Treating Tendonitis

Tendon inflammation, or tendonitis, is an inflammatory condition characterized by pain, swelling as well as impaired performance. The sites in which tendonitis often occurs include rotator cuff of the shoulder, wrist extensors and flexors, patellar and popliteal tendons and iliotibial band at the knee, insertion of the posterior tibial tendon in the leg and Achilles heel. Tendons are fibrous connective tissues that attach muscles to the bones and basically function to transmit forces from muscles to bones. The pain that occurs in tendon inflammation has been found to worsen especially during the night and especially during movement or activity.

Although the exact etiology for tendonitis is still unknown, many studies claim that this condition is mainly due to overuse. Aging has also been considered as a factor in the occurrence of tendonitis. As the person ages, the tendon as well as other connective tissues, loose its elasticity subjecting it to repeated trauma and injury. It is commonly found in middle adults aging from 35 to 55 years of age.

Other factors attributed to tendon inflammation are physically and psychosocially-related. Physical work-related factors include performing activities intensely, repeatedly, with sustained exertion, with poor body mechanics and when in cold temperatures. Examples of psychosocial factors are monotonous work, time pressure, heavy work load, lack of social support and poor relationship with co-workers and superiors. Other cases of tendonitis are also found in those who are undergoing oral and parenteral fluoroquinolone treatment.

Diagnosing tendon inflammation involves a series of thorough physical assessment with a physician. The signs and symptoms are evaluated if it is indeed tendonitis. Imaging studies are usually not indicated however, in cases that other conditions are suspected, X-rays, Magnetic Resonance Imaging (MRI) and ultrasonography can be very helpful. These diagnostic examinations are also indicated to patients who are poorly coping with the condition or if signs and symptoms are not responsive to usual treatment and management for tendon inflammation.

The goal of treatment for tendonitis is mainly directed to relieve pain. On the first appearance of pain associated with this condition, it is strongly recommended to stop the activity immediately or simply decrease the activity level. It is also very important to apply an ice pack or cold compress on the affected area within 24 to 48 hours. This will reduce or prevent edema or swelling. By minimizing the swelling, the tendon will be able to its normal state and perform its normal functions. The area should also be protected and immobilized through the use of braces, splints, slings and straps. This will allow the damaged tissues to completely heal for itself.

Over-the-counter pain medications are also effective in providing pain relief. Examples of these are non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen, as well as aspirin. When severe pain is experienced, peritendinous lidocaine or steroid injections may also be helpful. Corticosteroids are potent drugs use to relieve pain. It is directly injected into the affected are to provide immediate pain relief. There are also several cases in which the use of low-intensity ultrasound has been useful in alleviating pain.

How to treat tendonitis depends primarily on avoiding and preventing activities that have previously or have known to cause trauma. Strengthening exercises have been found to be very effective in preventing the recurrence of tendon inflammation by enhancing the strength and flexibility of the muscles and the tendons. Repetitive strenuous activities should also be avoided however, in cases when this is not possible, taking frequent breaks should be practiced.