Treatment of Tendonitis

Written by Na Hong Wei
Orthopedics
Updated on September 09, 2024
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The causes of tendinitis usually fall into the following three categories: The first is acute injury, commonly referred to as tendon strain. The initial step is to stop any activity, followed by immobilization of the affected tendon area. Immobilization typically involves allowing the part to be completely relaxed, under no pressure, and is usually for a period of three weeks. The second cause is chronic overuse, which is the most common reason for tendinitis. It frequently occurs at sites of bony protrusions or where there is a tunnel, and this can easily lead to constrictive tendinitis. Treatment might start with rest, followed by non-steroidal anti-inflammatory drugs if rest is ineffective. Then, injection treatments are considered, typically around three times; symptoms or pain from tendinitis will significantly reduce or even disappear. If there is no improvement after three injections, a fourth should not be attempted, and surgical treatment to release the tendon and alleviate the constriction may be considered. The last cause is due to a purulent infection. This condition requires symptomatic treatment, initially with antibiotics, followed by cultures and sensitivity tests of the effusion. If the infection occurs adjacent to the tendon or in the tendon sheath, surgery might be necessary to perform drainage again. In summary, the treatment of tendinitis largely depends on the specific cause and involves different approaches.

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Written by Na Hong Wei
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The difference between tendinitis and gout

The difference between tendinitis and gout is significant; these are two completely different diseases, although their symptoms are similar, including redness, swelling, heat, pain, and functional impairment. Tendinitis generally involves the muscles and tendons and is a type of aseptic inflammation caused by various reasons. In contrast, gout is due to abnormal metabolism of purines in the body, leading to the accumulation of gouty tophi in the joints, producing inflammatory symptoms. Therefore, tendinitis and gout are fundamentally different diseases.

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Written by Guan Yu Hua
Orthopedic Surgery
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Why does tendonitis recur?

Tendonitis, if not well-rested, can easily recur. It mostly occurs during activities, work, or exercise, presenting with pain, swelling, and limited mobility. Tendonitis primarily involves the tendons, which are very hard connective tissues connecting bones and muscles. Tendonitis is mainly caused by the excessive use of muscle fibers and repetitive strain leading to degenerative changes in tendon collagen fibers. This accumulation of degeneration in tendon collagen fibers is commonly referred to as tendinopathy. Examples include common types such as Achilles tendonitis, patellar tendonitis, quadriceps tendonitis, or injuries to the rotator cuff, and lateral epicondylitis of the humerus. Long-term repetitive friction and fatigue can easily cause repeated episodes in these areas. Strict immobilization, along with physical therapy, massage, electric stimulation, and heat application can help alleviate symptoms. Additionally, taking blood-activating and pain-relieving medications, and when necessary, undergoing injective treatments can effectively prevent recurrences and promote relief, reducing symptoms.

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Written by Su Zhen Bo
Orthopedics
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What should I do about calcific tendinitis?

In cases of calcific tendinitis, which is a relatively severe form of tendinitis, conservative treatment should initially be considered. It is important to reduce repeated external forces on the tendon area, ensure the area is kept warm, and treatments like small needle-knife loosening, orthopedic herbal fumigation soaking, or combined with physical therapy and electric heating can be used to soften the calcified tendon tissue, which can alleviate clinical symptoms. If the condition does not improve after conservative treatment, or if it recurs, surgical intervention may be considered as the next step. This could involve tendon release surgery or sheathectomy. Early joint movement is necessary after the surgery to avoid joint adhesion.

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Written by Li Jie
Orthopedics
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Which location to massage for tendinitis

Since a tendon is a bundle that extends from the muscle belly and is elongated, during massage, one should not only focus on the painful area but should consider the entire muscle and tendon. Massaging only the painful area is similar to the notion of treating just the head for a headache or just the foot for foot pain. Therefore, when massaging, it is necessary to cover the entire muscle from its origin to its insertion, reaching the painful parts of the tendon. Also, one should avoid rough massage techniques; instead, gentle manipulations are encouraged. Otherwise, it could lead to counterproductive effects and not be beneficial. Gentle massage or heat application are both acceptable methods.

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Written by Na Hong Wei
Orthopedics
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What is tendinitis?

Tendonitis refers to an inflammatory reaction caused by various factors such as over-fatigue, fiber tearing, or other injuries to the tendon and its surrounding tissues. Therefore, tendonitis usually has a cause, commonly seen in acute injuries or chronic strain. The main symptoms are: first, pain, which is often related to movement, intensifies during physical activity and alleviates during rest. Second, there is occasional slight swelling of the joint. Third, persistent pain occurs in bouts. This indicates that after the tendon recovers from an initial injury, persistent pain appears, which eases after rest or treatment but is prone to recurrence. Thus, tendonitis is an inflammation of the tendon and its surrounding tissues, usually a non-bacterial inflammation. If conservative treatment does not improve the condition after 7-10 days, it is recommended to seek medical treatment at a hospital.