Alleviate Tendonitis

Tendinitis (tendonitis) is an inflammation of a tendon, which is a thick fibrous cord that connects muscle to bone.[1] Tendinitis can occur anywhere in your body, but it most commonly appears in the shoulders, knees, wrists, and heels.[1] Some cases of tendinitis may last only a few days, while others can lead to chronic discomfort or pain, possibly limiting the range of movement and flexibility. By using lifestyle and home remedies or seeing a doctor, you can alleviate a case of tendinitis and avoid complications.[1]

Steps

Recognizing the Symptoms of Achilles Tendinitis

  1. Be aware of your risk for tendinitis. Any person can benefit from knowing "risk factors" that can increase your chance of having problems with this condition. Being aware of your risk can help you recognize and treat it effectively.[2]
    • The older you are the more likely you are to suffer from tendinitis.[2]
    • Occupational factors such as repetitive motions, awkward positions, frequent overhead reaching, vibration, and forceful exertion can increase your risk. Factory and construction workers may be particularly at risk.[2]
    • Playing sports such as baseball, basketball, bowling, golf, running, swimming, or tennis can increase your risk.[2]
    • If you have previously injured the area (sprain, strain, fracture etc.), you are more likely to get tendonitis.
  2. Identify potential symptoms. Tendinitis has many different symptoms that can range from mild to severe. Identifying potential symptoms that you have can help you get effective treatment as soon as possible.[3]
    • You may experience pain and stiffness along your tendon or joint, especially in the morning.[3]
    • You may experience pain along the tendon or joint that becomes more severe with activity.[3]
    • You may experience severe pain the day following exercise or strenuous activity.[3]
    • You may experience mild swelling.[3]
    • Your tendons may feel noticeably thicker.
  3. Observe pain and mobility problems. Pay attention to your body for any pain that is present along your tendon or joints or if you are experiencing problems moving any region of your body. These symptoms can indicate tendinitis and should be treated to prevent further pain.[3]
    • You can have pain that is mild to severe. Some points may be more tender than others depending on the exact location of the tendinitis.[3]
    • You may have a limited range of motion in the affected area, including a decreased mobility.[3]
  4. Distinguish tendinitis from other injuries. Tendinitis can occur on parts of your body that often have other injuries, such as the knee or elbow. Learning how to distinguish other pain from tendinitis in these parts of your body can help narrow the scope of treatment.[4]
    • Tendinitis may present similar symptoms to arthritis.[4] Like arthritis it is often present in joints such as the shoulder, elbow, wrist, hip, knee, and ankle and can have a rapid onset of pain with movement.
    • Unlike arthritis, you may have pain from tendinitis far away from the actual joint.[4]

Treating Tendinitis at Home

  1. Use the RICE principle. If you have a recurrent case of tendinitis or suspect you may have it, you can try treating it at home before seeing a doctor. By initially applying RICE—rest, ice, compression, and elevation—you may help alleviate tendinitis and prevent further issues. Change to very warm heat treatments after 48 hours and thereafter.[5]
    • Be aware that even with early treatment for pain, tendinitis may last for more than three months. If you wait for more than 1 to 1½ months before seeing a doctor, it might take longer for you to alleviate the condition.[5]
  2. Rest the affected area. Give your body a chance to heal by taking a break from stressful activities. Do lower-impact ones such as swimming and biking to help heal your tendonitis.[5]
    • If you do high-impact activities such as running or tennis, switch to lower-impact options. You can try biking, walking, or swimming to stay active while giving your affected tendon a rest.[5]
    • You may also want to rest the area completely for a while.[5]
    • Begin gently moving the affected area if you take a few days of full rest to help prevent stiffness.[5]
  3. Apply ice to the affected area. Use an ice pack on the painful area of your tendon. This can help reduce swelling and relieve pain (do not apply ice directly to skin; so use a cloth to protect against ice burns/frostbite).[5]
    • You can use an ice pack as often as necessary for 20 minutes at a time for the first 2 days (then change to very warm heat treatments from 3rd day and going forward). Wait 40 minutes for the iced area to warm up between applications of ice. [5]
    • You can take a slush bath by mixing ice and water in a bathtub. Soak the area or your entire body for up to 20 minutes.[5]
    • You can freeze a plastic foam cup full of water to massage the affected area gently.[5]
    • If you feel too cold, or your skin gets numb, remove the pack. Warm up for 40 minutes. Use a towel between the ice pack and your skin to help prevent frostbite/skin burns.[6]
  4. Compress the affected tendon. Use a wrap or compressive elastic bandage to compress the area with tendinitis. This can help relieve swelling and help preserve mobility in your joint.[5]
    • Swelling can cause loss of mobility in the injured joint or area, so compressing it will help.
    • Use compression until the affected area is no longer swelling.[5]
    • You can get compressive wraps and bandages at any pharmacy and many large department retailers.
  5. Elevate the affected area above your heart. Raise your affected tendon or joint above the level of your heart. This can help reduce swelling and may also help preserve mobility in your joint.[5]
    • Elevation is especially useful for tendinitis of the knee.[5]
  6. Take pain medication. Consume pain relievers for severe discomfort and/or as necessary. These medications may help alleviate pain and possible swelling.[5]
    • Take over the counter pain relievers such as aspirin, ibuprofen, naproxen sodium or acetaminophen.[5]
    • Ibuprofen and naproxen sodium may also help alleviate some of the swelling.[5]

Getting a Doctor’s Diagnosis and Medical Treatment

  1. See your doctor. If home treatment isn’t working or the tendinitis is adversely affecting your daily life, see your doctor. Tendinitis is common and very treatable, and getting a medical diagnosis early can help you get proper treatment.[3]
    • You can see your regular doctor or visit an orthopedist, who specializes in treating disorders such as tendinitis.[3]
    • Your doctor will conduct a physical exam to check for signs of tendinitis and will also likely ask for a health history, including factors such as what type of activities you do.[3]
  2. Examine the symptoms with your doctor. Your doctor will check for signs or signs of tendinitis once you’ve described your symptoms. Your doctor may be able to diagnose tendinitis with a simple examination instead of ordering more in-depth tests.[7] One common way of diagnosing tendinitis is palpation, where your doctor uses her hands and fingers to feel the affected areas carefully.[8]
    • Your doctor may check for swelling along the tendon or in the corresponding area.[7]
    • She may check for thickening or increase in the size of your tendon.[7]
    • Your doctor may look or feel for bony spurs along your elbow, shoulder, knee or heel.[7]
    • Your doctor may feel along your tendon and ask you what the point of maximum tenderness is.[7]
    • Your doctor may also test the range of motion. In particular, she’ll see if you have a decreased ability to flex your joint.[7]
  3. Get tests and a diagnosis. If your doctor suspects that you have tendinitis, she may order tests after conducting your physical exam. These tests can help confirm a diagnosis and help your doctor formulate a treatment plan.[9]
  4. Be X-rayed or have an MRI. Your doctor may not be able to diagnose tendinitis through a simple examination with her hands. She may order that you get an X-ray or MRI to ensure your symptoms are a result of tendinitis.[9] An MRI is more expensive than an X-ray, but may be more effective for diagnosing soft-tissue injuries such as tendinitis.[10]
    • X-rays and MRIs make images of the inside of your joint and tendon areas and can make it easier for your doctor to identify not only if you have tendinitis, but also exactly where the affected area is. This can help her better formulate a treatment plan.[9]
    • Your doctor may order an X-ray, which will require you to sit still while a technician makes images of the affected area. This can help better see the bones and may show bone spurs, or any thickening or calcification of your tendon.[9]
    • Your doctor may order an MRI, which will require you to lie inside of a large scanner for a few minutes. An MRI can show how severe the damage is to your tendon and help assess the type of treatment needed.[9] Be aware that an MRI is not necessary to diagnose tendinitis and may only be used for severe cases.[6]
  5. Have medical treatments. If your tendinitis is severe, your doctor may prescribe additional, more involved treatments such as injections, surgery, or physical therapy. These can provide some pain relief and heal the condition.[9]
    • In some cases, your doctor may recommend treatments such as extracorporeal shock wave therapy (ESWT).[11] This uses pressure waves to create a force on your tissues, relieving pain in areas affected by tendinitis.[12] Ultrasound therapy may also be recommended in some cases. Both of these treatments have inconsistent research support.[13]
    • Some studies support the use of acupuncture for tendinitis.[14]
    • A holistic approach that uses medication and physical therapy is likely to be most effective.
  6. Attend physical therapy. Seeing a physical therapist can help strengthen and stretch (improve flexibility) your affected area. It may help alleviate your tendinitis.[9]
    • Studies have shown that eccentric strengthening, which contracts a muscle while it’s lengthening, is especially effective for tendinitis.[9]
  7. Consider cortisone injections in the affected area. If your tendinitis is especially severe, your doctor may consider cortisone injections. Be aware this isn’t a common treatment and could rupture your tendon.[9]
    • Corticosteroids may decrease inflammation and help alleviate pain.[9]
    • Doctors do not recommend cortisone injections for chronic tendinitis, which is a case of tendinitis that last over three months.[9]
  8. Ask about a FAST operation on the affected area. If your tendinitis doesn’t heal after six months of nonsurgical treatment, you and your doctor should consider surgery. The minimally invasive FAST procedure may help completely treat the condition.[9]
    • FAST, or focused aspiration of scar tissue, that uses ultrasound and small instruments to remove tendon scar tissue.[9]
    • FAST has the same effect as an open surgery but doesn’t require hospitalization.[9]
    • The recovery time for FAST is generally 1-2 months.[9]

Tips

  • Light exercise can help reduce stiffness associated with inactivity of the injured area.
  • Platelet rich plasma treatment, or PRP, is an experimental treatment that may help chronic tendinitis.[9] However, studies do not show much promise for this treatment, so it is rarely used.[11][15]

Warnings

  • Do not wrap the injured area too tightly; you may cut off circulation.

Things You'll Need

  • Ice pack
  • A sling or brace
  • Over-the-counter pain medication

Related Articles

Sources and Citations

  1. ↑ 1.0 1.1 1.2 http://www.mayoclinic.org/diseases-conditions/tendinitis/basics/definition/con-20020309
  2. ↑ 2.0 2.1 2.2 2.3 http://www.mayoclinic.org/diseases-conditions/tendinitis/basics/risk-factors/con-20020309
  3. ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 http://www.mayoclinic.org/diseases-conditions/tendinitis/basics/symptoms/con-20020309
  4. ↑ 4.0 4.1 4.2 http://www.rheumatology.org/I-Am-A/Patient-Caregiver/Diseases-Conditions/Tendinitis-Bursitis
  5. ↑ 5.00 5.01 5.02 5.03 5.04 5.05 5.06 5.07 5.08 5.09 5.10 5.11 5.12 5.13 5.14 5.15 5.16 http://www.mayoclinic.org/diseases-conditions/tendinitis/basics/lifestyle-home-remedies/con-20020309
  6. ↑ 6.0 6.1 http://www.orthoinfo.aaos.org/topic.cfm?topic=A00147
  7. ↑ 7.0 7.1 7.2 7.3 7.4 7.5 http://www.mayoclinic.org/diseases-conditions/tendinitis/basics/preparing-for-your-appointment/con-20020309
  8. ↑ https://www.nlm.nih.gov/medlineplus/ency/article/002284.htm
  9. ↑ 9.00 9.01 9.02 9.03 9.04 9.05 9.06 9.07 9.08 9.09 9.10 9.11 9.12 9.13 9.14 9.15 http://www.mayoclinic.org/diseases-conditions/tendinitis/basics/tests-diagnosis/con-20020309
  10. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3495576/
  11. ↑ 11.0 11.1 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4215290/
  12. ↑ http://www.aofas.org/footcaremd/treatments/Pages/Extracorporeal-Shock-Wave-Therapy.aspx
  13. ↑ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505250/
  14. ↑ http://umm.edu/health/medical/altmed/condition/tendinitis
  15. ↑ de Vos RJ, Weir A, van Schie HT, et al. Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 2010; 303:144.
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