Tendonitis - What You Should Know

Tendonitis May Cause Pain and Tenderness Near a Joint

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A tendon is a strong, flexible fibrous cord that attaches muscle to bone. Tendons are different than ligaments. While tendons connect muscle to bone, ligaments connect bone to bone at a joint. Tendons are able to carry tremendous loads, much like a steel cable. Both tendons and ligaments are considered soft tissue.

What Is Tendonitis?

Tendonitis, sometimes spelled tendinitis, refers to inflammation of one or more tendons.

What Can Cause Tendonitis?

Tendonitis can be caused by severe injury, but more often it is caused by repetitive minor injuries to the affected area. In certain conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disease or diabetes, tendonitis can occur without any trauma.

Tendonitis may develop with overuse as a tendon repeatedly bears more load than it can withstand. That situation can occur with excessively high loads across normal tendons or with normal loads across degenerated tendons.

Who Is Likely to Develop Tendonitis?

People whose work or regular activity requires repetitive motion are more likely to develop tendonitis. Examples include gardeners, carpenters, athletes, dancers, or people who work extensively on a computer. People with poor posture or improper body mechanics could be at higher risk for developing tendonitis, too. Tendonitis is more common in adults, especially those 40 years of age or older (tendons lose elasticity as they age), but anyone can develop tendonitis.

What Are the Symptoms of Tendonitis?

Tendonitis causes pain and tenderness in the area just outside of a joint. There also can be loss of motion in the joint near the affected tendon. The shoulder, elbow, wrist, base of thumb, hip, knee and ankle are most commonly affected.

How Is Tendonitis Diagnosed?

Typically, tendonitis can be diagnosed from a medical history and physical examination.

Your doctor may use special physical examination maneuvers to determine which tendon is involved.

The anesthetic-injection test may also be useful for confirming the diagnosis of tendonitis. A small amount of an anesthetic agent, such as lidocaine, is injected into the affected area. If there is immediate pain relief, that helps to confirm the diagnosis of tendonitis. MRIs or ultrasound also can be used to look for tendonitis and tendon tears.

How Is Tendonitis Treated?

The goal of treatment for tendonitis is to treat the inflammation. Rest, compression, elevation, and nonsteroidal anti-inflammatory medications (NSAIDs) are part of the initial treatment regimen. Ultrasound, massage, gentle stretching and strengthening exercises, use of protective equipment (such as orthotics or splints), may also be considered. A corticosteroid injection into the affected area sometimes is considered, especially if all else has failed. A partial or completely torn tendon may require surgery.

Sources:

Biundo, Joseph J. Jr. MD. Regional Rheumatic Pain Syndromes. Chapter 3. Primer on the Rheumatic Diseases. Thirteenth edition. Arthritis Foundation.

Sheon, Robert P. MD. Tendinitis (Bursitis). American College of Rheumatology. May 2015.

Questions and Answers About Bursitis and Tendinitis. NIAMS. June 2016.

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