Tendonitis

Tendonitis happens when tendons, the strong cords of tissue that connect muscles to bones, get inflamed. This inflammation causes pain and swelling outside a joint.

Tendonitis can occur when repetitive motions, stress or repeat injuries irritate a tendon over time. Tendonitis can affect any tendon in the body, but we most commonly treat tendonitis as a sports injury—like tennis elbow, pitcher’s shoulder, jumper’s knee, and achilles tendonitis. When that happens, we’re ready to help you get back in top form, pain-free.

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Many conditions can cause tendonitis

Tendonitis can be caused by strain, injury or too much exercise. Diseases like diabetes and rheumatoid arthritis can also cause tendonitis. It’s a common condition in athletes and in people who perform repetitive motions, and is more common as you get older—tendons become less flexible with age. Sometimes tendonitis is accompanied by tenosynovitis, swelling of the sheath around the tendon.

Tendonitis diagnosis and treatment at UCHealth

If you’re experiencing symptoms of tendonitis like pain, swelling and irritation in or near a joint, see a UCHealth provider. Our specialists successfully treat most cases of tendonitis with rest, physical therapy and medications. We’ll develop a personalized treatment plan with you, based on your injury and activities. We can also perform minimally invasive procedures to treat more severe cases if necessary.

Your UCHealth provider will perform a physical exam to rule out other conditions like arthritis, gout or a strain by looking for these symptoms:

  • Pain in the tendon when moved
  • Swelling in the affected area
  • A “grating” feeling when moving the joint

Typically, tendonitis affects your shoulders, elbows, wrists, knees and heels in certain conditions:

  • Baseball elbow, golfer’s elbow, or medial epicondylitis. Causes pain from the elbow to the wrist on the palm side of the forearm. The pain is caused by damage to the tendons that bend the wrist toward the palm.
  • Calcific tendonitis. Occurs when calcium deposits build up in muscles or tendons.
  • DeQuervain tenosynovitis. A common tenosynovitis disorder, causing swelling in the tendon sheath of the tendons of the thumb.
  • Rotator cuff tendonitis. A shoulder joint injury that causes inflammation of the shoulder capsule and related tendons.
  • Tennis elbow, or lateral epicondylitis. Causes pain to the side of the elbow and forearm along the thumb side of the arm. The pain is caused by damage to the tendons that bend the wrist back and away from the palm.
  • Trigger finger or trigger thumb. A common type of tenosynovitis were it becomes hard to extend or flex the finger or thumb, and it may lock or trigger suddenly.

Your customized treatment plan will include everything you need to heal quickly and thoroughly. This may start with over-the-counter (OTC) anti-inflammatory drugs like aspirin, ibuprofen and naproxen sodium, along with the R.I.C.E. method, which you can do at home:

  • Rest the joint that’s injured
  • Ice to help pain and swelling
  • Compress the joint with a bandage
  • Elevate the joint

When you’re first injured, ice is a better choice than heat for the first three days because it numbs pain and reduces swelling. Ice the area for 15 minutes every four to six hours, using a towel or cloth between the ice and your skin.

After three days, heat may provide better benefit for chronic tendonitis pain because it increases blood flow and relaxes muscles.

Your treatment plan may also include other conservative treatment:

  • Corticosteroid injection. Your doctor injects a corticosteroid medication around the injured tendon to reduce inflammation and ease pain.
  • Physical therapy. A physical therapist teaches you exercises to stretch and strengthen the affected muscle-tendon unit.
  • Platelet-rich plasma (PRP) therapy. A new treatment that uses injections of your own platelet blood cells to speed healing in chronic tendon injuries like tennis elbow.
  • Sports massage is helpful for some joints.

Treatments for chronic tendonitis

For chronic tendonitis that is not responding to treatment, your provider may recommend a minimally invasive procedure:

Dry needling. This procedure involves making small holes in the tendon with a fine needle to stimulate factors involved in tendon healing.

Ultrasonic treatment. This minimally invasive procedure uses a small incision to insert a special device that removes tendon scar tissue with ultrasonic sound waves.

For a serious injury or severe chronic tendonitis, your provider may recommend an arthroscopic or open surgery procedure.

If your case of tendonitis is mild, treatment should get you back in the game in a few weeks.

If you need more serious treatment, it might take a few months before you’re back in top form. But rest assured that we’ll help you get there as quickly as possible.

Orthoinfo: American Academy of Orthopaedic Surgeons. Achilles Tendinitis (https://orthoinfo.aaos.org/en/diseases–conditions/achilles-tendinitis/)

National Center for Biotechnology Information (NCBI): National Library of Medicine. Tendonitis in the upper extremity: Is it a useful or useless diagnosis? (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2691556/)