Tendonitis

Written by Na Hong Wei
Orthopedics
Updated on September 22, 2024
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Tendonitis refers to a sterile inflammation of the tendon itself or its surrounding sheath caused by various reasons. The term "tendonitis" means that, firstly, the affected area is either the tendon or the surrounding tissue. Secondly, it is a sterile inflammation. The causes of tendonitis are generally the following four points: The first point is acute injury. The second point is chronic overuse. The third point is an increased load on the tendon itself, causing some micro-damage inside the tendon. This leads to inflammation due to bleeding and inflammatory irritation in the tendon or around the tendon. The fourth point involves prolonged exercise or excessive exercise load, which then leads to congestive hematoma around the tendon, ultimately leading to inflammation.

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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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How to treat shoulder tendinitis?

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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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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What should I do if my tendinitis is getting more painful?

When patients with tendinitis experience pain, they should first rest and avoid strenuous activities. They can also use non-steroidal anti-inflammatory drugs to relieve pain. These drugs include ointments that can be applied to the affected area, as well as oral medications that can be taken after meals for a short period to reduce inflammation and alleviate pain. Additionally, patients can use treatments such as heat application, physical therapy, and local injections, which can also effectively relieve pain. When conservative treatments are ineffective or if there is a functional impairment due to adhesions of the tendon and surrounding tissues, surgical treatment can be considered.

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What medicine should I take for tendinitis?

Tendonitis is an aseptic inflammatory reaction that occurs at the endpoint of a tendon due to chronic overuse or injury, causing localized pain and restricted movement. For tendonitis, non-steroidal anti-inflammatory drugs can be administered for symptomatic treatment. These drugs can reduce edema in surrounding tissues and decrease the inflammatory response, thus alleviating pain symptoms. Additionally, drugs that promote blood circulation and remove blood stasis can also be used for treatment.