Tendonitis

Tendonitis General Information

Tendons are parts of the muscle that serve to attach the muscle to the bone, and while the muscle is normally very elastic and soft, the tendons are much denser and stiffer. Due to this rigidity, the tendons are much stronger than regular muscle tissue; however it also makes them prone to low level tearing due to the constant pulling caused by movement. These tears produce the irritation and inflammation known under the generic medical term of Tendonitis (or Tendinitis). Most commonly, this condition occurs as a result of excessive repetitive movements which cause the tendon to gradually become tighter, which eventually leads to the tearing of the fibers. This affection may also result from a sudden, more serious injury and accidents.

Tendonitis may occur as a result of incorrect postures which the individual may assume at home or work; also, poor stretching and warming up before physical exercise or sports may increase the risk for this affection. In some cases, the condition may occur as a result of older anatomical abnormalities, such as abnormal or poor placing of bones or joints that cause stress to soft-tissue structures. Rheumatoid arthritis, psoriatic arthritis, gout, thyroid disorders or abnormal or unusual reactions may also cause this affection. In rare cases, it is possible for this condition to occur due to an infection.

Most commonly, the patient may experience tendinitis in the wrist, elbow, biceps, shoulder, hip, knee, ankle and Achilles. The affected area depends on the part of the body which is most exposed to efforts, or which is affected by the medical condition or accident.

Tendonitis Symptoms

Tendonitis causes a number of signs and symptoms that may be similar to many of the signs and symptoms that are caused by other diseases and affections. As such, it is highly advised that you contact a specialized health care professional in order to determine whether you are indeed suffering from this condition, or if there are other underlining diseases that may cause this reaction. The specialized health care professional may require further testing in order to determine without any doubt the nature of the condition you are suffering from. Once the diagnosis is placed, he or she will also provide you with a treatment plan, as well as with any other procedures and therapies that you may need to follow in order to fully recover.

In most cases, Tendonitis is accompanied by severe pain in the region of the affected tendon. The pain may appear gradually, and eventually build up to severe intensity. If calcium deposits are present, this may serve as an aggravating circumstance to the pain. It is also possible for the pain to appear in sudden intense bursts. In some cases, the pain is also accompanied by a loss of motion in the affected area (adhesive capsulitis).

The severity of the Tendonitis symptoms is proportional to the stress the affected tendon is under. As such, the more tension is applied to the tendon, the more intense the pain becomes. Generally, it is recommended that you avoid any activity which may cause moving or flexing the affected body part.

Tendonitis Treatment

Tendons are very slow to heal from injuries due to their dense, specialized structure and low vascularization. Unfortunately, this also leads to rare cases where the damaged tendons fully recover their initial strength. In most cases, healing occurs by the rapid secretion of type III collagen, a substance which is weaker than the regular tendon tissue; as such, recurrence of the injury is commonly encountered. In most cases, treatment of Tendonitis is mostly palliative. Typically the patient follows a therapy with NSAIDs (non-steroidal anti-inflammatory drugs), coupled with long periods of rest and a gradual return to normal physical activity.

Currently, there are two procedures that are being researched as possible therapies for Tendonitis. These are extracorporeal shockwave therapy and eccentric loading, both of which have shown to be more effective in healing the ruptures than the standard procedure. Apart from these, other alternative therapies include Vitamin E therapy, Nitric Oxide therapy and stem cell injections. The use of inflatable braces has also proven its usefulness in the treatment of Tendonitis. Like eccentric loading, both procedures have proven to be very effective in reducing the pain caused by this affection; however, using both therapies at once did not lead to an increase in effectiveness.

Shock-wave therapy has shown to be very effective in the treatment of calcific Tendinitis, however it did not seem to have any effect on the chronic pain caused by this affection. Most commonly, the results have shown an increase in cell proliferation, leading to increased tissue regeneration. This eventually led to a better reconstruction of the initial tendons than observed in Tendonitis cases treated with the typical therapy. Vitamin E has a positive effect on increasing the fibroblasts’ activity, which in turn stimulates the synthesis of collagen. This leads to an increase of the regeneration speed and capacity, and thus to faster healing.

Nitric oxide has shown to have a positive effect on the tendon’s healing; studies have shown an increase in the tendons’ healing capacities in the presence of nitric oxide, while its absence caused an impairment of the healing capacities. As such, supplementation with arginine may be useful for assisting the healing of the affected tissues – where arginine is the amino acid the body uses to synthesize nitric oxide. In clinical trials, applying patches containing glyceryl trinitrate over the area with increased tenderness has led to a significant reduction in pain and an increase in the strength and motion of the affected tendon.

In cases where Tendonitis has been diagnosed, the patient should discuss with the examining health care specialists the treatment possibilities that are available, taking into account the patient’s general health condition and medical history. The health care professional may then determine what the best therapy for that particular case is, taking into account the patient’s preferences. In some cases, the patient may be able to undergo therapies that are still in the experimental stage, or therapies that have only recently been developed.