Tendinitis is inflammation of the tendon, which is the sharp end of the muscle that attaches to the bone. Tendons work whenever muscles contract and bones are moved. Therefore, tendonitis often occurs because the tendons are overused, for example performing repetitive movements while working. Theoretically, tendonitis can affect any tendon, but inflammation is common in the wrist, elbow, shoulder, hip, and heel (achilles tendon). Occasionally, tendinitis causes severe pain and difficulty moving. These complaints can be resolved within a few weeks with home remedies. However, tendonitis sometimes becomes chronic and requires medical treatment.
Step
Part 1 of 3: Using Practical Therapy
Step 1. Do not overuse the tendons/muscles
Sometimes, tendons suddenly become inflamed from an injury, but tendonitis is more often triggered by small, repetitive movements over a period of days, weeks, or months. Repetitive motion places tension on the tendon, resulting in minor tearing and localized inflammation. Treat tendonitis by figuring out the movement that triggered it and don't do it (at least for a few days) or modify the movement. If the trigger for tendonitis is work-related, discuss with your boss about temporarily rotating duties. If the tendonitis is caused by exercise, you may be overexerting yourself or performing the movement with the wrong posture/technique. Therefore, consult a professional fitness trainer.
- Playing tennis or golf excessively is a major cause of tendinitis in the elbow joint, hence the terms "tennis' elbow" and "golfer's elbow".
- If you have time to rest, acute tendonitis can heal on its own, but if left unchecked, the problem is more difficult to overcome because the tendonitis becomes chronic (prolonged).
Step 2. Use a bag filled with ice to compress the inflamed tendon
The main cause of pain from tendonitis is inflammation as the body's mechanism to restore and protect injured tissue. However, the inflammation is sometimes so severe that the tendon becomes more problematic. One of the best ways to deal with this problem is to relieve inflammation, such as compressing the tendon with a bag filled with ice or frozen vegetables. In addition to reducing inflammation, this method can relieve pain. Perform therapy by cooling the tendon every few hours until the pain and inflammation are resolved.
- If the inflammation occurs in the tendons/small muscles under the skin tissue (eg in the wrist or elbow), apply cold compresses for about 10 minutes. If the inflammation is in a large tendon/muscle or is in a rather deep position, apply the compress for about 20 minutes.
- When compressing, bandage the tendon that is being compressed with a bag filled with ice using a Tensor or Ace bandage and then raise it to a higher position than usual. Both methods are very useful in overcoming inflammation.
- Don't forget to wrap the ice cube bag with a thin cloth before using it for compressing to prevent negative effects, such as skin damage or frozen skin cells due to prolonged exposure to cold objects.
Step 3. Take anti-inflammatory drugs
Another way to treat inflammation from tendonitis is to take over-the-counter non-steroidal anti-inflammatory drugs, such as aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve). These drugs are able to control inflammation so that swelling and pain are reduced, but are harmful to the stomach (and have a mild effect on the kidneys and liver). So, do not take the drug for more than 2 weeks.
- In addition to taking medication, apply an anti-inflammatory/pain-relieving cream or gel on inflamed tendons, especially those under the skin, as they are easier to absorb and more effective.
- Do not use pain relievers (acetaminophen) or muscle relaxants (cyclobenzaprine) because they are not used to treat inflammation.
Part 2 of 3: Using Temporary Therapy
Step 1. Perform a light stretch on the inflamed tendon
Mild to moderate tendonitis and muscle stiffness can be treated with stretching to relieve tension in the muscles, which improves blood flow, increases muscle flexibility, and widens the range of motion. Stretching can be used as a therapy to treat acute tendonitis (as long as the pain or inflammation is not severe), chronic tendonitis, and prevent tendonitis. As you stretch, move slowly and then hold for 20-30 seconds. Stretch 3-5 times a day, especially before and after high-intensity exercise.
- To treat chronic tendonitis or prevent muscle injury, apply warm compresses to the area of the body you want to stretch to make the muscles and tendons flexible and ready to stretch.
- Pain from tendonitis usually gets worse at night and after a lot of movement or exercise.
Step 2. Wear a splint to support the muscle
If the tendonitis occurs in the knees, elbows, or wrists, we recommend wearing a flexible neoprene arm sling or nylon/velcro bandage to protect the affected body part and limit movement. Wearing an arm sling or splint also makes you feel more comfortable and reminds you not to push yourself at work or exercise.
- Don't leave the inflamed tendon completely motionless. Tendonitis can be cured if the tendons, muscles, and joints are kept moving so that blood circulation in the problem area remains smooth.
- In addition to wearing a sling / bandage, use ergonomic furniture according to the size and shape of the body when working. If necessary, adjust the position of the chair, keyboard, and desktop to prevent excessive stress on joints and tendons.
Part 3 of 3: Using Professional Therapy
Step 1. Consult a doctor
If the tendonitis doesn't go away and home remedies don't help, see a doctor for a checkup. Usually, doctors use tools, such as ultrasound or MRI to find out how severe your tendonitis is and then suggest treatment options. If the tendon separates from the bone (breaks), the doctor will refer you to an orthopedic surgeon as a person who is competent in determining whether or not surgery is necessary. If the problem is not too severe, rehabilitation and/or steroid injections are usually quite effective.
- Surgery to treat severe tendonitis is often performed by inserting a very small camera and equipment through an incision as close as possible to the joint or area that needs treatment.
- Chronic tendonitis can be cured by the focused aspiration of scar tissue (FAST) method, which is minimally invasive surgery to remove torn tissue without irritating normal tissue.
Step 2. Ask for referrals for rehabilitation
If you have chronic tendonitis that is not too severe, your doctor will usually recommend that you undergo rehabilitation, such as physiotherapy. A physical therapist can help you manage tendonitis and problems with the surrounding muscles by showing you how to practice stretching and strengthening muscles. For example, eccentric strengthening by contracting the muscles/tendons while being stretched is beneficial for chronic tendonitis. In general, physiotherapy to treat chronic tendonitis needs to be done 3-4 times a week for 6-8 weeks.
- Physical therapists are also able to treat inflammation of the tendons using ultrasound or microwaves which have been proven to be effective in healing inflammation and stimulating tendon/muscle recovery.
- Some physical therapists (and other health care professionals) use low-energy (infrared) light waves to reduce inflammation and pain caused by mild to moderate musculoskeletal injuries.
Step 3. Take advantage of steroid injections
If needed, the doctor will suggest steroid injection therapy into or near the inflamed tendon. Steroids, such as cortisone, are very effective at reducing inflammation in a short period of time, thereby reducing pain and restoring joint mobility (at least temporarily), but there are risks to be aware of. Occasionally, the injured tendon becomes so weak that it tears after a corticosteroid injection. Therefore, corticosteroid injections to treat tendinitis should not be repeated for more than 3 months because this makes the tendons more prone to tearing.
- Steroid injections are useful for temporary pain relief, but should not be repeated.
- In addition to weakening the tendon, steroid injections can trigger infection, muscle atrophy around the injected tendon, nerve damage, and lowered immunity.
- If the tendonitis does not heal with steroid injections, especially after being supported by physiotherapy, you should consider the option of having surgery.
Step 4. Ask your doctor about platelet-rich plasma (PRP) therapy
This therapy is relatively new and is still under research. PRP therapy involves taking a patient's blood sample and rotating it with a machine to separate the platelets and various healing components from the red blood cells. Then, the plasma mixture is injected into the chronically inflamed tendon. This therapy is proven to reduce inflammation and accelerate the healing of muscle/tendon tissue.
- If necessary, PRP therapy has no side effects so it is much better than corticosteroid injections.
- As with any invasive therapy, there is always a risk of infection, profuse bleeding, and/or scarring.
Tips
- Smoking inhibits blood circulation so that muscles, tendons, and other tissues are deprived of oxygen and nutrients. So don't smoke!
- It is easier to prevent than to treat tendonitis. Don't push yourself if you've just started exercising or taking on a new task at work.
- If your muscles or tendons are sore from exercise or certain activities, choose other options to stay in shape. A variety of physical exercises, such as cross-training, can prevent tendonitis triggered by repetitive motion.
