The difference between tendinitis and tenosynovitis

Written by Na Hong Wei
Orthopedics
Updated on September 11, 2024
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Actually, tendinitis and tenosynovitis are essentially two aspects of the same condition. The term tendinitis usually refers to the part where the muscle transitions into the tendon, whereas tenosynovitis generally refers to the fibrous sheath over the tendon surface. Thus, tendinitis and tenosynovitis often coexist; tendinitis can lead to tenosynovitis, and conversely, tenosynovitis can also affect tendinitis, causing or exacerbating it.

Therefore, in clinical practice, there usually is not a clear distinction between tendinitis and tenosynovitis. It is common during surgeries for stenosing tenosynovitis to observe that the tendon is also congested and swollen, and even adhered to the tendon sheath. Thus, tendinitis and tenosynovitis are generally considered the same disease, merely referred to by two different names. However, if strictly distinguished, there is a certain difference, which lies in the location: tendinitis refers to the tendon itself, while tenosynovitis refers to the sheath outside the tendon.

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How to treat tendinitis and synovitis?

How to treat tendinitis and synovitis? Generally, the current approach is to first start with conservative treatments for tendinitis and synovitis. Conservative treatments include acupuncture, massage, physical therapy, topical ointments, and oral medications, all of which can help alleviate the symptoms of tendinitis and synovitis. However, if there is no improvement after more than six months of treatment, or if the symptoms, such as increasing pain, worsen, then a minimally invasive surgery might be necessary to provide relief.

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How long does it take for tendonitis to heal?

Tendons are a type of tough connective tissue that connects muscles to bones. When tendons are subjected to repeated excessive stretching, excessive stimulation, or injury, it can lead to localized pathological changes, causing pain, swelling, and dysfunction at the affected site. This may also involve the tendon sheath that envelopes the tendon, leading to a series of aseptic inflammatory responses, thereby causing dysfunction and a range of symptoms in the affected area. Generally, after sufficient rest, avoiding intense activities, and the appropriate use of anti-inflammatory analgesic drugs, recovery can be achieved in about two weeks.

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Can tendinitis heal on its own without treatment?

Tendinitis is a sterile inflammation of the tendon, manifested as localized fatigue damage to the tendon, which may involve tension, spasm, and adhesion of the tendon. Generally, there is some sterile exudation, and there may be some edema and swelling. Generally, patients with tendinitis are advised to rest initially. Some patients with milder conditions may heal on their own after resting, without treatment. However, for more severe cases, recovery may be slow and less effective if they only rest without treatment. In such cases, treatments like acupuncture, moxibustion, electrotherapy, and application of medicated plasters along with immobilization can generally achieve good results.

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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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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.