What Is the Best Treatment for Tendonitis (Tendinitis)?

Tendinitis or tendonitis describes inflammation to the fibrous connective tissue of they muscles, most often as a result of work overuse or sports injuries.

Tendinitis (also called tendonitis or tendinopathy) refers to inflammation of a tendon. Tendons are bands of fibrous connective tissue that attach muscle to bone. 

Tendinitis commonly occurs near a joint, such as in the shoulders, biceps, elbows, hands, wrists, thumbs, calves, knees, and ankles. Because tendinitis often results from sports injuries, common names for forms of tendinitis include: 

• Tennis elbow
• Golfer's elbow
• Pitcher's shoulder
• Swimmer's shoulder
• Jumper's knee

Symptoms of tendinitis include: 

• Swelling around a joint 
• Tenderness around a joint 
• Stiffness of the joint
• Pain around a joint
• Pain usually worsens with movement improves with rest or treatment

Symptoms may: 

• Occur suddenly
• Last for days or longer
• Recur in the same body parts

Causes of tendinitis include:

• Sports injuries
  • Tennis
  • Golf
  • Baseball
  • Swimming
  • Basketball
  • Running
  • Bowling
• Repetitive movements
• Poor posture or walking habits
• Stress on soft tissues from an abnormal or poorly positioned joint or bone, such as leg length differences or joint deformities
• Infection
• Arthritis and related conditions
  • Rheumatoid arthritis
  • Osteoarthritis 
  • Gout
• Metabolic conditions, such as diabetes
• Side effects from certain medications 
  • Fluoroquinolone antibiotics
  • Statins

Risk factors for developing tendinitis include: 

• Age
  • As we age, tendons become less flexible and more prone to injury
  • Tendinitis is more common in people over the age of 40
• Occupation -- jobs that involve:
  • Repetitive motions
  • Frequent overhead reaching
  • Awkward positions
  • Vibration
  • Forceful exertion

Tendinitis is diagnosed with a physical exam. To confirm the diagnosis, to determine the extent of the injury, or to rule out other conditions, imaging tests may be indicated, such as:

• X-ray
• Ultrasound
• Magnetic resonance imaging (MRI)

Treatment for tendinitis includes: 

• RICE method: this is the best home treatment for mild injury 
  • Rest: avoid activates that cause or aggravate the injury
  • Ice: helps decrease pain, swelling, and redness
    • If done immediately after the injury, it may prevent some inflammation
    • Use an ice pack or ice wrapped in a towel
    • Apply ice for 20 minutes at a time, several times daily
  • Compression: helps support the injured area and prevent inflammation
    • Use elastic wraps such as Ace bandages
    • Do not wrap too tightly
  • Elevation: keep the injured area propped up above the heart if possible to help reduce fluid buildup in the injured tissue
• Physical or occupational therapy
  • Hot/cold treatments
  • Ultrasound (sound wave)
  • Laser and water therapy
  • Soft tissue or joint mobilization (manual therapy)
  • Orthotics or pressure-relieving devices 
  • Exercise program
  • Analysis of posture and walking
  • Education regarding appropriate activities
  • Assistive devices
  • Modifications for daily activities and work habits to prevent re-injury 
• Splints, braces or slings 
• Pain medicines
  • Acetaminophen (Tylenol)
  • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin) or naproxen (Aleve)
  • Prescription pain medications 
  • Corticosteroids injections
• Surgery
  • Used for tendon ruptures or lesions on the tendons
• Other procedures and treatments
  • Platelet-rich plasma (PRP)
  • Dry needling
  • Ultrasound treatment

Tendinitis is usually an overuse injury, so the best way to prevent it is to avoid or modify the activities that cause it. Other things you can do to help prevent tendinitis include: 

• Gently stretch muscles and tendons with warm-ups before exercise or sports
• Wear proper footwear and use proper equipment for sports and other activities
• Use proper form for sports 
• Increase intensity and duration of activity gradually and stop if you feel pain
• Consult a physical or occupational therapist for suggestions on modifying daily activities