Understanding Tendinitis -- Diagnosis and Treatment

How Do I Know if I Have Tendinitis?

Tendinitis, also called overuse tendinopathy, typically is diagnosed by a physical exam alone. If you have the symptoms of overuse tendinopathy, your doctor may order an ultrasound or MRI scans to help determine tendon thickening, dislocations and tears, but these are usually unnecessary for newly diagnosed cases. Your doctor can also assess whether you have similar problems such as bursitis (inflammation of the fluid "cushion" surrounding the joints).

What Are the Treatments for Tendinitis?

The goals of treatment for overuse tendinopathy are to restore movement to the joint without pain and to maintain strength in surrounding muscles while giving the tissues time to heal. Adequate rest is crucial. Returning too soon to the activity that caused the injury can lead to chronic overuse tendinopathy or torn tendons.

As an immediate treatment for overuse tendinopathy, doctors and physical therapists often recommend the RICE program: rest, ice, compression, and elevation of the injured tendon. They may also suggest a short course of aspirin, ibuprofen, or other anti-inflammatory drugs to help inflammation and pain. Occasionally, your doctor may discuss injecting corticosteroids (a stronger anti-inflammatory drug) around the tendon for an acute injury, but these are not used in chronic overuse tendinopathy due to potential harmful effects of use.

A physical therapist can propose an exercise plan that rests the tendon while strengthening nearby muscle groups and maintaining overall muscle tone. Only gradually will you begin to exercise the tendon itself. Your program may also include "eccentric" exercises, in which you gradually strengthen the muscle while stretching, stopping at the first sign of pain. You may also work into easy stretching exercises, done several times a day.

Ultrasound and whirlpool treatments are useful for relaxing muscles and tendons, improving circulation, and promoting healing.  

For chronic tendinitis, there is open surgery and FAST (focused aspiration of scar tissue), which is ultrasound-guided and minimally invasive.

How Can I Prevent Tendinitis?

Vary your exercises and gently stretch all the muscles and tendons you are planning to exercise. Include warm-up and cool-down exercises and stretches in your routine. As a general rule, a good warm-up is five minutes for every 30 minutes of planned exercise. So, one hour on the treadmill or elliptical trainer should be preceded by 10 minutes of warm-up. Try to prevent repetitive use of the same joint, resting it when possible. Make sure to wear appropriate footwear or other equipment, and slowly increase your exercise load as a dramatic increase in tendon use can pose a significant risk for overuse tendinopathy.

 

WebMD Medical Reference Reviewed by Lisa Bernstein, MD on March 27, 2017

Sources

SOURCES: 

American College of Rheumatology: "Tendinitis and Bursitis."

National Institute of Arthritis and Musculoskeletal and Skin Diseases: "What Are Bursitis and Tendinitis?"

Mayo Clinic: "Tendinitis." 

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