| Tendinitis | |
|---|---|
| Classification and external resources | |
| ICD-10 | M77.9 |
| ICD-9 | 726.90 |
| DiseasesDB | 31624 |
| eMedicine | emerg/570 |
| MeSH | D052256 |
Tendinitis (informally also tendonitis), meaning inflammation of a tendon (the suffix -itis denotes diseases characterized by inflammation), is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment.[1] The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper's knee, affecting the patellar tendon).
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Tendinitis injuries are common in the upper and lower limbs (including the rotator cuff attachments), and are less common in the hips and torso. Individual variation in frequency and severity of tendinitis will vary depending on the type, frequency and severity of exercise or use; for example, rock climbers tend to develop tendinitis in their fingers or elbows, swimmers in their shoulders. Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping while Patellar tendinitis is a common among basketball and volleyball players owing to the amount of jumping and landing.[2] A veterinary equivalent to Achilles tendinitis is bowed tendon, tendinitis of the superficial digital tendon of the horse.
Symptoms can vary from aches or pains and local stiffness, to a burning that surrounds the whole joint around the inflamed tendon. Swelling may happen along with heat and redness, but not in all cases, there may be visible knots surrounding joint. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as muscles tighten from the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain which may contribute to the symptoms. If the symptoms of tendinitis last for several months or longer it is probably tendinosis.
Treatment of tendon injuries is largely conservative. Use of non-steroidal anti-inflammatory drugs, rest, and gradual return to exercise is a common therapy. Resting assists in the prevention of further damage to the tendon. Ice, compression and elevation are also frequently recommended. Physical therapy, orthotics or braces may also be useful. Initial recovery is typically within 2 to 3 days and full recovery is within 4 to 6 weeks.[3] As tendinosis is more common than tendinitis, and has similar symptoms, tendinitis is often initially treated the same as tendinosis. This helps reduce some of the chronic long-term risks of tendinosis, which takes longer to heal.
Steroid injections have not been shown to have long term benefits and are equivalent to NSAIDs in the short term.[4] In chronic tendinitis laser therapy has been found to be better than conservative treatment at reducing pain; however, no other outcomes were accessed.[5]
Autologous blood injection is a technique where the area of tendinitis is injected with the patient's own blood in order to stimulate tendon healing. The procedure does result in a pain flare for several days as the blood irritates the tendon; however, platelet-derived growth factor, which is contained in platelets, is thought to commence the healing process. The treatment has been tested in two small trials for tennis elbow.[6][7]
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