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Johns Hopkins Symptoms and Remedies

Johns Hopkins Medicine

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Tendinitis

What is it?

Tendinitis is inflammation of a tendon, one of the fibrous cords that join a muscle to a bone. Injury or repetitive overuse can cause microscopic tears and painful swelling in a tendon. Sites most commonly affected include the shoulder, the elbow (tennis or golfer's elbow), the wrist (de Quervain's tenosynovitis), the fingers (trigger finger), and the ankle (Achilles tendinitis).When the muscles in the affected area are used regularly despite pain, the injured tendon may be slow to heal.While many cases of tendinitis last no more than two weeks and are usually alleviated by rest and proper conditioning, repeated use of the injured tendon may lead to chronic tendinitis, characterized by scarring of the involved tissues and limited flexibility. Those over age 40 are most prone to the chronic form of tendinitis.

What Causes It?

Overuse due to prolonged, repetitive movements as required by tennis, golf, bowling, and certain occupations, like carpentry and painting. * Physical trauma, such as falling on an arm, twisting an ankle, or lifting heavy objects. * Inadequate conditioning or insufficient warm-up prior to exercise. * Degenerative changes owing to aging and years of continual use. * Calcium deposits in a tendon (calcific tendinitis).

Prevention

  • Avoid highly repetitious movements, or interrupt them with activities requiring other muscle groups.
  • Engage in regular, moderate exercise to maintain strength and flexibility.
  • Be sure to stretch and warm up adequately before engaging in exercise or other demanding physical activity.

Diagnosis

  • Patient history including recent physical activity.
  • Physical examination may include palpation (physically touching and manipulating the area) and range of motion tests to determine the area and extent of the injury.
  • Arthrography (injection of a contrast material into a joint to create a clear x-ray image of soft tissues) may be used to identify tendon damage.
  • Ultrasound scans or MRI (magnetic resonance imaging) may be used to identify minor tears.

How to Treat It

  • Rest is essential, although gentle exercise may be advised to prevent stiffness. Slings or splints may be used for a few days to immobilize the injured area.
  • Take over-the-counter anti-inflammatory drugs like aspirin, ibuprofen, or naproxen.
  • Ice packs should be used immediately after an injury to reduce swelling. Do not apply ice to one area for more than 20 minutes at one time. After 72 hours, hot compresses may soothe discomfort and increase blood flow to speed healing.
  • Corticosteroids may be injected directly into the affected area to relieve pain and inflammation (not routinely recommended for Achilles tendinitis, where injections may weaken or rupture the tendon).
  • Surgery to repair the tendon may be required if the tendon is torn.
  • Temporarily switch to low-impact exercise, like bicycling or swimming, if you suspect high-impact exercise is responsible.

When to Call a Doctor

  • Call a doctor if muscle or joint pain persists for more than two weeks and interferes with activities despite treatment with rest and pain relievers.