hydrated.
Pay attention to appropriate shoes, clothing, and other equipment.
Tendonitis treatment is focused on relieving pain and alleviating inflammation. Home remedies and self-help including the RICE principle – Rest, Ice, Compression and Elevation – can take care of mild forms.
Change Lifestyle Habits:
1. Stop the offending activity at least temporarily, to rest and heal.
2. Restart activities – especially new ones – gradually, resting in between.
3. Avoid inflammatory foods like alcohol, caffeine, salt, sugars, refined grains, hydrogenated oils, processed and fried foods.
4. Increase anti-inflammatory, nutrient, and antioxidant-packed foods, along with vitamin and mineral-rich fruits and vegetables, high-quality “clean” proteins, and collagen-rich bone broth.
5. Physical therapy techniques to avoid stiffness and atrophy by keeping the joint mobile and flexible can be essential.
6. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as aspirin, ibuprofen, naproxen or acetaminophen can temporarily reduce tendonitis discomfort. Anti-inflammatory/pain-relieving cream or gels can be applied topically.
7. Change the ergonomics (chair, desktop, computer keyboard placement) of your work environment to match your body shape and size, and relieve stress.
If home care and lifestyle adjustments don’t help, medical care should be sought. Your doctor will take your health history, examine you, and may order diagnostic testing to assess and diagnose the severity of your condition.
In less advanced cases, pain medications, steroid injections, and physical rehabilitation may work. If the tendon is ruptured an orthopedic surgeon might have to repair the damage.
Platelet-rich plasma (PRP) therapy takes the patient’s own blood and spins it in a centrifuge to separate platelets and other healing constituents from the red blood cells. This plasma is injected into the tendons to reduce inflammation and promote healing.
When lifestyle changes, home-care, and intermediate professional treatments fail, a wide range of other treatment options exist for specific forms of tendonitis.
Acupuncture: needling to increase blood supply and circulation to the affected tendon. This releases endorphins and serotonin (the body’s natural pain relievers), often eliminating the necessity of painkillers.
Cryotherapy: nitrogen or carbon dioxide can freeze damaged tissue, and separate it from the joint and tendon surroundings to reduce pain and restore motion.
Dry needling: fine needle makes microscopic holes in the tendon to stimulate healing.
Electrotherapy: small electrical impulses stimulate nerve fibers, release endorphins, and alleviates pain. This reduces inflammation, boosts tissue repair and healing, stimulates blood circulation, and increases range-of-motion.
Massage therapy: deep massage therapy helps promote mobility, speeds healing and can prevent tendonitis. Massage therapists manipulate the area of the injured tendons with their hands, using different techniques for specific areas.
Supportive Devices: elbows and wrists benefit from protective, supportive devices like neoprene, nylon or Velcro sleeves, slings, braces, or splints.
Ultrasound technology: sound waves create heat around joint to hasten healing by reducing pain and inflammation, relaxing muscles and promoting circulation.
Whirlpool treatment: similarly, this therapy loosens muscles, improves blood circulation and heals tendons.
If you think you may be suffering from tendonitis in or around the joints, the orthopedists at Watauga Orthopaedics can help relieve your pain and restore your mobility so you can live your life without pain. Call Watauga Orthopaedics at (423) 282-9011 to request an appointment, or schedule an appointment online.