Tendinitis – Causes, Symptoms and Treatment
Tendinitis is a painful inflammation or irritation of a tendon, most often caused by overuse or injury. It commonly affects the shoulder, elbow, knee, or heel.
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Tendinitis is a painful inflammation or irritation of a tendon, most often caused by overuse or injury. It commonly affects the shoulder, elbow, knee, or heel.
What is Tendinitis?
Tendinitis (also spelled tendonitis) is an inflammation or irritation of a tendon – the thick, fibrous cord of tissue that connects muscle to bone. Tendons transmit the force generated by muscles to the bones, enabling movement. When tendons are repeatedly overloaded or suddenly injured, an inflammatory response can develop, leading to pain, swelling, and reduced mobility.
While tendinitis can affect virtually any tendon in the body, it most commonly occurs in the shoulder, elbow, wrist, hip, knee, and heel.
Causes
The most common causes of tendinitis include:
- Overuse: Repetitive, one-sided movements – common in sports or occupational settings (e.g., manual labor, office work)
- Acute injury: Sudden, unaccustomed physical exertion or direct trauma to the tendon
- Poor posture or technique: Biomechanical imbalances that place uneven stress on tendons
- Age-related degeneration: Tendons become less elastic and more vulnerable with age
- Systemic conditions: Rheumatoid arthritis, gout, or metabolic disorders such as diabetes can increase susceptibility
- Medications: Certain antibiotics (e.g., fluoroquinolones) are associated with tendon damage
Symptoms
Typical symptoms of tendinitis include:
- Pain along the affected tendon, worsening with movement or activity
- Tenderness to the touch over the tendon
- Swelling and occasionally warmth in the affected area
- Stiffness and limited range of motion, especially in the morning or after rest
- A mild creaking or crackling sensation (crepitus) during movement
Commonly Affected Tendons
- Achilles tendon (heel): particularly common in runners
- Patellar tendon (knee): also known as Jumper's Knee
- Rotator cuff tendons (shoulder): often related to overhead activities
- Lateral or medial epicondyle (elbow): Tennis elbow or Golfer's elbow
- Wrist and thumb: De Quervain's tenosynovitis
Diagnosis
Tendinitis is primarily diagnosed through a clinical examination, during which the physician assesses pain history, location, and possible triggers. Additional diagnostic tools may include:
- Ultrasound: To evaluate tendon structure, swelling, and potential tears
- MRI (Magnetic Resonance Imaging): For detailed visualization of tendon tissue and surrounding structures
- X-ray: To rule out bone changes or calcifications
- Blood tests: If a systemic cause such as rheumatoid arthritis or gout is suspected
Treatment
Conservative Treatment
The majority of tendinitis cases can be successfully managed without surgery:
- Rest and activity modification: Reducing or temporarily stopping the aggravating activity
- Ice therapy: Applying cold packs during the acute phase to reduce pain and swelling
- Physiotherapy: Targeted strengthening and stretching exercises, particularly eccentric training programs
- Pain relief medications: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac for short-term relief
- Braces and supports: To offload and stabilize the affected region
- Shockwave therapy: Particularly effective for chronic cases
- Corticosteroid injections: Provide short-term anti-inflammatory relief but should be used cautiously
Surgical Treatment
Surgery is rarely required and is only considered in severe cases, such as tendon rupture or persistent, treatment-resistant chronic tendinopathy. Procedures may involve removal of damaged tendon tissue or tendon reconstruction.
Prognosis and Prevention
With appropriate treatment, most cases of tendinitis resolve fully. Chronic tendinopathy often develops when the tendon is reloaded too soon or treatment is incomplete. Preventive measures include:
- Adequate warm-up before physical activity
- Gradual increase in training intensity
- Regular stretching and strengthening exercises
- Ergonomic workplace design
- Sufficient recovery time between training sessions
References
- Maffulli, N. et al. (2003): Tendinopathy of tendo achillis. In: Journal of Bone and Joint Surgery, 85(B), pp. 1137–1142.
- Childress, M.A. and Beutler, A. (2013): Management of Chronic Tendon Injuries. In: American Family Physician, 87(7), pp. 486–490.
- World Health Organization (WHO): Musculoskeletal conditions. Geneva, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/musculoskeletal-conditions
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Related search terms: Tendinitis + Tendonitis + Tendinopathy + Tendon Inflammation