Tendinitis

Tendinitis is inflammation of a tendon – a thick, flexible cord of tissue that attaches muscle to bone. Tendons help muscles move bones. Tendinitis most commonly occurs in the shoulder, bicep, elbow, hand, wrist, thumb, calf, knee or ankle.  Since the pain of tendinitis occurs near a joint, it is sometimes mistaken for arthritis. The condition is more common in adults over the age of 40 and athletes. Some forms of tendinitis are named after certain sports (e.g., tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder and jumper's knee).

Tendinitis often results from sports injuries or repetitive movements. But it can also be caused by:

• Bad posture or walking habits.
• An infection.
• Stress on soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or joint deformities).
• Some types of arthritis and related conditions ( rheumatoid arthritis , osteoarthritis and gout ).
• Metabolic conditions, such as diabetes.
• Side effects from certain medications (e.g., fluoroquinolone antibiotics and statins drugs) although this is very rare.
  

Tendinitis causes inflammation, tenderness and pain in areas around a joint, such as the tendons, ligaments and muscles. Some types can occur suddenly, last for days or longer. The pain is worse with movement and usually get better with rest or treatment. Tendinitis symptoms can re-occur in the same area of the body.

Tendinitis may go away over time. If not, the doctor will recommend treatments to reduce pain and inflammation and preserve mobility. Severe symptoms may require specialized treatment from a rheumatologist, an orthopaedic surgeon or a physical therapist. When properly treated, most tendinitis conditions don’t result in permanent joint damage or disability. Treatment options include:

• RICE (Rest, Ice, Compression, Elevation) - many soft tissue conditions are caused by muscle overuse, so the first treatment may include rest, cold therapy, a tight bandage and elevating the area.
• Physical or occupational therapy. A physical therapist can provide hot/cold treatments, ultrasound (sound wave), laser and water therapy; soft tissue or joint mobilization (manual therapy); orthotics or pressure-relieving devices; a personalized exercise program; analysis of posture and walking; and education regarding appropriate activities. An occupational therapist can recommend assistive devices, modifications for daily activities and work habits to prevent re-injury and make daily activities easier.
• Splints, braces or slings – these assistive devices allow the affected area to rest until the pain eases.
• Over-the-counter (OTC) and prescription medicines – these medicines include relievers ( analgesics ), such as acetaminophen, or a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin , ibuprofen or naproxen that’s available as pills, gels, creams or patches. Depending on the severity of the symptoms, a stronger pill version of an analgesic or NSAID may be prescribed.
• Corticosteroids injections. These powerful anti-inflammatory drugs are injected directly into a joint at the doctor’s office.
• Surgery. This is may be an option if the tendon ruptures (a tear of the Achilles tendon in the lower calf) or there are lesions on the tendons.
  

Because tendinitis is usually caused by overuse, the best way to prevent it from occurring again is to avoid or modify activities that cause the problem. A physical or occupational therapist can provide suggestions on modifying daily activities. Range-of-motion exercises can help to improve flexibility and reduce stiffness.