Tendonitis relief pain

by Nathan Wei, MD, FACP, FACR

Nathan Wei is a nationally known board-certified rheumatologist and author of the Second Opinion Arthritis Treatment Kit. It's available exclusively at this website... not available in stores.

Click here: Second Opinion Arthritis Treatment Kit

Tendonitis is inflammation or degeneration involving a tendon (the fibrous structure that joins muscle to bone).

Some tendons move inside a lubricated sheath while other tendons have no sheath.

Those tendons that have a sheath can develop inflammation of the tendon sheath through repetitive motion or trauma. As the sheath becomes more inflamed, it tightens onto the tendon, causing pain.

Tendons without sheaths become injured as a result of degeneration. This condition is referred to as "tendinosis."

Tendonitis or tendinosis can occur as a result of injury, overuse, or with aging as the tendon loses some of its elasticity. It can also be seen in systemic diseases such as rheumatoid arthritis. Tendonitis can occur in any tendon, but some commonly affected sites are the shoulder, the wrist, the heel (Achilles tendon), the knee, the hand, and the elbow.


• pain and tenderness around a joint (hip pain, knee pain, shoulder pain, elbow pain, wrist pain, or pain in other joints) aggravated by movement
• pain increases with activity
• night pain


Shoulder: Rotator cuff tendonosis or bicipital tendonitis (the biceps tendon has a sheath) occurs from repetitive motion
Elbow: Repetitive motion or strain leading to tendonosis of the extensor or flexor tendon bundles (lateral and medial epicondylitis)
Wrist: Repetitive motion leading to Dequervain’s tenosynovitis, a painful tendonitis involving the thumb. Rheumatoid arthritis can cause tendonitis in the wrist and hand. When the fingers are involved, trigger finger may result. The finger catches and there is swelling and pain involving the tendon sheath.
Hip; Tendonosis in the hip usually occurs as a result of repetitive motion.
Knee: Tendonosis involving the patellar tendon results from jumping or running
Ankle and foot: The large Achilles tendon can undergo degeneration and microscopic tears. The danger here is that it may also rupture. Rheumatoid arthritis may affect the tendons in the ankle and foot.

Physical exam will show tenderness along the affected tendon and pain when the muscle to which the tendon is attached is used against resistance.

The goal of treatment is to relieve pain and reduce inflammation.

Rest or immobilization of the affected tendons is helpful for recovery. This may be achieved using a splint, or a removable brace. The application of heat or cold to the affected area will reduce the pain and inflammation. Non-steroidal anti-inflammatory medications (NSAIDs) help to relieve pain in addition to reducing inflammation. Physical therapy modalities such as ultrasound may be helpful. Steroid injections into the tendon sheath can be very helpful in controlling pain and allowing physical therapy to start.

A better approach is to use platelet-rich plasma (PRP) administered by ultrasound guidance. PRP is an ultraconcentrate of blood that contains multiple growth and healing factors and creates new tendon tissue.

Rarely, surgery is needed to physically remove the inflammatory tissue from around the tendon.

After recovery, strengthening exercises for the muscles surrounding the affected tendon may prevent recurrence of the injury.

Symptoms improve with treatment and rest. If the injury is caused by overuse, a change in work habits may be indicated to prevent recurrence of the problem.


• recurrence of tendonitis
• tendon rupture


• avoid repetitive motion and overuse of an extremity
• warm up by stretching first, then exercising at a relaxed pace before engaging in vigorous activity
• keep all your muscles strong and flexible

For more information about tendonitis, visit our sister site:
Tendonitis Tendonitisand PRP.com provides reliable, accurate, and useful information on tendonitis treatment written by a board-certified rheumatologist. Learn more about how to get tendonitis relief using the most up-to-date methods.

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