Tendinitis

Tendinitis is inflammation or irritation of a tendon � any one of the thick fibrous cords that attach muscles to bones. The condition, which causes pain and tenderness just outside a joint, can occur in any of your body's tendons. Tendinitis is common around your shoulders, elbows, wrists and heels.

If tendinitis is severe and leads to the rupture of a tendon, you may need surgical repair. But many times, rest and medications to reduce the pain and inflammation of tendinitis may be the only treatments you need. You can also take preventive measures to reduce your chance of developing tendinitis.

Signs and symptoms

Symptoms of tendinitis that are produced near a joint aggravated by movement include the following:

Pain
Tenderness
Mild swelling, in some cases

Tendinitis in various locations in your body produces these specific types of pain: Tennis elbow. This type causes pain on the outer side of your forearm near your elbow when you rotate your forearm or grip an object.�� Golfer's elbow.� This type causes pain on the inner side of your forearm near the elbow when you grip objects or flex at the wrist.� Achilles tendinitis. This form causes pain just above your heel.� Adductor tendinitis. This type leads to pain in your groin. Patellar tendinitis. In this type, you experience pain just below your kneecap. Rotator cuff tendinitis. This tendinitis leads to shoulder pain.

If the sheath of tissue that surrounds the tendon becomes scarred and narrowed in small joints, such as the

finger, it may cause the tendon to lock in one position, such as occurs in the condition called trigger finger. The pain of tendinitis is usually worse with activities that use the muscle that is attached to the involved tendon.

Causes

Tendons are usually surrounded by a sheath of tissue similar to the lining of the joints (synovium). They're subject to the wear and tear of aging, direct injury and inflammatory diseases. The most common cause of tendinitis is injury or overuse during work or play.

The pain is usually the result of a small tear in or inflammation of the tendon that links your muscle to your bone. Tendinitis can also be associated with inflammatory diseases that occur throughout your body, such as rheumatoid arthritis.

Risk factors

You have a greater risk of developing tendinitis if you perform excessive repetitive motions of your arms or legs.

For instance, professional baseball players, swimmers, tennis players and golfers are susceptible to tendinitis in their shoulders, arms and elbows. Basketball players, runners and dancers are more prone to tendon inflammation in their legs and feet.

But you don't have to be a professional athlete to develop tendinitis. The incidence of tendinitis increases with age as muscles and tendons lose some of their elasticity. Improper technique in any sport is one of the primary causes of overload on tissues, including tendons, which can contribute to tendinitis.

Some common names for various tendinitis problems are tennis elbow, golfer's elbow, pitcher's shoulder, swimmer's shoulder and jumper's knee.

Complications

Tendinitis may become chronic or long term and can lead to the rupture of a tendon. Tendinitis can also

cause permanent damage to the tissue that makes up your tendons.

Sometimes the discomfort of tendinitis disappears within a matter of weeks or months, especially if you rest the involved joint. If you continue to use the affected area while you still have signs and symptoms of tendinitis, the condition often heals more slowly and may progress to a chronic condition termed tendinosis or tendinopathy. This condition may change the structure of the tendon to a weaker, more fibrous tissue.

Treatment

The goals of tendinitis treatment are to relieve your pain and reduce inflammation. Often, home treatment � which includes rest, ice and over-the-counter pain relievers � may be all that you need.

Other treatments for tendinitis include:

Strengthening exercises,�soft tissue therapies, and�physical therapy modalities. People with tendinitis and tendinosis may also benefit from a program of specific exercise designed to strengthen the force-absorbing capability of the muscle-tendon unit.�� Soft tissue therapies, like myofascial release, combined with new technology, such as the Theralase Cold Laser,�has shown remarkable success in treating these injuries.

Corticosteroid injections or topical applications. Sometimes your doctor may inject a corticosteroid medication around a tendon to relieve tendinitis. Injections of cortisone reduce inflammation and can help ease pain. However, there are potential side effects. For example, repeated injections may weaken a tendon, increasing your risk of rupturing the tendon. Also, corticosteroid medications should never be directly injected into the tendon itself because this can contribute to tendon rupture. As an alternative to an injection, a corticosteroid solution can be topically applied to the painful region and drawn in through your skin using a gentle electric current via a process called iontophoresis.

Surgery. Depending on the degree and type of tendon tear, you may benefit from a surgical procedure that can improve tendon health. In certain people, surgeons can repair full-thickness tendon tears to reduce pain and restore function.