Tendinitis

Symptoms

Symptoms of tendinitis tend to occur where a tendon attaches to a bone. Symptoms often include:

• Pain, often described as a dull ache, especially when moving the hurt limb or joint.
• Stiffness or weakness in the affected area.
• Tenderness.
• Mild swelling.

When to see a doctor

Most cases of tendinitis respond with self-care measures, such as rest, ice and pain relievers. See your healthcare professional if your symptoms don't lessen after a few days and if they get in the way of daily activities.

Risk factors

Risk factors for developing tendinitis include older age and having jobs that involve doing the same motion over and over. Some medical conditions and certain medicines also may increase the risk.

Age

As people get older, their tendons become less flexible, making the tendons easier to injure. Tendons also are often slower to heal and recover from activity as people age.

Work

Tendinitis is more common in people, such as gardeners and manual laborers, whose jobs involve:

• Repeated motions.
• Awkward positions.
• A lot of overhead reaching.
• Vibration.
• Forced movements.

Activities

When doing physical activities, the following can increase the risk of tendinitis:

• Sudden increase in amount or difficulty of training.
• Too little recovery time after an injury or too little time to get used to the activity again after time off.
• Hard surfaces, such as concrete or gym floors.
• Poor equipment, such as old shoes or ones without support.
• Poor posture or poor technique, such as incorrect form when playing tennis or throwing a ball.

Medical conditions and medicines

If you have certain medical conditions, such as diabetes, or take certain medicines, you can have an increased risk of tendinitis. Medicines that may increase risk include:

• Antibiotics known as fluoroquinolones.
• Corticosteroids such as cortisone.
• Statins, used to lower cholesterol levels.
• Aromatase inhibitors, used to lower breast cancer risk.
• Testosterone taken at too high a dose or other anabolic steroids.

Prevention

To lower your chance of developing tendinitis, follow these suggestions:

• Ease up. Avoid activities that place too much stress on your tendons, especially for long periods. If you have pain during an exercise, stop and rest.
• Mix it up. If one exercise or activity causes you pain, take a break from it and try something else. Cross-training can help you mix high-impact exercise, such as running, with lower impact exercise, such as biking or swimming.
• Improve the way you move. If you don't do an activity or exercise properly, you could be setting yourself up for issues with your tendons. Think about taking lessons or getting professional instructions when starting a new sport or using exercise equipment.
• Move right in the workplace. Make sure your chair, keyboard and desktop are positioned correctly for your height, arm length and the tasks you do. This can help protect your joints and tendons from stress.
• Prepare your muscles. Strengthen muscles used in your activity or sport. For example, if you play baseball, use weights to strengthen the specific muscles you need to use. Strengthening muscles that you use can help them bear the load better and lower the risk of injury.

Treatment

The goals of tendinitis treatment are to relieve pain, reduce irritation and prevent future tendon conditions. Self-care, including rest, ice and pain relievers, might be all that's needed. But full recovery might take several months.

Changing how you do certain activities and doing physical therapy exercises can help improve pain and prevent future injuries. Other treatment options include noninvasive and surgical procedures.

Treatment options for tendinitis may include:

Medicines

Pain relievers, such as aspirin, naproxen sodium (Aleve), ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) may lessen pain. You also can apply pain-relieving creams or gels to the skin.

Physical therapy

Physical therapy exercises can help strengthen the muscle and tendon in the affected area. You can do resistance exercises to effectively treat many long-lasting tendon conditions.

Procedures

In situations where physical therapy hasn't resolved symptoms, your healthcare professional might suggest:

• Steroid injections. The effectiveness of steroid shots for tendinitis varies depending on the condition. A steroid shot around a tendon often helps to quickly ease the pain, though pain relief may be temporary. But repeated steroid shots can weaken a tendon and increase the risk of the tendon tearing over time.
• Dry needling. In this procedure, a healthcare professional makes small holes in the tendon with a fine needle. This procedure can reduce tendon pain.
• Shockwave therapy. This treatment uses high-energy sound waves or pressure waves to treat injured tissue. These waves promote blood flow to help the tissue heal. Treatment is done using a hand-held device that is placed on the skin.
• Ultrasound therapy. This treatment uses sounds waves to generate heat in the tissue. This can promote healing in a damaged tendon by increasing blood flow to the area.
• Platelet-rich plasma therapy. This treatment involves taking a sample of your own blood and spinning the blood to separate out the platelets and other healing factors. The solution is then injected into the area of long-lasting tendon irritation.
• Surgery. Depending on the seriousness of the injury, you may need to have surgery to repair the tendon, especially if the tendon has torn away from the bone. There are both minimally invasive and open procedures. A minimally invasive procedure usually results in less pain and quicker recovery than an open procedure. An open procedure requires a larger incision. Which procedure is best for you may depend on the type of injury to the tendon and its location.

Preparing for an appointment

You might start by talking to your family healthcare professional. You may be referred to a specialist in sports medicine or physical medicine and rehabilitation.

What you can do

You may want to write a list that includes:

• Details about your symptoms.
• Other medical conditions you've had.
• Medical conditions your parents, brothers and sisters have had.
• All the medicines and vitamins you take, including doses.
• Questions you want to ask the care team.

For tendinitis, some basic questions to ask 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?
• I have other medical issues. How best can I manage them together?
• Will I need to limit my activities?
• What self-care can I do at home?

What to expect from your doctor

Your healthcare professional is likely to ask you questions, such as:

• Where do you feel pain?
• When did your pain begin?
• Did it begin all at once or come on bit by bit?
• What kind of work do you do?
• What are your hobbies? What do you do for fun?
• Have you been instructed in proper ways to do your activity?
• Does your pain occur or worsen during certain activities, such as kneeling or climbing stairs?
• Have you recently had a fall or other kind of injury?
• What treatments have you tried at home?
• What did those treatments do?
• What, if anything, makes your symptoms better?
• What, if anything, makes your symptoms worse?