Tendinitis
Overview
A tendon is a thick, fibrous cord that attaches muscle to bones. Tendons and muscles are what allow the body to move.
When a tendon becomes irritated, the condition is called tendinitis. Because tendinitis is associated with overusing a joint, it's sometimes called tennis elbow, golfer's elbow, or swimmer's shoulder. Common joints where tendinitis occurs are the shoulder (rotator cuff tendinitis), elbow or knee (patellar tendinitis). But it can also occur in the hip, heels (Achilles tendinitis) and wrists.
Symptoms
Pain and stiffness around the tendon is the primary symptom of tendinitis. The pain may appear either gradually or suddenly. Sudden discomfort or pain can be associated with calcium deposits affecting the area.
Other symptoms may include:
- Swelling at the affected area
- Limited range of motion at the affected area
- A snapping or catching feeling when the tendon is in motion
Diagnosis
To diagnose tendinitis, a doctor will perform a physical examination and discuss the symptoms since tendons are soft tissues X-rays aren't usually helpful. A doctor may order an X-ray, however, if there might be a chance that another condition is causing the symptoms. A magnetic resonance imaging (MRI) scan can show tears or weakness in the tendon. An MRI is not usually needed, though. If a condition such as rheumatoid arthritis is suspected, a doctor may order a blood test.
Treatment
In many cases, treatment is not needed and the tendinitis goes away when the joint is given rest. Ice and nonsteroidal anti-inflammatory drugs may help reduce the pain and swelling if needed.
In some cases, conservative, non-surgical treatment such as corticosteroids or physical therapy are used. Corticosteroids are injected around a tendon to relieve the pain and swelling. However, this treatment is not often used as there is a possibility of side effects. If these drugs are injected directly into the tendon, they may cause it to rupture. Additionally, getting these shots regularly may weaken the tendon.
For some patients, physical therapy to strengthen the muscles that support the joint and to stretch the tendon may also be helpful.
If the tendinitis is severe, the tendon may rupture or tear. If the tendon becomes scarred, it may catch in the small spaces of a joint. When this happens, the joint locks in one position. An example of this is trigger finger. Then surgery may be needed.
Surgery can be done to repair tears. Sometimes damaged tendons are removed to promote the growth of more healthy tissues. The knowledgeable and highly trained staff at the Cedars-Sinai Department of Rheumatology, the Hand Surgery Program and the Sports Medicine Program will work with each patient to determine the best treatment option.
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