Usually, your doctor can diagnose tendinitis during the physical exam alone. Your doctor may order X-rays or other imaging tests if it's necessary to rule out other conditions that may be causing your signs and symptoms.
The goals of tendinitis treatment are to relieve your pain and reduce inflammation. Often, taking care of tendinitis on your own — including rest, ice and over-the-counter pain relievers — may be all the treatment that you need.
For tendinitis, your doctor may recommend these medications:
- Pain relievers. Taking aspirin, naproxen sodium (Aleve) or ibuprofen (Advil, Motrin IB, others) may relieve discomfort associated with tendinitis. Topical creams with anti-inflammatory medication — popular in Europe and becoming increasingly available in the United States — also may be effective in relieving pain without the potential side effects of taking anti-inflammatory medications by mouth.
- Corticosteroids. Sometimes your doctor may inject a corticosteroid medication around a tendon to relieve tendinitis. Injections of cortisone reduce inflammation and can help ease pain. Corticosteroids are not recommended for tendinitis lasting over three months (chronic tendinitis), as repeated injections may weaken a tendon and increase your risk of rupturing the tendon.
- Platelet-rich plasma (PRP). PRP treatment involves taking a sample of your own blood and spinning the blood to separate out the platelets and other healing factors. The solution is then injected into the area of chronic tendon irritation. Though research is still underway to determine optimal uses, concentrations and techniques, PRP injection in the region of chronic tendon irritation has shown promise in the treatment of many chronic tendon conditions.
You might benefit from a program of specific exercise designed to stretch and strengthen the affected muscle-tendon unit. For instance, eccentric strengthening — which emphasizes contraction of a muscle while it's lengthening — has been shown to be a very effective treatment for many chronic tendon conditions, and is now considered first line treatment.
Surgical and other procedures
In situations where physical therapy hasn't resolved symptoms, your doctor might suggest:
- Dry needling. This procedure involves making small holes in the tendon with a fine needle to stimulate factors involved in tendon healing.
- Ultrasonic treatment. This minimally invasive procedure uses a small incision to insert a special device that removes tendon scar tissue with ultrasonic sound waves.
- Surgery. Depending on the severity of your tendon injury, surgical repair may be needed, especially if the tendon has torn away from the bone.
Lifestyle and home remedies
To treat tendinitis at home, R.I.C.E. is the acronym to remember — rest, ice, compression and elevation. This treatment can help speed your recovery and help prevent further problems.
- Rest. Avoid activities that increase the pain or swelling. Don't try to work or play through the pain. Rest is essential to tissue healing. But it doesn't mean complete bed rest. You can do other activities and exercises that don't stress the injured tendon. Swimming and water exercise may be well-tolerated.
- Ice. To decrease pain, muscle spasm and swelling, apply ice to the injured area for up to 20 minutes several times a day. Ice packs, ice massage or slush baths with ice and water all can help. For an ice massage, freeze a plastic foam cup full of water so that you can hold the cup while applying the ice directly to the skin.
- Compression. Because swelling can result in loss of motion in an injured joint, compress the area until the swelling has ceased. Wraps or compressive elastic bandages are best.
- Elevation. If tendinitis affects your knee, raise the affected leg above the level of your heart to reduce swelling.
Although rest is a key part of treating tendinitis, prolonged inactivity can cause stiffness in your joints. After a few days of completely resting the injured area, gently move it through its full range of motion to maintain joint flexibility.
You can also try over-the-counter medications — such as aspirin, ibuprofen (Advil, Motrin IB, others), naproxen sodium (Aleve) or acetaminophen (Tylenol, others) — in an attempt to reduce the discomfort associated with tendinitis.
Preparing for your appointment
You may initially discuss your signs and symptoms with your family doctor, but you may need referral to a specialist in sports medicine or rheumatology — the treatment of conditions that affect the joints.
What you can do
You may want to write a list that includes:
- Detailed descriptions of your symptoms
- Information about medical problems you've had
- Information about the medical problems of your parents or siblings
- All the medications and dietary supplements you take
- Questions you want to ask the doctor
For tendinitis, some basic questions to ask your doctor include:
- What is the most likely cause of my symptoms?
- Are there any other possible causes?
- Will I need to have any tests done?
- What treatment approach do you recommend?
- I have other medical problems. How best can I manage them together?
- Will I need to limit my activities?
- Are there any self-care measures I can try?
- Do you have any brochures or other printed material I can take with me? What websites do you recommend for information about my condition?
What to expect from your doctor
During the physical exam, your doctor will check for points of tenderness around the affected area. The precise location of your pain can help determine if it's caused by other problems.
Your doctor will also move your affected joint into different positions to try to replicate your signs and symptoms.
Questions your doctor may ask include:
- Where do you feel pain?
- When did your pain begin?
- Did it begin suddenly or occur gradually?
- What kind of work do you do?
- What hobbies or recreational activities do you participate in?
- Have you been instructed in proper technique for your activity?
- Does your pain occur or worsen during certain activities, such as kneeling or climbing stairs?
- Have you recently experienced a fall or any other kind of injury?
- What kind of treatments have you tried at home?
- What effect did those treatments have?
- What, if anything, appears to improve your symptoms?
- What, if anything, seems to worsen your symptoms?
Dec. 14, 2017