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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 Research News:

University of Glasgow: Scientific breakthrough unlocks potential novel tendon therapy
“Tendinopathy is essentially the result of an imbalance between collagen type-1 and type-3 and we have discovered the molecular cause. This breakthrough has allowed us to find a way to alter the levels of collagen type-3 in tendons, with the ultimate aim to get patients with tendon injuries better quicker.”

Biologic augmentation of rotator cuff repair with mesenchymal stem cells during arthroscopy improves healing and prevents further tears: a case-controlled study
“This study showed that significant improvement in healing outcomes could be achieved by the use of BMC (bone marrow concentrate) containing MSC (mesenchymal stem cells) as an adjunct therapy in standard of care rotator cuff repair. Furthermore, our study showed a substantial improvement in the level of tendon integrity present at the ten-year milestone between the MSC-treated group and the control patients.”

Treatment of Lateral Epicondylosis Using Allogeneic Adipose-Derived Mesenchymal Stem Cells: A Pilot Study
“This pilot study on the safety and efficacy of allo-MSC injection for treating chronic LE demonstrated that the intervention was safe and efficacious in improving pain, performance, and anatomical defects for more than a 52-week follow-up period. This is the first clinical study using allogeneic MSCs to treat chronic tendinopathy.”

Cell Therapy Ltd announces positive Phase II clinical trial results of Tendoncel ™, a first-in-class topical regenerative medicine for severe tendon injury
“Patients using the non-invasive Tendoncel ™ topical gel for 21 days experienced a clinically relevant and statistically significant improvement in their tendon injury. Reporting an average improvement of 70% on the DASH disability scale and 74% improvement on the PRTEE scale, Tendoncel’s results exceed those expected of injectable treatments and have the advantage of painless topical application.”

Mechanotherapy: how physical therapists’ prescription of exercise promotes tissue repair
“Mechanotransduction is the physiological process where cells sense and respond to mechanical loads. This paper reclaims the term “mechanotherapy” and presents the current scientific knowledge underpinning how load may be used therapeutically to stimulate tissue repair and remodelling in tendon, muscle, cartilage and bone.”

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