Tendinitis: Causes, Symptoms, and Treatment

What is Tendinitis?

Tendinitis (also spelled tendonitis) is the inflammation or irritation of a tendon, the thick fibrous cords that attach muscle to bone. This condition causes pain and tenderness just outside a joint. While tendinitis can occur in any of your tendons, it's most common around your shoulders, elbows, wrists, knees, and heels.

Tendinitis is often caused by repetitive, minor impact on the affected area, or from a sudden more serious injury. It is a common condition, especially in individuals who perform repetitive motions as part of their job or hobbies.

According to the Mayo Clinic, tendinitis can affect anyone, but it's more common in adults, especially those over 40, as tendons become less flexible with age.

Common Causes

Tendinitis is typically caused by repetitive motions or sudden injuries. Here are some common causes:

• Repetitive motions: Performing the same motion repeatedly, such as typing, painting, or playing a musical instrument, can strain tendons.
• Sudden injuries: A sudden, more serious injury can cause tendinitis, especially if the tendon is not used to the stress.
• Aging: As we age, our tendons become less flexible and more prone to injury.
• Poor posture or technique: Incorrect posture or technique during physical activities can put extra stress on tendons.
• Overuse: Overusing a tendon, especially in sports or physical activities, can lead to tendinitis.
• Medical conditions: Certain conditions like rheumatoid arthritis, diabetes, and infections can increase the risk of tendinitis.
• Improper workspace setup: An ergonomically poor workspace can contribute to tendinitis, especially in the wrists and hands.
• Lack of warm-up: Not warming up properly before physical activity can make tendons more susceptible to injury.
• Muscle imbalance: Weak or tight muscles can put extra stress on tendons.
• Certain medications: Some medications, like fluoroquinolone antibiotics and statins, can increase the risk of tendon injuries.

Associated Symptoms

Tendinitis typically causes pain and tenderness in the area around a joint. Other common symptoms include:

• Dull ache, especially when moving the affected limb or joint
• Tenderness
• Mild swelling
• Stiffness or reduced range of motion in the affected joint
• A grating or crackling sensation when moving the tendon
• Weakness in the affected area
• Redness or warmth in the affected area (in some cases)

Symptoms may vary depending on the location and severity of the tendinitis. For example, tennis elbow (lateral epicondylitis) causes pain on the outside of the elbow, while golfer's elbow (medial epicondylitis) causes pain on the inside of the elbow.

When to See a Doctor

While mild tendinitis can often be treated at home, you should see a doctor if:

• Your pain is severe or doesn't improve with rest and home treatments
• You notice significant swelling, redness, or warmth in the affected area
• You have a fever, which could indicate an infection
• You hear or feel a popping or snapping sensation, which could indicate a tendon rupture
• You're unable to move the affected joint or bear weight on it
• Your symptoms interfere with your daily activities or sleep
• You have recurrent tendinitis that keeps coming back

If you're unsure whether your symptoms warrant a doctor's visit, it's always best to err on the side of caution and seek medical advice.

Diagnosis

To diagnose tendinitis, your doctor will likely start with a physical examination, checking for pain, tenderness, and range of motion in the affected area. They may also ask about your medical history, recent activities, and any previous injuries.

In some cases, your doctor may recommend imaging tests to rule out other conditions or to assess the severity of the tendinitis. These tests may include:

• X-rays: While X-rays can't visualize tendons, they can help rule out other conditions like arthritis or fractures.
• Ultrasound: This imaging test uses sound waves to create images of the tendon and can show inflammation or tears.
• Magnetic Resonance Imaging (MRI): An MRI uses a strong magnetic field and radio waves to create detailed images of the tendon and surrounding structures.

In rare cases, your doctor may recommend a arthroscopy, a minimally invasive surgical procedure that allows them to visualize the inside of a joint.

Treatment Options

Treatment for tendinitis aims to relieve pain and reduce inflammation. In most cases, tendinitis can be treated with conservative measures. Here are some common treatment options:

Home Treatments

• Rest: Avoid activities that aggravate the tendon. Rest is crucial for healing.
• Ice: Apply ice packs to the affected area for 15-20 minutes, several times a day, to reduce pain and inflammation.
• Compression: Use an elastic bandage or brace to compress the area and reduce swelling.
• Elevation: Keep the affected area elevated, especially at night, to reduce swelling.
• Over-the-counter pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB) or naproxen (Aleve) can help relieve pain and reduce inflammation.
• Gentle stretching and strengthening exercises: Once the pain has subsided, gentle exercises can help restore strength and flexibility. A physical therapist can guide you through appropriate exercises.

Medical Treatments

• Physical therapy: A physical therapist can teach you exercises to stretch and strengthen the affected tendon and surrounding muscles. They may also use techniques like ultrasound, massage, or electrical stimulation to promote healing.
• Corticosteroid injections: In some cases, your doctor may inject a corticosteroid medication around the tendon to reduce inflammation and pain. However, these injections should be used sparingly, as they can weaken the tendon and increase the risk of rupture.
• Platelet-rich plasma (PRP) therapy: This treatment involves injecting a concentration of your own platelets into the affected tendon to promote healing. While research is ongoing, some studies suggest PRP therapy may be beneficial for chronic tendinitis.
• Extracorporeal shock wave therapy (ESWT): This non-invasive treatment uses shock waves to stimulate healing in the tendon. It's typically used for chronic tendinitis that hasn't responded to other treatments.
• Surgery: In rare cases, if the tendon is severely damaged or other treatments haven't been effective, surgery may be necessary to repair the tendon.

Prevention Tips

While not all cases of tendinitis can be prevented, there are steps you can take to reduce your risk:

• Ease into new activities: Gradually increase the intensity and duration of new exercises or activities to give your tendons time to adapt.
• Use proper technique: Whether you're playing a sport, lifting weights, or performing a repetitive task at work, using the correct technique can help prevent tendon injuries.
• Warm up and cool down: Always warm up before physical activity and cool down afterward to prepare your muscles and tendons for exercise and help them recover.
• Strengthen your muscles: Strong muscles can help support and protect your tendons. Incorporate strength training exercises into your fitness routine.
• Stretch regularly: Regular stretching can help maintain flexibility and reduce the risk of tendon injuries.
• Take breaks: If your job or hobby involves repetitive motions, take regular breaks to rest your tendons.
• Use ergonomic equipment: Ensure your workspace is set up ergonomically to reduce strain on your tendons.
• Listen to your body: If you feel pain or discomfort, stop the activity and rest. Pushing through pain can lead to injury.
• Maintain a healthy weight: Excess weight can put additional stress on your tendons, especially in your knees and ankles.
• Stay hydrated: Proper hydration helps maintain the health and elasticity of your tendons.

Emergency Warning Signs

While tendinitis is typically not a medical emergency, there are some warning signs that require immediate medical attention. Seek emergency care if you experience any of the following:

• Sudden, severe pain: This could indicate a tendon rupture, which requires immediate medical attention.
• Inability to move the joint: If you can't move the affected joint or bear weight on it, seek medical help right away.
• Signs of infection: If the affected area is red, warm, swollen, and you have a fever, you may have an infection that requires prompt treatment.
• Numbness or tingling: These symptoms could indicate nerve involvement and require immediate evaluation.
• Deformity: If the affected area looks deformed or out of place, seek emergency care.

If you're unsure whether your symptoms warrant emergency care, it's always best to seek medical attention right away. Early intervention can help prevent further damage and promote faster healing.

For more information on tendinitis, visit reputable sources like the Mayo Clinic, National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), or American Academy of Orthopaedic Surgeons (AAOS).