Tendonitis

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Treatment

Rest is critical for healing tendons. Patients should avoid activities that put pressure or stress on the affected area. In time, the injured joint can be moved slowly and gently to prevent stiffness. A sling, splint, cane, or crutches may be helpful.

Applying ice to the injured area in 20-minute increments several times a day can help reduce pain and swelling. An ice cube can be used to massage the affected area for 3–5 minutes.

In some cases, elastic wraps or Ace bandages can be used to compress the affected area, keep it still, and protect it from further damage and stress. Compression also can help decrease swelling so that motion may be regained more quickly. Swelling can also be reduced by elevating the injured area above heart level.

Medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs; e.g., ibuprofen, aspirin) can alleviate the pain of tendonitis. However, these drugs should not be taken for longer than 7 to 10 days without consulting a physician. NSAIDs can cause stomach pain, ulcers, and rarely, kidney problems.

Cortisone injections are sometimes recommended to reduce pain and inflammation, but results of this treatment are mixed and there are risks involved. Having many injections over time actually can weaken tendons and make them more prone to rupture. Tendon rupture can also occur if the injection mistakenly goes directly into the tendon.

Physical therapy, ultrasound, and electrical stimulation can be used to reduce pain and inflammation. Patients are taught strengthening exercises and to help prevent further injury. Returning to the same activity level as before the injury should be a gradual process.

Researchers are studying other treatment options like acupuncture, low-energy shock wave treatments, and botulinum toxin injections for tennis elbow; however, more analysis is needed.

Surgery may be performed in severe cases of tendonitis that do not respond to other treatment methods, or if bones must be realigned. In some cases, damaged tendons can be removed, allowing healthy tissue to replace them. Serious tendon tears also can sometimes be repaired surgically. Following surgery, patients often have some tenderness in the area for several months.

Cases of tendonitis that do not improve with treatment or that worsen in severity require follow-up care with a physician.

Prevention

Pain that continues for 2–3 weeks should be reported to a qualified health care provider. To help prevent tendonitis, it is important to stretch before activities and "cool down" afterward. Proper posture and body mechanics, core strength training, and varying forms of exercise also may be helpful.

If tendonitis results from improper techniques in sports or other recreational activities, it may help to have a professional instructor evaluate motions and equipment. Golf instructors can advise on the best ways to hold clubs and tennis coaches can observe a player's racket hold. Even the type of racket used and the way it is strung can affect a tennis player's risk for tendonitis.

To avoid putting too much strain and pressure on one area of the body, vary activities instead of focusing on just one. A baseball pitcher might try soccer, for example, or a knitter might take up swimming.

Employees should make sure that their workspaces are designed as ergonomically as possible. For example, office workers can adjust the height of their computer keyboards to prevent wrist strain.

Tendonitis, Treatments, Prevention reprinted with permission from painchannel.com
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