Tendinopathy
| Tendinopathy | |
|---|---|
| Specialty | Physical medicine and rehabilitation  |
Tendinitis (informally also tendonitis), meaning inflammation of a tendon, is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment.[1] (The suffix -itis denotes diseases characterized by inflammation.) The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper's knee, affecting the patellar tendon).
Types
Tendinitis injuries are common in the upper and lower limbs (including the rotator cuff attachments), and are less common in the hips and torso . Individual variation in frequency and severity of tendinitis will vary depending on the type, frequency and severity of exercise or use; for example, rock climbers tend to develop tendinitis in their fingers or elbows, swimmers in their shoulders. Achilles tendinitis is a common injury, particularly in sports that involve lunging and jumping while Patellar tendinitis is a common among basketball and volleyball players owing to the amount of jumping and landing.[2] A veterinary equivalent to Achilles tendinitis is bowed tendon, tendinitis of the superficial digital tendon of the horse.
Diagnosis
Symptoms can vary from aches or pains and local stiffness, to a burning that surrounds the whole joint around the inflamed tendon. Swelling may happen along with heat and redness, but not in all cases, there may be visible knots surrounding joint. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as muscles tighten from the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain which may contribute to the symptoms. If the symptoms of tendinitis last for several months or longer it is probably tendinosis.
Treatment
Treatment of tendon injuries is largely conservative. Use of non-steroidal anti-inflammatory drugs (NSAIDs), rest, and gradual return to exercise is a common therapy. Resting assists in the prevention of further damage to the tendon. Ice, compression and elevation are also frequently recommended. Physical therapy, orthotics or braces may also be useful. Initial recovery is typically within 2 to 3 days and full recovery is within 4 to 6 weeks.[3] As tendinosis is more common than tendinitis, and has similar symptoms, tendinitis is often initially treated the same as tendinosis. This helps reduce some of the chronic long-term risks of tendinosis, which takes longer to heal.
Steroid injections have not been shown to have long term benefits and are equivalent to NSAIDs in the short term.[4] In chronic tendinitis laser therapy has been found to be better than conservative treatment at reducing pain; however, no other outcomes were assessed.[5]
Research
Autologous blood injection is a technique where the area of tendinitis[dubious – discuss] is injected with the patient's own blood in order to stimulate tendon healing. The procedure does result in a pain flair for several days, as the blood irritates the tendon; however, platelet-derived growth factor, which is contained in platelets, is thought to commence the healing process. The treatment has been tested in two small trials for tennis elbow.[6][7]
In horses
In horses tendinitis is called bowed tendon from the appearance of the affected tendon after it heals without treatment. Mesenchymal stem cells, derived from a horse's bone marrow or fat, are currently being used for tendon repair in horses. [8]
See also
- Repetitive strain injury
- Tendinosis
- Achilles Tendinitis
- Calcific tendinitis
- Orthopedic surgery
- Prolotherapy
- Stenosing tenosynovitis
- Tennis elbow
- Tenosynovitis
- Tension myositis syndrome
References
- ^ Khan, KM (2002-03-16). "Time to abandon the "tendinitis" myth : Painful, overuse tendon conditions have a non-inflammatory pathology". BMJ. 324 (7338): 626–7. doi:10.1136/bmj.324.7338.626. PMC 1122566. PMID 11895810.
{{cite journal}}: Unknown parameter|coauthors=ignored (|author=suggested) (help) - ^ Mayo Clinic (2007). "Patellar tendinitis". Retrieved 2007-06-04.
- ^ Wilson, JJ (2005). "Common overuse tendon problems: A review and recommendations for treatment" (PDF). American Family Physician. 72 (5): 811–8. PMID 16156339.
{{cite journal}}: Unknown parameter|coauthors=ignored (|author=suggested) (help); Unknown parameter|month=ignored (help) - ^ Gaujoux-Viala C, Dougados M, Gossec L (2009). "Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials". Ann. Rheum. Dis. 68 (12): 1843–9. doi:10.1136/ard.2008.099572. PMC 2770107. PMID 19054817.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ "BestBets: Laser therapy in the treatment of tendonitis".
- ^ Edwards SG, Calandruccio JH. (2003). "Autologous blood injections for refractory lateral epicondylitis". J Hand Surg [Am]. 28 (2): 272–8. doi:10.1053/jhsu.2003.50041. PMID 12671860.
- ^ Connell DA, Ali KE, Ahmad M, Lambert S, Corbett S, Curtis M (2006). "Ultrasound-guided autologous blood injection for tennis elbow". Skeletal Radiol. 35 (6): 371–7. doi:10.1007/s00256-006-0081-9. PMID 16552606.
{{cite journal}}: Unknown parameter|month=ignored (help)CS1 maint: multiple names: authors list (link) - ^ Koch TG, Berg LC, Betts DH (2009). "Current and future regenerative medicine - principles, concepts, and therapeutic use of stem cell therapy and tissue engineering in equine medicine". Can Vet J. 50 (2): 155–65. PMC 2629419. PMID 19412395.
{{cite journal}}: CS1 maint: multiple names: authors list (link)
External links
- HealthTouch.com,[dead link] Tendinitis/Bursitis provided by the American College of Rheumatology.