Tendonitis

Tendonitis is an inflammation or irritation of a tendon, a cord-like structure that connects muscles to bones.  There are hundreds of tendons located throughout the body. Tendonitis can occur in any part of the body in which tendons are located, but most often occurs in certain locations such as the elbow, shoulder (rotator cuff), wrist, knee, hip and ankle (Achilles tendon).  Tendonitis typically causes pain due to inflammation and swelling.  In some cases, a loss of mobility of the joint will occur due to excessive inflammation.


What causes Tendonitis?

Tendonitis is often caused by repetitive overuse of a joint that causes irritation and inflammation of the tendons.  The condition can also be caused by a direct trauma to the joint, can occur in conjunction with other conditions and injuries, or can be caused by some medical conditions (such as rheumatoid arthritis and gout).


What are the symptoms of Tendonitis?

The primary symptoms of tendonitis are pain, swelling, tenderness and inflammation when the joint is moved.  In some cases, the inflammation and pain can cause partial or full immobility of the joint.


How is Tendonitis diagnosed?

A medical professional will take a complete medical history and will perform a physical exam.  Questions will be asked about when the symptoms started, what increases or decreases pain and swelling, and what types of activities you regularly engage in that may stress the injured area.  A physical exam will include testing the area for swelling, inflammation, tenderness, redness and warmth.  The degree of pain will be assessed when certain movements are performed and range of motion will also be determined.  In most cases of tendonitis, tenderness is felt when pressing directly on the tendon during a physical exam and provides enough information for diagnosis.   In some cases, x-rays may be used to see if there is another injury, such as a fracture or bone spur, causing swelling and pain.  An MRI or CT scan can provide more information regarding the soft tissues, including the extent and location of the inflammation.


When should I seek care for Tendonitis?

If you experience pain, tenderness or swelling in any joint that does not go away with a short period of rest, application of ice and over the counter anti-inflammatory medication, you should seek medical advice.  If the symptoms are caused by a direct trauma to the area, the pain is severe or increases suddenly, or if there is redness and warmth accompanying the swelling, you should seek prompt medical attention.


What will the treatment for Tendonitis consist of?

Initial treatment for tendonitis typically includes rest and temporary immobilization, the avoidance of activities that exacerbate symptoms, application of ice, and nonsteroidal anti-inflammatory medications.  Physical therapy is often recommended and includes stretching and strengthening exercises.  In some cases, steroid injections will help to ease inflammation and swelling that does not diminish with more conservative treatment (but is not recommended for all types of tendonitis).  Surgery is rarely indicated for the treatment of tendonitis, but may in some circumstances be necessary if there is damage to the tendon or there is another structure causing compression on the tendon.  When surgery is performed, it is usually followed by a rehabilitation program after a brief period of rest.


Which muscle groups/joints are commonly affected by Tendonitis?

Tendonitis can occur in any location throughout the body in which tendons are located.  There are hundreds of tendons in the body but the condition is most likely to occur in the wrist, elbow, shoulder (rotator cuff), knee, hip or ankle (Achilles tendon).


What type of results should I expect from the treatment of Tendonitis?

Conservative treatments for tendonitis will typically be effective in eliminating or reducing the inflammation, irritation, and pain caused by tendonitis.  The severity of the condition, how long it was going on before treatment began, and whether or not activities that exacerbate symptoms have been eliminated or modified, will determine how long it will take for a full recovery to be achieved and whether the condition will return.  If repetitive activities and movements that caused the initial condition are not modified, there is a likelihood of re-injury.  In some cases, wearing a brace or splint while performing certain activities can help prevent the re-development of symptoms.

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