Treatment of Tendinitis

Tendons are tissues which connect muscles to bones.  They aid in joint mobility and stability. Tendinitis, or Tendinopathy, is inflammation of various tendons, are common and can occur throughout the body. This condition can lead to chronic pain with loss of functioning and disability.  

The most common areas where tendinopathy occurs include the elbows (lateral epicondyle), shoulders (supraspinatus), knee (medial and lateral collateral ligaments) and feet (plantar fascia).  

Causes of tendinitis may include an acute injury such as from trauma (ie motor vehicle accidents, sports injuries), repetitive injury (examples include tennis elbow, foot strain from walking etc), or daily activities (knee and hip joint tendinitis).

Treatment of tendinitis begins with conservative therapy.  This can include ice application (for the first few days to reduce inflammation), heat application (thereafter to reduce spasm and induce muscle relaxation), topical and/or oral anti-inflammatory medication, and a physical therapy program.

Should symptoms persist, injection therapy may be indicated.  Cortisone injections are the most common type of injection for these conditions.  However, cortisone has been associated with weakening of tendons. Some simple non-corticosteroid injections do exist.  My other blog titled “Alternatives to Steroid Injections” link: Click here discusses these.

For conditions which are refractory to these treatments, there is a relatively new therapy, called Tenex TM, which is a percutaneous tenotomy that may be extremely beneficial.  It utilizes ultrasound frequency combined with fluid lavage to debride (removing) and remove affected tissue.  It does this without disturbing surrounding healthy tissue. This is the most advanced non-surgical treatment available.  It can be used to treat such conditions involving the shoulder, elbow, hands, hips, knees, and ankles. Any pain in the body due to tendinitis may be treated with this therapy.  

Lastly, after a Tendinotomy, I have performed Platelet Rich Plasma treatments to the affected area, if warranted, to help regenerate new healthy tissue.  Platelet-rich plasma click here treatments are one type of regenerative therapy which helps utilize the bodies own healing mechanism to regenerate healthy tissue.

In conclusion, tendinitis is a very common condition which can inflict most people at some time in their lives.  It can interfere with one’s ability to participate in sports, or even perform basic daily activities. Many effective therapies exist which can permanently treat the condition.  The interventional therapies discussed here are quick, simple and safe, and all are done as an outpatient procedure, with little to no downside. The goal as always is to treat the condition leading to permanent relief and avoiding surgery.

Author
Dr. Todd Koppel

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