Tendinitis

Also known as tendonitis

Tendinitis is a general term for inflammation of the tendons – chords of fibrous connective tissue that connect muscle to the bone. It produces pain and tenderness near a joint.

Tendinitis is often caused by an overuse injury brought on by a specific motion that is either repeated often or with effort. While tendons are found throughout the body, tendinitis is most common around your shoulders, elbows, wrists, knees and heels.

Some common names of tendinitis affecting different areas include:

  • Tennis elbow.
  • Pitcher's shoulder.
  • Swimmer's shoulder.
  • Jumper's knee.

Most cases of tendinitis can be successfully treated with rest, physiotherapy and pain medications. In severe cases, the tendon may rupture and will need to be surgically repaired.

Symptoms & diagnosis

Tendons are responsible for the smooth gliding motion of muscles and joints. When they are inflamed or damaged, pain or reduced movement occurs at the affected area. Typical symptoms of tendonitis include:

  • pain
  • swelling
  • stiffness and restricted mobility at the affected joint
  • muscle weakness
  • the skin over the affected area may feel warm to the touch

To diagnose tendinitis, your doctor will ask you questions about your symptoms and conduct a physical examination. Imaging studies, such as x-rays and MRIs, are usually not necessary, but sometimes used to rule out other bony issues.

Treatment

Tendinitis responds well to R.I.C.E (rest, ice, compression and elevation).

R.I.C.E

Rest Rest the joint and avoid activities that cause pain (e.g. tennis if you have tendinitis of your elbow or shoulder, kneeling if you have tendinitis of your knee)
Ice Apply ice (for 20 minutes every one to two hours at first) to help decrease the inflammation and swelling. This speeds up healing

Anti-inflammatory medications (gel or tablets) can also help, but can have side effects
Compression Compression (with supportive bandages or wraps) 
Elevation Holding the leg, hand or arm in a raised position also help

Not getting better?

If the symptoms do not settle with these measures, see your doctor, nurse or a physiotherapist. Sometimes other treatments are needed.

Other treatments include:

  • splinting – this needs supervision because if held for too long joints can become stiff
  • cortisone injections – cortisone is a powerful anti-inflammatory medication which can be injected directly to the site of inflammation. Not all types of tendinitis are helped by cortisone injections and there can be side effects so discuss with your doctor first
  • ultrasound
  • physical therapy
  • surgery.

Once the inflammation and pain have decreased, specific exercises are needed to make the tendon strong and avoid further problems.

Prevention

Tendinitis can be avoided by increasing activity levels slowly.

  • If you are starting a new exercise programme, start low, and go slow.
  • Build up repetitions, weights or total time gradually.
  • Stop and review if pain occurs.

Get expert help if you experience recurrent pain or problems.

Learn more

Achilles tendinitis  Mayo Clinic, Mayo Foundation for Medical Education and Research, 2015
Diagnosis and treatment of biceps tendinitis and tendinosis American Academy of Family Physicians, 2009
Jumper's knee  Kids Health from The Nemours Foundation, USA
Rotator cuff problems  Medline Plus, USA, 2013
Achilles tendinitis American Academy of Orthopedic Surgeons, 2010

Credits: Written by Dr J Bycroft for Health Navigator Jan 2015.. Last reviewed: 29 Jan 2015