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A doctor may ask about any symptoms that are being experienced and conduct a physical examination. The doctor may attempt to move the tendon and if the tendon sheath has become inflamed and swollen, a creaky sound could be heard.

If a specific point on the tendon is tender and swollen, this is a high indicator of tendinitis.

if the problem still persists, after attempting rest, applying ice or heat, and over the counter medications, the doctor may recommend additional testing.

A diagnosis can be confirmed by x-ray... if calcium deposits are present around the tendon, this is an indicator of tendinitis.

Other testing methods can be used as well, like an MRI or ultrasound and can confirm any swelling around the tendon sheath.

Treatments

Treatments of Tendon Pain

Treatment options aim to alleviate pain and reduce inflammation.

Some treatment options are:

  • rest
  • applying cold or hot pressure
  • OTC medications
  • using a brace for the joint area

Treatment: Rest

Resting will give the tendon time for the inflammation and swelling to go down. For example if the injury is sports related, a person will need to take adequate time to rest and avoid strenuous activity.

A brace or splint may help reduce movement and allow for recovery.

It's important to note, not resting can lead to further complications.

Treatment: Hot and Cold

An ice pack or heating pad can help relieve swelling and pain in the area.

Ice packs should be applied to the area 10 to 15 minutes, once or twice a day.

As with most ice packs, it's important not to apply directly to the skin... wrap the pack in a towel or purchase a medical grade ice pack.

Taking a warm bath, applying warm/hot towels, or topical medication (like a cream or ointment), can help grant some relief.

Within the first 48 hours, it's best to apply ice treatment. Afterwards, heat treatment can be a better option.

Physical-Therapy-Modalities

Treatment: Pain Relievers

OTC Medication: Pain relievers like ibuprofen have been known to help alleviate tendon pain

Corticosteroid Injections: Injecting around the tendon area can help pain symptoms however, repeat injections may do more harm than good and significantly increase the chance of tendon rupture.

Physical Therapy: Massaging the tendon area may help with pain relief and speed the healing process.

Stretching and Exercise: Much like physical therapy, specific exercises that are designed to strengthen and stretch the tendon and muscle can help with pain.

Treatment: Shock Wave Therapy or Surgery

If soft-treatment fails and symptoms still persist, further action may need to be taken. Extracorporeal shock wave therapy is another treatment option. ESWT sends a shock through the skin and breaks up calcium deposits around the tendon. Alternatively, calcium deposits may be removed surgically.

Untreated tendinitis can result in further complications and potential for tendon rupture. In this case, surgery may be needed.

Prevention, the Ultimate Treatment

Tendinitis is less likely to occur by following some simple strategies.

Exercise: muscle strengthening activities may help prevent tendinitis. Seek help from a medical expert for exercise tips

Stretching & Cooling Down: Always warm up and stretch properly before and after strenuous sporting activities.

Repetitive Movements: Avoid repetitious movements and take a break when needed.

It's best not to stay in an uncomfortable position for prolonged periods of time. Its beneficial to rest and come back to an activity later.

If a job requires repetitive movements, discuss preventative strategies with an employer to reduce risk of injury.

Inflamed tendons and tendinitis have the possibility of tearing which will often require surgery.

Tendon Pain

CHRONIC TENDON INJURY RESEARCH

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Tendinosis Tendonitis Tendinopathy

Tendon Pain: Tendinosis, Tendonitis or Tendinopathy?

There are many tissues in our body that perform different types of jobs. Tendon is one such fibrous band of tissue that helps connect a bone to a muscle. When this tendon tissue is injured, damaged or inflamed it manifests itself in many ways. Doctors give it many names including tendonitis, tendinopathy or tendinosis.

It also is known as tenosynovitis, paratenonitis, or tendon tear or rupture. As a non-doctor, it would be a good idea to have some understanding of these conditions. It will help them to prevent such tendon injuries and also plan the treatment accordingly.

We are happy to share some basic descriptions of the various terms that are used for describing different conditions of the tendon.

Partial & Complete Tendon Ruptures

When a tendon gets torn it is referred to as a rupture. When it is torn in two pieces it is called as complete rupture. If some tendon still remains in place and is intact, it is called partial rupture. There also is a difference between acute and chronic tendon ruptures.

An acute tendon rupture is basically a one-time event and it can result in immediate pain and could also lead to decreased functioning of the affected joint. This may also be followed by bruising and swelling. On the other hand acute rupture is diagnosed and treated within two weeks after it has occurred. Chronic tendon ruptures may occur because of various reasons and a few of them are being listed down here under:

  • Partial rupture worsens over a period of time.
  • Acute rupture that remains untreated for many weeks is also categorized as chronic tendon rupture. The time period could be 4 to 6 weeks and it depends on the tendon.
  • Doctors may suggest surgery or immobilization with a splint or a period of rest when it comes to treating this problem.

What is Tendonosis?

The tissues that connect the muscles to the joints are known as tendons. These tendons are made up of thick and fibrous tendons. Tendonosis or Tendinosis is a condition that is caused by the deteriorating collagen (a type of structural protein) in these tendons.

This condition is usually caused by increased use of tendons. Tendonosis may occur in any part of the body in any of the tendons but the most common tendons where it may occur are:

  • Heel (Achilles tendon)
  • Elbows
  • Wrists
  • Shoulder (rotator cuff)
  • Knees (patellar tendon)

What is Tendonitis?

Let’s start with what is Tendonitis? Tendonitis was previously used to describe almost any type of tendon pain. However, today medical professionals use the term tendonitis to refer to acute inflammation of the tendon. This happens due to small tears. It is actually refers to inflammation and hence tendonitis is referred to inflammation of the tendon.

It manifests itself with some common symptoms like pain that is localized, warmth and swelling. It could be caused because of a sudden and acute injury and it also could be caused by repeated micro-traumas that impact a single tendon or a group of tendons. The inflammation is treated by resting the join that is affected and also by taking over the country NSAIDs or Non-steroid anti-inflammatory drugs. These drugs include naproxen, ipuproven and even diclofenac sodium. It takes several weeks for patients to recover from tendonitis.

According to research, inflammation of the tendon is not very common. Often many people think that they may be suffering from tendonitis which may actually be tendinosis. In fact even chronic tendonitis could lead to a situation known as tendinosis.

Comparisons Between Tendinosis and Tendonitis

Recovery time in case of acute tendinosis could be around 2 to 3 months while in case of tendonitis it could happen between 2 to 3 days. In case of acute tendinosis the recovery time could be between three to six months. However, chronic cases of tendonitis the recovery time is between four to six weeks. Long term prognosis for tendonitis suggests that 99% of cases could see complete recovery. However, in case of tendinosis only 80% cases could see completely recovery.

Treatment goals: For tendonitis the goals are to decrease inflammation. This is possible through rest, and also by use of anti-inflammatory medications for short period of time. The tendon could also be iced intermittently. Use of splint or cast could also be useful. For tendinosis, the objective is to encourage formation of collagen and other proteins. This is done by physical therapy, exercise and surgery is also recommended in some cases.

The long term outlook after surgery is that in almost 95% cases of tendonitis there is completely recovery while it is 70 to 85% in case of tendinosis. We need to also bear in mind that the treatment goals for tendonitis and tendinotis are different and the recovery times therefore are also quite different.

We need to understand that tendinosis is degeneration of the tendon that is non-inflammatory in nature. The degeneration can include some basic changes to the structure as well as composition of the tendon. These changes could be caused because of repeated strain injuries to the tendon where adequate time is not given for healing of the tendon.

Tendinosis-vs-Tendinitis-vs-Tendinopathy
Who-Is-At-Risk

Differences Between Tendonitis & Tendinosis

There are some key difference between tendonitis and tendinosis. Tendinosis could take many months to treat. There are a few experts who believe that there should be different treatment methods for the two conditions. They believe that tendinosis should not depend too much of corticosteroids and NSAIDs.

These drugs could inhibit the normal reconstruction and growth of the tendon and also could weaken its structure. It could lead to long terms healing problems. Tendinosis impacts people who are into high intensity activities and sports and this requires regular and repeated tendon movement.

Ok, so What Is Tendinopathy?

Any problem that involves the tendon is referred to as tendinopathy. Pathy actually is a Greek word and it means disorder or disease. Hence, tendinopathy could be referred to as a disease or disorder of a tendon or a group of tendons. Experts believe that tendinopathy could be an umbrella term that could include all tendon conditions. However, others may use this term to describe a tendon condition that is chronic in nature and it does not heal within a prescribed period of time.

It could be the case of a runner suffering from repeated hamstring tendon strain which does not get resolved properly. In such cases the runner might be diagnosed with a case of tendinopathy. Patients who are being diagnosed with tendinopathy should get specific details of the tendon injuries from doctors.

What is Paratenonitis?

We need to understand that the Achilles tendon is protected and surrounded by a thin sheath of tissue and the same is referred to as paratenon. On the other hand the tendons in the hand and wrists are surrounded by different type of tissue and this is referred to as synovial sheath.

There are certain tendons in the body such as Achilles tendon. When you have inflammation of the paratenon it is referred to as paratenonitis. When the synovial sheath that is surrounding the tendon becomes inflamed the condition is referred to as tenosynovitis.

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