What is tendonitis?

Tendonitis is a condition characterized by inflammation, irritation, or swelling of a tendon, the thick fibrous cord that attaches muscle to bone.

Tendonitis often occurs due to repetitive movements, overuse of the tendon, or sudden injury. Common symptoms include pain, tenderness, and swelling around the affected tendon. The pain typically worsens with movement of the affected area and can restrict mobility.

Treatment for tendonitis usually involves rest, icing the affected area, taking anti-inflammatory medications (such as ibuprofen), and sometimes physical therapy to strengthen the tendon and surrounding muscles. In severe cases, corticosteroid injections or surgery may be necessary, although these are less common treatment options.

How is tendonitis diagnosed?

Diagnosing tendonitis typically involves a combination of medical history, physical examination, and sometimes imaging studies. Here's how each component of diagnosis typically unfolds:

·       Medical History: The doctor will begin by discussing your symptoms, including when they started, any activities or movements that worsen the pain, and any previous injuries or conditions that might contribute to tendonitis to better understand your condition.

·       Physical Examination: The doctor will then perform a physical examination to assess the affected area. They may palpate the tendon to check for tenderness, swelling, or warmth, which are common signs of inflammation. They may also test your range of motion and ask you to perform specific movements to see if they exacerbate the pain.

·       Imaging Studies: While not always necessary, imaging studies such as ultrasound or MRI (Magnetic Resonance Imaging) may be ordered if the diagnosis is unclear or if the doctor suspects a severe injury or alternative condition. These imaging techniques can help visualize the tendon, detect any tears or structural abnormalities, and confirm the presence of inflammation.

·       Laboratory Tests: In some cases, blood tests may be ordered to rule out other conditions that could mimic tendonitis or to check for signs of infection or autoimmune diseases.

The diagnosis of tendonitis is often based on the combination of symptoms, physical examination findings, and sometimes imaging studies. It's essential to accurately diagnose tendonitis to tailor appropriate treatment and prevent further injury.

What are the symptoms of tendonitis?

The symptoms of tendonitis can vary depending on the affected tendon and the severity of the condition. However, common symptoms include:

·       Pain: Pain is the hallmark symptom of tendonitis. It usually occurs at or near the tendon affected. The pain may be dull and achy initially but can become sharper with movement or specific activities involving the affected tendon.

·       Tenderness: Tenderness is often present when the affected tendon is touched or pressed. This tenderness is localized to the area around the tendon.

·       Swelling: Inflammation of the tendon can lead to swelling in the affected area. Swelling may be noticeable and can contribute to a feeling of warmth or increased sensitivity.

·       Stiffness: Tendonitis can cause stiffness, especially after periods of rest or immobility. The stiffness often improves with movement but may return after rest.

·       Decreased Range of Motion: Pain and stiffness associated with tendonitis can limit the normal range of motion of the joint or muscle involved. This limitation can affect daily activities and exercise routines.

·       Weakness: In some cases, weakness may accompany tendonitis, especially if the pain and inflammation prevent normal use of the muscle-tendon unit.

·       Crepitus: Occasionally, you may feel or hear a creaking or crackling sensation (crepitus) when the tendon moves.  

The specific symptoms can vary based on factors such as the location of the tendonitis and its underlying cause (e.g., overuse, injury, systemic conditions). It's important to seek medical attention if you experience persistent pain or symptoms suggestive of tendonitis, as early diagnosis and treatment can help prevent further complications.

What are the normal treatments for tendonitis?

The treatment of tendonitis typically focuses on reducing pain and inflammation, promoting healing, and preventing recurrence. Here are the normal treatments for tendonitis:

·       Rest and Activity Modification: Resting the affected tendon is crucial to allow it to heal. Avoiding activities that worsen symptoms or cause pain is essential. Gradual return to activity should be guided by symptoms.

·       Ice Therapy: Applying ice packs to the affected area can help reduce inflammation and relieve pain. Ice should be applied for about 15-20 minutes at a time, several times a day, especially after activities that aggravate symptoms.

·       Nonsteroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation. These should be used according to the instructions and under medical advice, especially for prolonged use.

·       Physical Therapy: A physical therapist can provide exercises and techniques to stretch and strengthen the affected tendon and its surrounding muscles. They may also use modalities like ultrasound or electrical stimulation to aid in healing.

·       Bracing or Splinting: Immobilizing the affected area with a brace or splint may help reduce stress on the tendon and allow it to heal. This is often used temporarily in cases where rest alone is insufficient.

·       Corticosteroid Injections: Injections of corticosteroids directly into the tendon sheath can help reduce inflammation and pain. This treatment is typically reserved for severe cases that do not respond to other treatments.

·       Platelet-Rich Plasma (PRP) Therapy: PRP involves injecting a concentrated solution of platelets from your own blood into the affected tendon. Platelets contain growth factors that can promote healing.

·       Extracorporeal Shockwave Therapy (ESWT): ESWT uses shockwaves to stimulate healing of the tendon. It is sometimes used for chronic cases of tendonitis that have not responded to other treatments.

·       Surgery: In rare cases where tendonitis is severe and conservative treatments have failed, surgery may be necessary to repair the tendon or remove damaged tissue.

The specific treatment plan for tendonitis depends on factors such as the location and severity of the tendonitis, your overall health, and your activity level. It's essential to work with a healthcare provider to develop a personalized treatment approach that addresses your specific needs and promotes effective healing of the affected tendon.

How does acupuncture help tendonitis patients?

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body. While its exact mechanisms are still being researched, acupuncture is believed to stimulate the nervous system and promote the release of natural painkillers like endorphins. Here's how acupuncture may help tendonitis patients:

·       Pain Relief: Acupuncture can help alleviate pain associated with tendonitis. By stimulating specific acupuncture points, it may block pain signals, reduce inflammation, and promote the release of endorphins, which are natural pain-relieving chemicals in the body.

·       Reduced Inflammation: Acupuncture has been suggested to have anti-inflammatory effects. This can be beneficial for tendonitis patients as inflammation is a common contributor to pain and tissue damage.

·       Improved Blood Flow and Healing: The insertion of acupuncture needles may help improve circulation and blood flow to the affected area. Enhanced blood flow can bring oxygen and nutrients to the tendon, which is important for healing.

·       Muscle Relaxation: Tendonitis often involves tightness and muscle tension around the affected tendon. Acupuncture can help relax muscles and reduce stiffness, which may improve range of motion and alleviate discomfort.

·       Complementary Therapy: Acupuncture is often used as a complementary therapy alongside conventional treatments like rest, physical therapy, and medications. It can be integrated into a comprehensive treatment plan to enhance overall outcomes.

It's important to note that while many people find acupuncture helpful for managing pain and promoting healing, its effectiveness can vary from person to person. The evidence supporting acupuncture for tendonitis specifically is still evolving, and more research is needed to fully understand its mechanisms and benefits in this context. If considering acupuncture, it's advisable to consult with a qualified acupuncturist who can assess your condition and provide personalized treatment based on your symptoms and health history.