Tendonitis / Tendinitis
Tendinitis (also known as tendinitis or tenonitis) is a general term used to describe inflammation associated with a tendon. Tendons connect muscles to bone, and inflammation of these rope-like tissues is the most common cause of soft-tissue pain. Tendonitis differs from arthritis, which refers to inflammation of a joint. Common areas of tendonitis include the shoulder (which involves inflammation at one of the tendons of the rotator cuff), the elbow (“tennis elbow” and “golfer’s elbow”), the wrist, the knee (above and below the kneecap), the back of the ankle (Achilles tendonitis) and the foot.
The onset of tendonitis can usually be attributed to overuse of the associated area. As we grow older, repetitive motion can injure the tendon where it attaches to the bone, promoting an inflammatory response by the body. This inflammation can cause “pain on motion,” swelling, warmth, tenderness, and redness. This latter symptom is called “erythema” and refers to the dilation of the blood’s capillaries as part of the inflammatory process. Tendonitis can also occur in areas where calcium deposits have developed.
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lessThe first line of treatment for tendonitis involves the “RICE” protocol, which stands for “Rest, Ice, Compression, and Elevation.” Methods of treating recurring tendonitis differ for the various locations in the body, and can include immobilization with a splint, sling, or crutches; physical therapy; the application of heat, including skin balms, hot packs, and soaking; anti-inflammatory medications such as NSAIDs (non-steroidal anti-inflammatory drugs), local injection of corticosteroids; and, for the most severe forms of tendonitis, surgical procedures.
In the most difficult and treatment-unresponsive cases, surgical procedures can be used to realign tendons, remove spurs which are causing pressure on tendons, and to remove areas of calcium buildup. An added concern is that persistent tendon inflammation combined with overuse in some areas, such as the Achilles tendon or shoulder rotator cuff tendons, may lead to weakening and subsequent rupture of the tendon. Treatment options and ultimate outcome are often very limited once the tendon has become irreversibly damaged or has ruptured.
It is very important not to neglect persistent tendonitis and to rely on rheumatologic and orthopedic specialists to properly diagnose and treat the condition. Surgical intervention by an experienced orthopedist may be indicated to avoid ongoing unresponsive symptoms, particularly when the tendon is at risk of tearing or rupture.
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