How to treat tendonitis and strains?

Written by Na Hong Wei
Orthopedics
Updated on September 24, 2024
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How to treat tendinitis and strain? That is, in cases with tendinitis that have also resulted in acute injury, the approach should align with treating acute injuries associated with tendinitis.

Firstly, rest and immobilization. Resting helps to prevent further injury, and immobilization allows joints or tendons time to relax, rest, and repair.

Secondly, apply ice. Ice should be applied to the injured area immediately after the injury. Typically, the first icing lasts for half an hour, followed by subsequent half-hour sessions every three hours, continuing up to 48 hours, after which it should switch to heat application.

Thirdly, immobilize the joint or tendon. Immobilization serves two purposes: first, to prevent the injury from worsening; second, to help prevent further swelling.

Fourthly, the injured limb should be elevated, raised above the level of the heart by 30 degrees.

This is the internationally renowned RICE principle for treating tendon strains and injuries, focusing primarily on four aspects: rest, ice, compression, and elevation.

Other Voices

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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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Can tendinitis be treated with an injection?

Tendonitis can be treated with injections, which provide both anti-inflammatory and pain-relieving effects, often resulting in a very satisfactory therapeutic outcome. However, there are some considerations to keep in mind when performing these injections: First, the injection site must be free of infection and dermatitis; the skin must be clean and intact. Second, it is best to avoid injecting the medication near the attachment points of muscles or tendons on bones. In some cases, such as with femoral condyle osteoarthritis, injections near these points are necessary, but care should be taken not to inject directly into the attachment points to prevent tendon rupture at those sites, which are currently irreplaceable with current scientific techniques. Third, do not exceed three tendonitis injections. Many patients may recover after one or two injections, but some might go for a third if they do not feel significant improvement. If there is no noticeable benefit after three injections, or if the treatment is ineffective, the injection therapy might not be suitable for you, and other treatments should be considered. Therefore, while tendon injections can be an option for tendonitis, it is essential to apply the correct methods.

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Written by Guan Jing Tao
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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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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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How to treat extensor tendinitis of the foot?

For the treatment of extensor tendinitis of the foot, it is firstly important to rest and avoid intense activities to prevent exacerbating the symptoms, and also to avoid exposure to cold. When pain occurs, anti-inflammatory and analgesic medications can be used to alleviate inflammation and pain. Additionally, treatments such as hot compresses, foot baths, and physical therapy can be used to promote blood circulation and improve symptoms. Local block treatments can also be effective in relieving inflammation. When conservative treatments are ineffective or motion is restricted due to tissue adhesions, surgical treatment can be considered.