Definition

     Tendinitis is inflammation, irritation, and swelling of a tendon, which is the fibrous structure that joins muscle to bone. In many cases, tendinosis (tendon degeneration) is also present.

Causes

     Tendinitis can occur as a result of injury, overuse, or with aging as the tendon loses elasticity. It can also be seen in systemic diseases such as rheumatoid arthritis or diabetes. Tendinitis can occur in any tendon, but some commonly affected sites are the shoulder, the wrist, the heel (Achilles tendonitis), and the elbow.

Symptoms

• Pain and tenderness along a tendon, usually in proximity to a joint (hip pain, knee pain, shoulder pain, elbow pain, wrist pain, or pain in other joints)

• Pain is worse with movement or activity

• Pain at night

Screening and Diagnostics

     On physical exam, a doctor will look for tenderness along the affected tendon and pain when the muscle to which the tendon is attached is used against resistance. There are specific tests for specific tendons. The tendon can be inflamed and the overlying skin may be warm and red.

Treatment 

     The goal of treatment is to relieve pain and reduce inflammation.

     Rest or immobilization of the affected tendons is helpful for recovery. This may be achieved using a splint or a removable brace. The application of heat or cold to the affected area can help.

     Non-steroidal anti-inflammatory medications (NSAIDs), such as aspirin or ibuprofen, can also reduce both pain and inflammation. Steroid injections into the tendon sheath can also be very useful in controlling pain and allowing physical therapy to start.

     Physical therapy that stretches and strengthens the muscle and tendon is essential. This can restore the tendon's ability to function properly, improve healing, and prevent future injury.

     Rarely, surgery is needed to physically remove the inflammatory tissue from around the tendon.

Prognosis

     Symptoms improve with treatment and rest. If the injury is caused by overuse, a change in work habits may be indicated to prevent recurrence of the problem.

Complications

• Recurrence of tendinitis

• Chronic inflammation of the tendon predisposes it to further injury, such as rupture.

Prevention

• Avoid repetitive motion and overuse of an extremity

• Warm up by exercising at a relaxed pace before engaging in vigorous activity

• Keep all your muscles strong and flexible