Tendinitis is a condition of inflammation of the tendon. The condition is painful and can limit range of motion of a joint. Tendinitis can occur in anyone, but is more common in adults over the age of 40. Preventing tendinitis involves avoiding activities that cause increased stresses or pain, improving techniques with exercises and with workplace ergonomics, and performing stretching and strengthening exercises.
Tendons
A tendon is a flexible band of tissue that attaches muscles to bones. In order to move a joint, a muscle needs to contract and pull on the tendon that attaches to bone. Pulling on the bones helps to move the joint.
Causes
Tendinitis can result from overuse, trauma, or aging. Tendinitis refers to inflammation of the tendon. Aging causes the tendon to become less flexible and therefore makes the tendon more susceptible to tendinitis. Diseases including rheumatoid arthritis and diabetes can make an individual more at risk for developing tendinitis.
Symptoms
Tendinitis causes pain and swelling in the affected tendon. The tendon can be tender to the touch, or pain may be felt with movement of the affected joint.
Locations
Common sites of tendinitis include the Achilles tendon, peroneal tendons, posterior tibial tendon, patellar tendon, wrist, elbow, biceps tendon, rotator cuff, and triceps.
The Achilles tendon is located at the heel of the foot. Pain with Achilles tendinitis is located on the back of the heel and in the back side of the lower leg. Patients may have limited ankle motion or weakness due to discomfort. It may be painful for patients to stand on their toes.
Peroneal tendinitis occurs on the lateral/outer ankle, and outside of the shin with pain in this region.
Posterior tibial tendinitis occurs on the medial/inner ankle, and inside of the shin and causes pain in this region. Patients may have weakness and pain with walking and lifting up the foot.
Biceps tendinitis causes pain in the upper arm near the shoulder. Patients may have pain when moving the arm forward or flexing at the elbow.
Rotator cuff tendinitis occurs in the shoulder most commonly with the supraspinatus. Pain may occur with moving the arm above the head. The shoulder may be tender to touch.
Triceps tendinitis causes pain in the back of the elbow when trying to straighten the elbow or fully bend at the elbow. Patients may have tenderness on the backside of the elbow at the triceps tendon.
Wrist tendinitis causes pain in the forearm and wrist with activity.
Patellar tendinitis occurs just below the knee cap or patella. Patients have tenderness over the patellar tendon. Patients may have pain with jumping, running, walking, and straightening the leg. Going up and down stairs may be painful.
Treatments
Tendinitis treatment begins with nonoperative methods. Rest and icing the joint can be helpful to decrease swelling. Anti-inflammatory medication such as naproxen or ibuprofen can help reduce the inflammation. Steroid injections can be made directly into the tendon sheath to help control symptoms. According to Dr. Dennis Cardone of Robert Wood Johnson Medical School in New Jersey, side effects of steroid injections include tendon rupture. Physical therapy is important to help improve range of motion and strength of the muscles and tendons. Physical therapists can also try ultrasound therapy to help improve the symptoms. Surgical treatment sometimes is necessary to remove the inflammatory tissue from around the tendon.
References
- "AAOS Comprehensive Orthopaedic Review"; Dr Jay Lieberman; 2008.
- "The Sports Medicine Patient Advisor (2nd edition)"; Dr. Pierre Rouzier; 2004.
- "Expert Guide to Sport Medicine"; Dr. Matthew Davis, Dr Peter Davis, and Dr David Ross (eds); 2005.
- "American Family Physician" Joint and Soft Tissue Injection
