Tendinitis, sometimes spelled tendonitis, is the inflammation and swelling of a tendon, the cord that connects muscle to bone. Caused primarily by excessive use, injury or aging, tendinitis can also be found in those with a systemic condition, such as rheumatoid arthritis. Common locations of tendinitis include the elbow, shoulder, wrist and heel. Treatment is relatively simple and involves pain management and reducing swelling.
Primary Treatment
Tendinitis is not a serious condition, and while a severe case or a tear in a tendon may require surgery, the most common method of treatment is over-the-counter pain relievers combined with rest and ice. Non-steroidal, anti-inflammatory drugs, such as ibuprofen, can help alleviate the swelling and pain, while resting the tendon (a brace or a splint can be used to limit mobility) and applying liberal amounts of ice facilitate recovery and help ease swelling, respectively.
Secondary Treatment
Should the tendinitis be severe or not respond to rest, corticosteroids may be recommended by your doctor. Either injected or used as a topical cream, corticosteroids help to reduce swelling and alleviate pain in the inflamed tendon. Given the possibility of the tendon rupturing due to repeated or improper injections, the topical solution is a preferred alternative. After the solution is applied to the skin, a process called iontophoresis is used, utilizing a small electric current to draw the medication from the skin into the tendon.
A study published in the "Annals of Rheumatoid Diseases" concluded that corticosteroid injections were just as effective as over-the-counter, non-steroidal, anti-inflammatory drugs in the treatment of tendinitis. The benefits were short-term, and the study failed to provide evidence of any long-term benefits.
Other Treatments
When the pain becomes less prominent, stretching the muscle every day can help prevent the tendon from becoming too tight. When the pain begins to subside or is entirely gone, add weights to the stretches, eventually graduating to weight lifting. Strengthening the tendons decreases the risk of tendinitis recurring.
Surgery for tendinitis is rare and typically used only in cases where the tendon itself has ruptured. In cases where the swelling is excessive and severe, it is possible to remove the inflamed tissue around the tendon surgically.
Ultrasound therapy may be utilized to treat tendinitis as well. It involves the use of sound waves to break down surrounding scar tissue. It also helps to soften the area, which can increase mobility. A 1999 study published in the "New England Journal of Medicine" concluded that ultrasound therapy on a shoulder suffering from calcific tendinitis (caused by calcium deposits in the tendon) was an effective short-term treatment.
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