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tendonitis

Definition
Tendonitis is inflammation of a tendon. A tendon is a cord or band that connects a muscle to a bone.

What is going on in the body? 
Tendons are usually smooth and strong. With age or overuse, tendons can become worn and weak, leading to tendonitis. Tendonitis occurs most often in the shoulder, elbow, wrist, hip, knee, and ankle.

What are the signs and symptoms of the condition? 
Symptoms of tendonitis include stiffness or pain around a joint, especially with motion. The pain is sometimes worse at night. There may also be tenderness and swelling over the length of the tendon. Occasionally, the tendon can be felt rubbing as it glides back and forth.

What are the causes and risks of the condition? 
Tendinitis is caused by overuse, injury, or ageing. It can be associated with inflammatory diseases that occur throughout the body, such as rheumatoid arthritis. Rarely it is caused by an infection such as gonorrhoea.

What can be done to prevent the condition? 
Excessive repetitive motions should be avoided to prevent tendonitis.

How is the condition diagnosed? 
Tendonitis is usually suspected after observing the signs and symptoms. An X-ray is not often helpful, though ultrasound imaging may be. Although rarely necessary, a special X-ray test known as MRI, or magnetic resonance imaging, can reveal any weakening of the tendon or changes in the tendon sheath or covering.

What are the long-term effects of the condition? 
Tendonitis may become chronic or long-term, and may lead to rupture of the tendon.

What are the risks to others? 
There are no risks to others.

What are the treatments for the condition? 
RICE (Rest, Ice, Immobilisation, and Elevation) is the appropriate treatment for tendonitis. Temporary use of a splint can help rest the tendon.

Non-steroidal anti-inflammatory drugs, or NSAIDs, can also be taken to reduce inflammation, swelling, and discomfort. Occasionally, it is beneficial to inject a corticosteroid into the tendon sheath.

Physiotherapy may also help and includes massage, ultrasound, and stretching and strengthening exercises. It is important to stretch before and after activity.

Although rarely necessary, surgery can be useful. It can clean out the inflammatory tissue from the tendon sheath or relieve pressure on the tendon by removing bone.

What are the side effects of the treatments? 
NSAIDs may cause indigestion, ulcers, or bleeding. They may also affect the kidneys or liver. Surgery and medication injections carry a risk of bleeding and infection.

What happens after treatment for the condition? 
With a return to activity, tendonitis can recur. Prolonged tendonitis in certain areas of the body can lead to rupture of the tendon.

How is the condition monitored? 
Pain and swelling should be monitored and reported to the doctor.

Author: John A.K. Davies, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 21/10/2004
Contributors
Potential conflict of interest information for reviewers available on request
 


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