Understanding Tendinitis: Causes, Symptoms, and Treatments

What is tendinitis?

Tendinitis is a condition that causes your tendons – thick sinews that connect your muscles to your bones – to become inflamed. This causes acute pain and tenderness, making it difficult to move the affected joint.

You can develop tendinitis in any tendon, but it is most common in the shoulder, knee, elbow, heel and wrist. Examples include Achilles tendon, tennis elbow, golfer’s elbow, or pitcher’s shoulder.

What causes tendinitis?

Your tendons can become inflamed through injury due to an accident or through overuse and repetitive actions while playing sports.

Other causes include:

• Ageing as the tendons lose their elasticity and become weak
• Certain antibiotics (quinolones such as Levaquin)
• Certain diseases, such as rheumatoid arthritis
• Exercising using the wrong techniques
• Working in jobs that require overhead lifting or repetitive movements

How do I know if I have tendinitis?

You will feel a dull ache around the joint, which increases in severity when you move the joint. It will also feel painful if someone touches the area. You may experience some tightness and swelling.

Try to treat the area by applying ice for a few days. If the condition does not improve, see a doctor for an accurate diagnosis.

Your doctor will examine the area where you feel pain and test for tenderness and range of motion. Be sure to tell your doctor what activities and sports you do along with your medical history. If your doctor can’t make a diagnosis from a physical examination alone, you may be sent for an x-ray or an ultrasound or MRI scan.

What are my treatment options?

If you take action early, rest, ice and over-the-counter pain relief may be all that is needed.

However, if your symptoms persist, you may be given an anti-inflammatory cream to apply, which will also help to relieve the pain.

Your doctor may inject a corticosteroid medication around the tendon to reduce inflammation directly, although this will be a short-term measure as repeated injections will weaken the tendon, increasing the risk of further injury. Not all tendinitis is suitable for a corticosteroid injection.

If your case is chronic, your doctor may recommend a still experimental treatment that has shown promise – platelet-rich plasma (PRP) treatment. The doctor will take a sample of your blood and spin it to separate the platelets and inject this mixture into your tendon.

Physiotherapy for tendonitis

You may be guided through specific exercises designed to stretch and strengthen the tendon and muscle as a first-line treatment. However, if this and medication don’t work, surgical intervention is your next and last option.

Minimally invasive options for tendonitis

Ultrasonic or extra-corporeal shockwave treatment: Your surgeon or physiotherapist will use a device to help remove scar tissue or manage pain arising from the tendon tissue using ultrasonic sound or shock waves.

Joint arthroscopy: In severe cases, your doctor may recommend joint arthroscopy, a procedure that can be done on any joint and allows the surgeon to insert a scope with a camera into the area while you are under either local or general anaesthetic. This will allow the surgeon to examine the injury more closely and decide whether a repair can be done there and then or whether open surgery is needed to make the repair.

If you have concerns about having tendinitis or other bone-related conditions, make an appointment with an orthopaedic specialist.