Tendinitis

Overview

Tendinitis is inflammation of the tendons, the thick fibrous cords that attach muscles to bones. It leads to pain, tenderness, and mild swelling around the affected joint. Tendinitis can occur in any tendon, but it is most common in the shoulders, elbows, wrists, knees, and heels. Treatment includes rest, physical therapy, and medication to reduce pain. Long-lasting tendon inflammation may cause a tendon to tear, which might require surgery.

Understanding the disease

Symptoms

The symptoms of tendinitis typically occur where a tendon attaches to a bone. They often include pain, tenderness, and mild swelling. The pain may be described as a dull ache, especially when moving the affected limb or joint.

Risk Factors

The risk factors for developing tendinitis include age, having jobs or hobbies that involve repetitive motions, performing physical activities with poor form, and taking certain medications such as fluoroquinolines, corticosteroids, and aromatase inhibitors.

Development

Tendinitis develops when the tendons, which are the thick fibrous cords that attach muscles to bones, become inflamed. The inflammation usually occurs near a joint. Tendinitis can happen in any tendon, but it's most common in the shoulders, elbows, wrists, knees, and heels. Tendinitis can result from a sudden injury, but it's more commonly caused by repetitive motions, such as those involved in certain jobs or hobbies. When the same movement is repeated over time, it puts stress on the tendons, increasing the risk of tendinitis. Incorrect body movements or poor posture during physical activities can also contribute to the development of tendinitis. Certain factors can increase the risk of developing tendinitis. As people age, their tendons become less flexible, making them more susceptible to injury. Jobs that involve repetitive motions, awkward positions, overhead reaching, vibration, and forced movements can increase the risk. Additionally, engaging in physical activities with poor form, using poor equipment, or participating in activities with hard surfaces can increase the risk of tendinitis. Certain medical conditions, such as diabetes, and certain medications, including antibiotics like fluoroquinolines, corticosteroids like cortisone, and aromatase inhibitors used to lower breast cancer risk, can also increase the risk of tendinitis. If left untreated, tendinitis can lead to the breakdown or tearing of the tendon, potentially requiring surgery. To prevent tendinitis, it's important to avoid activities that place excessive stress on tendons, mix up high-impact and lower-impact exercises, and improve the way you move by using proper form and technique.

Assessment and Diagnosis

Triage

If tendinitis symptoms don't lessen after a few days and if they get in the way of daily activities, it's advisable to see a healthcare provider.

Diagnosis

To diagnose tendinitis, a physical exam is usually sufficient. The doctor will examine the affected area to determine the location of pain, tenderness, or swelling. They will also evaluate the flexibility, alignment, range of motion, and reflexes of the affected joint. Imaging tests like X-rays, ultrasound, or magnetic resonance imaging (MRI) may be ordered to rule out other conditions causing similar symptoms or to assess the extent of the tendinitis.

Management and Treatment

Complications

If left untreated, tendinitis can increase the risk of a tendon breaking down or tearing. A completely torn tendon might need surgery.

Prevention

tendinitis can be prevented by following certain measures to reduce the risk factors. Some ways to prevent tendinitis include:

1. Easing up on activities that place too much stress on the tendons, especially during long periods of time.
2. Mixing up exercises and activities to avoid overusing specific tendons.
3. Improving the way you move by refining your technique and getting professional instructions when starting a new sport or exercise.
4. Gradually increasing your activity level, especially when starting a new exercise regimen.
5. Taking it easy by avoiding activities that place excessive stress on the tendons and warming up properly before engaging in strenuous activities.
6. Stretching and strengthening the muscles and tendons, especially the calf muscles.
7. Varying your exercises and activities to alternate high-impact and low-impact sports.
8. Choosing appropriate running surfaces and dressing properly for cold-weather training.
9. Addressing any underlying medical conditions, such as diabetes, and being aware of medications that may increase the risk of tendinitis. Remember to tailor your prevention strategies to your individual needs and risk factors.

Home Remedies

Home remedies for tendinitis include:

1. Rest: Avoid activities that aggravate the condition and give your tendon time to heal.
2. Ice: Apply ice to the affected area for 15-20 minutes, several times a day to reduce pain and inflammation.
3. Compression: Use an elastic bandage to compress the affected area, helping to minimize swelling and support the tendon.
4. Elevation: Elevate the affected limb to reduce swelling.
5. Over-the-counter pain relievers: Consider using nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen to help alleviate pain and reduce inflammation.
6. Stretching and exercise: Gentle stretching exercises can help improve flexibility and strengthen the surrounding muscles, which can aid in recovery.
7. Heat therapy: Applying heat to the affected area can help alleviate stiffness and promote relaxation of the tendon and surrounding muscles.
8. Massage: Gentle massage of the affected area can help improve circulation and reduce muscle tension.
9. Proper footwear: Wearing appropriate, well-fitting shoes with adequate support can help prevent or reduce the risk of tendinitis. Remember to consult a healthcare provider if home remedies do not provide relief or if the condition worsens.

Treatment

Tendinitis can be treated with rest, physical therapy, and medication to reduce pain. Treatment options may vary depending on the severity and location of the tendinitis. The following measures can help alleviate symptoms:

1. Rest: Reducing the activity that causes the tendinitis can help reduce pain and inflammation.
2. Ice: Applying ice to the affected area can help alleviate pain and reduce inflammation.
3. Compression: Wearing a compression bandage or sleeve may help reduce swelling and support the affected area.
4. Elevation: Elevating the affected limb can help reduce swelling.
5. Physical therapy: A physical therapist can provide exercises and other treatments to help reduce pain and inflammation, improve mobility, and prevent future tendinitis.
6. Medications: Over-the-counter pain relievers like acetaminophen or ibuprofen can help alleviate pain. In some cases, prescription medication or corticosteroid injections may be recommended. Remember to consult a healthcare provider for proper diagnosis and treatment recommendations, as they can provide personalized advice based on your specific situation.

Preparing for medical consultation

To prepare for an appointment for tendinitis, you should:

1. Make a list of your symptoms and when they began.
2. Write down key medical information, including any other medical conditions you have and medications or supplements you take.
3. Log your typical daily activity, including the intensity and frequency of physical activities.
4. Note any recent injuries or changes in your activity level that may have contributed to your tendinitis.
5. Prepare a list of questions to ask your healthcare provider during the appointment. Some basic questions to ask your doctor about tendinitis include:

• What is the most likely cause of my symptoms?
• Are there other possible causes?
• What tests do I need?
• What treatment do you recommend?
• Will I need to limit my activities?
• What self-care can I do at home? Remember to bring this list with you to your appointment and be prepared to share any relevant information with your healthcare provider. This will help ensure that you make the most of your time together and receive the appropriate care for your tendinitis.