Tendinitis

Diagnosis

Usually, a physical exam alone can diagnose tendinitis. X-rays or other imaging tests might be used to rule out other conditions that could be causing the symptoms.

Treatment

The goals of tendinitis treatment are to relieve pain and reduce irritation. Self-care, including rest, ice and pain relievers, might be all that's needed. But full recovery might take several months.

Medications

Medicines used to treat tendinitis include:

• Pain relievers. Aspirin, naproxen sodium (Aleve), ibuprofen (Advil, Motrin IB, others) or acetaminophen (Tylenol, others) may relieve tendinitis pain. Some of these drugs can cause stomach upset, or kidney or liver problems. Creams containing pain relievers can be applied to the skin. These products can help relieve pain and avoid the side effects of taking these drugs by mouth.
• Steroids. A steroid shot around a tendon might help ease the pain of tendinitis. These shots aren't for tendinitis lasting more than three months. Repeated steroid shots can weaken a tendon and increase the risk of the tendon tearing.
• Platelet-rich plasma. This 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 going on to find the best way to use platelet-rich plasma, it has shown promise in the treatment of many chronic tendon conditions.

Physical therapy

Physical therapy exercises can help strengthen the muscle and tendon. Eccentric strengthening, which emphasizes contraction of a muscle while it's lengthening, is an effective treatment for many chronic tendon conditions.

Surgical and other procedures

In situations where physical therapy hasn't resolved symptoms, your health care provider might suggest:

• Dry needling. This procedure, usually performed with ultrasound to guide it, involves making small holes in the tendon with a fine needle to stimulate factors involved in tendon healing.
• 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, use rest, ice, compression and elevation. This treatment can help speed recovery and help prevent more problems.

• Rest. Avoid doing things that increase the pain or swelling. Don't try to work or play through the pain. Healing requires rest, but not complete bed rest. You can do other activities and exercises that don't stress the injured tendon. Swimming and water exercise may be good options.
• 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 paper cup full of water so that you can hold the cup while applying the ice directly to the skin.
• Compression. Because swelling can cause loss of motion in an injured joint, wrap the area tightly until the swelling stops. Use wraps or elastic bandages.
• Elevation. If tendinitis affects your knee, raise the hurt leg above the level of your heart to reduce swelling.

Although rest is a key to treating tendinitis, not moving joints can cause them to become stiff. After a few days of resting the injured area, gently move it through its full range of motion to keep your joints flexible.

Preparing for your appointment

You might start by talking to your family health care provider. But you may be referred 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:

• Details about your symptoms
• Other medical problems you've had
• Medical problems your parents, brothers and sisters have had
• All the medicines and vitamins you take, including doses
• Questions you want to ask the care provider

For tendinitis, some basic questions to ask include:

• What is the most likely cause of my symptoms?
• Are there other possible causes?
• What tests do I need?
• What treatment do you recommend?
• I have other medical problems. How best can I manage them together?
• Will I need to limit my activities?
• What self-care can I do at home?

What to expect from your doctor

Your provider is likely to ask you questions, such as:

• Where do you feel pain?
• When did your pain begin?
• Did it begin all at once or come on bit by bit?
• What kind of work do you do?
• What are your hobbies? What do you do for fun?
• Have you been instructed in proper ways to do your activity?
• Does your pain occur or worsen during certain activities, such as kneeling or climbing stairs?
• Have you recently had a fall or other kind of injury?
• What treatments have you tried at home?
• What did those treatments do?
• What, if anything, makes your symptoms better?
• What, if anything, makes your symptoms worse?