Signs and Symptoms
Tendonitis usually causes:
- Pain near a joint that is worse with activity or when you first start moving
- Tenderness when you press on the tendon
- Mild swelling or warmth
- Stiffness, especially in the morning
- Weakness or pain with certain movements, such as lifting your arm or gripping
Common types include rotator cuff tendonitis in the shoulder, tennis and golfer's elbow, De Quervain's tendonitis at the wrist, patellar tendonitis (jumper's knee), gluteal tendon pain at the hip and Achilles tendonitis at the back of the heel.
What Causes It?
Most tendonitis comes from doing too much, too soon, or from repeating the same motion many times at work, in sports or at home. Poor technique, weak supporting muscles, tight muscles and age-related changes in the tendon all contribute. Long-standing tendon pain often involves wear and breakdown of the tendon fibers rather than true inflammation, which doctors call tendinopathy or tendinosis.
How We Diagnose It at POPB
Your physician asks about your activities and examines the area to pinpoint which tendon is involved. Dr. Adelman uses diagnostic ultrasound in the office to look at the tendon in real time, which can show thickening, tears or fluid. X-ray, and MRI when needed, are also available on site to rule out other problems such as a fracture or arthritis.
Non-Surgical Treatment Options
Most tendonitis responds to non-surgical care:
- Relative rest: reducing the activity that irritates the tendon without stopping all movement
- Physical therapy in our office, especially progressive strengthening (including eccentric exercises) and stretching. Therapists share your chart with your physician.
- Ice, bracing or straps, and short courses of anti-inflammatory medication when appropriate
- Ultrasound-guided injections when appropriate. Cortisone is used cautiously around some tendons because it can weaken them.
- Shockwave therapy or MLS laser therapy for some stubborn cases
- PRP (platelet-rich plasma), prepared from your own blood, for selected long-standing cases. Evidence is still developing, results vary, and it is not FDA-approved for specific tendon conditions.
Surgical Options
Surgery is rarely needed for tendonitis. It may be considered when a tendon has torn or when pain continues after several months of well-done non-surgical treatment. Depending on the location, Dr. Press or Dr. Wolfson can discuss surgical options such as debridement (removing damaged tissue) or tendon repair.
Recovery
Mild tendonitis may settle in a few weeks. Longer-standing tendon pain often takes two to three months or more of consistent strengthening. Returning to full activity gradually helps prevent a flare. Recovery varies with the tendon involved, how long symptoms have been present, and your activity goals.
Insurance and Cost
Office visits, imaging, ultrasound-guided injections and physical therapy are generally covered by Medicare and most commercial PPO plans when medically necessary. PRP and other biologic injections are usually not covered by insurance. Shockwave and MLS laser coverage varies by plan, so ask our team. Tendonitis from repetitive work tasks may be covered by workers' compensation. Our staff verify benefits when you call.
When to Be Seen
Call our office if tendon pain lasts more than two to three weeks, keeps coming back, limits work or sport, or causes weakness.
Seek urgent care if you feel a sudden pop followed by weakness, which can mean a tendon has torn. Go to the emergency room or call 911 if the area becomes hot, red and swollen with fever, which can signal infection.
