Tendinitis is the painful inflammation of a tendon and its ligaments, which attach it to the bone. It often results from the stress of repetitive movements. Acute tendinitis may become chronic if it is not treated. The areas most commonly affected by tendinitis are the shoulder (rotator cuff tendinitis or impingement syndrome), elbow (tennis elbow or golfer's elbow), wrist and thumb (de Quervain's disease), knee (jumper's knee), and ankle (Achilles tendinitis). Calcific tendinitis, which occurs when calcium deposits build up in a joint, often appears in people with a chronic disease, such as diabetes.

Signs and Symptoms

What Causes It?

Although the exact cause of tendinitis is unknown, it can result from overuse, undertraining, or poor technique in sports, repetitive movement in certain occupations, falling, lifting or carrying heavy objects, and extreme or repeated trauma. It may also be seen with certain inflammatory conditions (for example, Reiter's syndrome, ankylosing spondylitis), autoimmune disorders (for example, diabetes mellitus), and some infections.

What to Expect at Your Provider's Office

Your health care provider will give you a thorough physical examination. X rays may be taken and other diagnostic tests may be performed.

Treatment Options

Your provider may prescribe pain relievers or steroid injections. Treatment also may include ice, rest, or temporary immobilization. Massage, strengthening exercises, or physical therapy help improve tendon use. Ultrasound and use of electricity help to control pain. Surgery is used only for severe tendinitis that is not healing from other treatments.

Drug Therapies

Complementary and Alternative Therapies

Nutrition Herbs
Herbs may be used as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. Homeopathy
Homeopathic remedies for tendinitis include creams or gels. Arnica cream by itself or in combination with Calendula officinalis, Hamamelis virginiana, Aconitum napellus, and Belladonna, applied three to six times a day, speeds healing and decreases discomfort. For acute injuries, always start with Arnica.

Internally, the dose is usually 3 to 5 pellets of a 12X to 30C remedy every one to four hours until the symptoms get better. Physical Medicine Acupuncture
In 1997, the National Institutes of Health reported that acupuncture may be an effective therapy for tennis elbow. In addition, two studies examining the effect of acupuncture on this and other types of tendinitis have found that acupuncture provides better pain relief than placebo.

Acupuncturists report that patients with tendinitis frequently exhibit a primary deficiency in the liver meridian, with a relative excess in the gallbladder meridian. In addition to needling treatment on the liver meridian and the supporting kidney meridian, treatments using moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) may also be included. Needling and/or moxibustion may also be directly applied to painful areas and related sore points.

Although no well-designed studies have examined the effectiveness of chiropractic treatment for tendinitis, chiropractors commonly treat this condition with ultrasound, electrical muscle stimulation, manual trigger point therapy (applying firm pressure by hand on a trigger point for several seconds and then stretching the muscle afterwards), and massage. Joint manipulation may also be performed on individuals with diminished joint mobility.

Following Up

Tendinitis often has three stages: Stage 1 is characterized by a dull ache following activity, which improves with rest; stage 2, by pain with minor movements (for example, dressing); and stage 3, by constant pain.

Special Considerations

Recurrences are common, particularly for athletes and people whose work requires repetitive motions.


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