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Tendinitis

Calcific tendinitis; Bicipital tendinitis

 

Tendons are the fibrous structures that join muscles to bones. When these tendons become swollen or inflamed, it is called tendinitis. In many cases, tendinosis (tendon degeneration) is also present.

Causes

 

Tendinitis can occur as a result of injury or overuse. Playing sports is a common cause. Tendinitis also can occur with aging as the tendon loses elasticity. Body-wide (systemic) diseases, such as rheumatoid arthritis or diabetes , can also lead to tendinitis.

Tendinitis can occur in any tendon. Commonly affected sites include the:

  • Elbow
  • Heel ( Achilles tendinitis )
  • Knee
  • Shoulder
  • Thumb
  • Wrist

 

Symptoms

 

Symptoms of tendinitis may vary with activity or cause. Main symptoms may include:

  • Pain and tenderness along a tendon, usually near a joint
  • Pain at night
  • Pain that is worse with movement or activity
  • Stiffness in the morning

 

Exams and Tests

 

The health care provider will perform a physical exam. During the exam, the provider will look for signs of pain and tenderness when the muscle attached to the tendon is moved in certain ways. There are specific tests for specific tendons.

The tendon can be inflamed, and the skin over it may be warm and red.

Other tests that may be done include:

  • Ultrasound
  • X-ray
  • MRI

 

Treatment

 

The goal of treatment is to relieve pain and reduce inflammation.

The provider will recommend resting the affected tendon to help it recover. This may be done using a splint or a removable brace. Applying heat or cold to the affected area can help.

Over-the-counter pain relievers such as NSAIDs like aspirin or ibuprofen, can also reduce both pain and inflammation. Steroid injections into the tendon sheath can also be very useful for controlling pain.

The provider may also suggest physical therapy to stretch and strengthen the muscle and tendon. This can restore the tendon's ability to function properly, improve healing, and prevent future injury.

In rare cases, surgery is needed to remove the inflamed tissue from around the tendon.

 

Outlook (Prognosis)

 

Symptoms improve with treatment and rest. If the injury is caused by overuse, a change in work habits may be needed to prevent the problem from coming back.

 

Possible Complications

 

Complications of tendinitis may include:

  • Long-term inflammation raises the risk for further injury, such as rupture
  • Return of tendinitis symptoms

 

When to Contact a Medical Professional

 

Call for an appointment with your provider if symptoms of tendinitis occur.

 

Prevention

 

Tendinitis can be prevented by:

  • Avoiding repetitive motions and overuse of the arms and legs.
  • Keeping all your muscles strong and flexible.
  • Doing warm up exercises at a relaxed pace before vigorous activity.

 

 

References

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 263.

Lareau EM. Tendinitis and bursitis. In: Adams JG, ed. Emergency Medicine . 2nd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 86.

 
  • Tendon vs. ligament - illustration

    A tendon is a fibrous connective tissue which attaches muscle to bone. Tendons may also attach muscles to structures such as the eyeball. A tendon serves to move the bone or structure. A ligament is a fibrous connective tissue which attaches bone to bone, and usually serves to hold structures together and keep them stable.

    Tendon vs. ligament

    illustration

  • Tendonitis - illustration

    Tendonitis is the inflammation, irritation, and swelling of a tendon. It can occur as a result of injury, overuse, or with aging as the tendon loses elasticity. Any action that places prolonged repetitive strain on the forearm muscles can cause tendonitis. The most common symptom of tendonitis is pain, tenderness, and the increase of pain with movement.

    Tendonitis

    illustration

    • Tendon vs. ligament - illustration

      A tendon is a fibrous connective tissue which attaches muscle to bone. Tendons may also attach muscles to structures such as the eyeball. A tendon serves to move the bone or structure. A ligament is a fibrous connective tissue which attaches bone to bone, and usually serves to hold structures together and keep them stable.

      Tendon vs. ligament

      illustration

    • Tendonitis - illustration

      Tendonitis is the inflammation, irritation, and swelling of a tendon. It can occur as a result of injury, overuse, or with aging as the tendon loses elasticity. Any action that places prolonged repetitive strain on the forearm muscles can cause tendonitis. The most common symptom of tendonitis is pain, tenderness, and the increase of pain with movement.

      Tendonitis

      illustration

    A Closer Look

     

    Self Care

     

    Tests for Tendinitis

     

       

      Review Date: 7/13/2016

      Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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