How to treat shoulder tendinitis?

Written by Na Hong Wei
Orthopedics
Updated on September 10, 2024
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Shoulder tendinitis is commonly seen in supraspinatus tendinitis, infraspinatus tendinitis, and long head of the biceps tendinitis. The treatment is mainly conservative. During the acute phase of tendinitis, resting, immobilization, and wearing protective gear are recommended. Secondly, oral intake of non-steroidal anti-inflammatory drugs can be considered. Thirdly, traditional Chinese medicines can be taken orally or applied topically. Fourthly, injection therapy can be considered, which usually has good effects. Fifthly, physical therapy is an option, including heat therapy and microwave therapy, with a special recommendation for shockwave therapy, which is very effective for tendinitis throughout the body. If conservative treatment is ineffective, surgical treatment may be necessary, tailored to the specific tendon involved.

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Written by Na Hong Wei
Orthopedics
1min 38sec home-news-image

What causes tendinitis?

Tendonitis refers to a type of sterile inflammation that occurs in the tendons and surrounding tissues due to various reasons. Its formation typically follows these four causes: First, acute injury, which usually occurs after the tendons are impacted violently, causing tears or ruptures and leading to an inflammatory reaction in the tendon and surrounding area. Second, long-term wear and tear. This is primarily seen in tendons that are repeatedly subjected to abnormal, unhealthy wear and tear, leading to increased tendon burden or instability at the attachment points, which then causes a surrounding inflammatory response. Third, increased tendon load, leading to damage in the tendon itself, and even causing tears and bleeding, forming a reactive inflammation. The final cause is due to excessively long exercise periods or overloading the tendons through exercise, causing tendon congestion and edema, and eventually leading to inflammation. This can occur in individuals who suddenly engage in heavy exercise after a period of inactivity, or athletes who train daily for extended periods without adequate rest, causing the tendons to be under constant stress. Over time, like a bowstring, this can lead to slackening or rupture, causing an inflammatory response around the tendon or in the tendon itself. Thus, tendonitis generally arises from the reasons mentioned above, often seen in chronic strain and improper posture during exercise, and less commonly from acute injuries and increased loads.

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Written by Na Hong Wei
Orthopedics
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Can tendinitis be treated with a cortisone injection?

Can a cortisone injection be used for tendinitis? From a clinical perspective, for tendinitis, other conservative treatments such as physical therapy, massage, and oral medications can be used. When treatments like phototherapy are ineffective or not yielding results, a cortisone injection is certainly an option. As long as it is accurately targeted, the results of a cortisone injection are very satisfactory. In some cases of tendinitis, a cortisone injection can even achieve a curative effect. Thus, after tendinitis, a cortisone injection can definitely be used for treatment.

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Written by Guan Jing Tao
Orthopedics
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Will tendinitis gradually heal by itself?

The answer is negative. Even minor injuries, if not properly addressed and managed, can gradually develop into more severe and chronic diseases. This later affects normal daily life. Tendonitis, for example, is mostly caused by repetitive stretching, severe tearing, or corresponding work-related strain. Therefore, the first step is rest. Additionally, local applications of topical plasters or physical therapies like thermotherapy, acupuncture, and appropriate spectrum treatments can alleviate localized pain and swelling. However, at least two to four weeks of rest is required. After recovery, it is also necessary to avoid repetitive stretching and excessive physical strain to prevent recurrence.

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Written by Na Hong Wei
Orthopedics
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Treatment of Tendonitis

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
Orthopedics
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Symptoms of tendonitis

The symptoms of tendonitis basically come down to three points. First, pain or a fixed tender point, generally located around joints or nearby areas, with severe cases possibly exhibiting numbness or tingling. Second, dysfunction, which is due to the stiffness of the joint associated with pain which limits joint movement, and occasionally there is mild swelling of the joint. Furthermore, if the tendon pain reoccurs from the originally damaged site and continues for a long time or recurs, it can lead to stiffness in the joint, subsequently resulting in limited joint mobility. The third point is the inflammatory response; tendonitis has specific signs of inflammation, including redness, swelling, heat, pain, and dysfunction.