• Tendonitis and tenosynovitis


    Painful inflammation of a tendon is called tendonitis, and painful inflammation of the lining of the tendon sheath is called tenosynovitis. Inflammation of both often occurs simultaneously. Normally, tendon fibers merge into muscle fibers and serve as the muscle's attachment (insertion) to bone. The typical muscle has a tendon on each end that attaches to bone and allows the force of the muscle contraction to be transmitted through the tendon to produce movement. Tendonitis may be due to microscopic or partial tearing of the tendon.

    Common signs and symptoms

    • Pain, tenderness, redness or bruising and swelling in the area of injury; severity varies with the extent of inflammation or injury
    • Loss of normal mobility of the injured joint
    • Pain that is worse with contraction of the muscle the tendon is attached to and with motion of the joint it crosses
    • Weakness in the tendon caused by calcium deposits that may accompany tendinitis
    • Most common sites include Achilles tendon, rotator cuff, patellar tendon, peroneal tendons, posterior tibial tendon and biceps tendons


    • Sudden overload of a contracted muscle, overuse, sudden increase or change in activity or strenuous athletic activity
    • Less commonly, a result of a direct blow
    • Poor biomechanics

    Treatment considerations

    Initial treatment consists of ice to relieve pain, stretching of the affected joint, and modification of activity to rest the injured tendon and sheath. A brace, elastic bandage wrapping, splint, cast, or sling may be prescribed to protect affected joint for a short period. Strengthening exercises are prescribed as the tendon inflammation and pain subside. Physical or occupational therapy may be recommended to regain strength and normal use of the joint.

    Surgery may be necessary if the tendinitis or tenosynovitis persists despite adequate conservative treatment and may involve removing chronically inflamed tendon lining or scar tissue within the tendon. Surgery may also be necessary if the tendon is torn. Cortisone injections are sometimes given to reduce the inflammation of the tendon sheath or tissue around the tendon, but never into the tendon. Injections into the tendon may weaken the tendon and result in tendon rupture.

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