How is Tendonitis Treated?
Tendons are thick, fibrous bundles of tissue that attach muscle to bone. When a tendon and its surrounding muscle tissue become irritated or inflamed, tendonitis can develop. Tendonitis is often caused by repetitive activities (like swinging a golf club or typing for hours at a time), injuries, or poor posture. It can occur nearly
anywhere in your body, but shows up most frequently at the elbow, wrist, shoulder, ankle, hip or knee. Prompt treatment of tendonitis is important to prevent the pain from becoming chronic or to prevent other physical problems.
The treatment of tendinitis depends upon the severity of the condition. Mild cases caught at an early stage may require little more than rest, ice, and a short course of non-steroidal anti-inflammatory drugs, such as ibuprofen.
More serious or unresponsive cases could require more aggressive action, often by a physical therapist. After ruling out infection (if infection is present, antibiotic treatment may be warranted,) a therapist may use ultrasound treatments to soothe tissues and start breaking up inflammation. He or she may also gently stretch muscles around the irritated tendon, which helps bring more blood into the area, speeding up healing. This is important because connective tissue, like tendons and ligaments, has a very poor blood supply compared to muscles. A fresh supply of blood not only brings oxygen and nutrients to the area, but also removes waste products that build up from the body’s healing process.
Once you are on a good path to recovery, the therapist may work with you to improve your posture and body mechanics to prevent a recurrence. Gentle strengthening exercises for the surrounding muscles not only take some of the load off of the compromised tendon, but could correct any imbalances that might have led to the initial development of tendonitis.
Depending upon the location of the tendonitis, the therapist may recommend a temporary splint or brace to avoid further injury from everyday activities, such as driving, typing, or doing household chores. If the tendonitis is in the lower extremity, other strategies might be required to take weight off of the beleaguered tendon so it can rest. For instance, temporary use of a cane could help ease the burden of tendonitis in a hip or knee, or an orthotic device might be
prescribed to support your foot in cases of tendonitis in the ankle or arch. You may also be advised to modify any activities that could have led to the initial inflammation. For example, if you spend hours at the computer, your therapist might recommend ergonomic changes, like making sure you’re typing with your hands and wrists in a neutral (unflexed) position.
If tendonitis does not respond to common therapies, your doctor or therapist may recommend a corticosteroid injection. Steroid medicines like cortisone are injected into the site of the tendonitis to quickly fight inflammation and ease pain.
In extremely rare circumstances, if the treatment of tendinitis is unsuccessful, surgery might be recommended.
Interview with physical therapist Thomas Kingsley
Photos from Morguefile.com