Information From Your Health Care Provider

TENDINITIS & TENOSYNOVITIS

Basic information

description

Tendinitis is an inflammation of a tendon. Tenosynovitis is an inflammation of the protective covering (tendon sheath) around a tendon. They often occur at the same time. Tendons are made up of tough, fibrous, cord-like tissue. They connect muscles to bones.

FREQUENT SIGNS & SYMPTOMS

Limited movement, tenderness, pain, and swelling around the inflamed tendon. Common sites are the shoulder, elbow, Achilles' tendon (heel), or hamstring.
Weakness in the tendon caused by calcium deposits that often accompany tendinitis.

causes

Inflammation or a small tear in a tendon. The tendons become inflamed for a variety of reasons. Inflammation is a reaction of the body's tissues to injury, infection, or irritation. The four signs of inflammation are redness, swelling, heat, and pain.

risk increases with

Injury or overuse, usually from an athletic activity, exercising, or during work.
Incorrect movement and strain during activity. For example, repeatedly holding and swinging a tennis racket incorrectly may cause tendinitis at the elbow (tennis elbow).
Certain joint diseases (rheumatoid arthritis, scleroderma, gout, and Reiter's disease).
Aging (tendons are more prone to injury).

PREVENTIVE MEASURES

Gradually build up the intensity and frequency of an activity.
Avoid overuse of muscles and tendons. Maintain strength and flexibility. Warm up before each workout and stretch afterwards.
Learn the proper techniques for any exercise or sport you intend to do regularly.
Wear proper gear for any sport or exercise activity including well-fitting shoes.

expected outcomes

Usually curable with treatment and rest of the affected tendon area. Pain and swelling usually decrease in a few days. Allow 6 weeks for complete healing.

possible complications

Chronic disability.
Tendon rupture.
Frozen shoulder.

diagnosis & treatment

general measures

Many cases of tendinitis are self-treated.
See your health care provider if symptoms persist or are more severe. A physical exam of the affected area will be done and questions asked about your symptoms and activities. X-rays do not show tendon problems, but they may be done to rule out a fracture, if an injury occurred.
Treatment may involve rest, ice or heat, drugs, range-of-motion exercises, and steps to prevent recurrence.
When resting, sleeping, or sitting, place the injured area on a pillow—at or above heart level.
Wrap the area in a compressive (Ace) bandage to reduce swelling.
Apply ice packs to the affected area. Do this several times a day for the first 24 to 48 hours. Then apply them twice a day until pain is gone. You can apply heat if it feels good. Take hot showers, soak in a warm bath, apply warm compresses, or use a heating pad.
You may want to use a sling or splint for an arm or shoulder to limit movement. Use crutches, a cane, or a brace for affected leg, knee, or heel, if needed.
Surgery may be recommended in chronic tendinitis.

medications

Use nonprescription nonsteroidal anti-inflammatory drugs and pain relievers such as ibuprofen.
Steroid injection for painful tendons may be prescribed. This reduces pain and inflammation and allows movement. Injections are done just a few times because steroids can weaken the tendon.

activity

Resume normal activities as symptoms improve.
After a few days, begin range-of-motion exercises to prevent stiffness in the area. Do them 3 to 4 times a day.
Physical therapy may be recommended.