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Tendinitis

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Tendinitis
Classification and external resources
ICD-10 M77.9
ICD-9 726.90
eMedicine emerg/570 
MeSH D052256

Tendinitis (informally also tendonitis), meaning inflammation of a tendon (the suffix "itis" means "inflammation"), is a type of tendinopathy often confused with the more common tendinosis, which has similar symptoms but requires different treatment.[1] The term tendinitis should be reserved for tendon injuries that involve larger-scale acute injuries accompanied by inflammation. Generally tendinitis is referred to by the body part involved, such as Achilles tendinitis (affecting the Achilles tendon), or patellar tendinitis (jumper's knee, affecting the patellar tendon).

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[edit] Diagnosis

Swelling in a region of inflammation or partial tear can be detected visually or by touch. Symptoms can vary from an ache or pain and stiffness to the local area of the tendon, or a burning that surrounds the whole joint around the inflamed tendon. With this condition, the pain is usually worse during and after activity, and the tendon and joint area can become stiffer the following day as swelling impinges on the movement of the tendon. Many patients report stressful situations in their life in correlation with the beginnings of pain which may contribute to the symptoms. If the symptoms of tendinitis last for several months or longer it is probably tendinosis.

[edit] Treatment

Standard treatment of tendon injuries is largely palliative. Use of non-steroidal anti-inflammatory drugs combined with rest, orthotics or braces, and gradual return to exercise is a common therapy. Initial recovery is typically within 2 to 3 days and full recovery is within 4 to 6 weeks.[2] As tendinosis is more common than tendinitis, and has similar symptoms, tendinitis is often initially treated the same as tendinosis would be. This helps reduce some of the chronic long-term risks of tendinosis, which takes longer to heal.

In chronic tendinitis laser therapy has been found to be better than conservative treatment at reducing pain. No other outcomes were however accessed.[3]

A novel treatment of late has been autologous blood injection, a technique where the area of tendintis is injected with the patient's own blood in order to stimulate tendon healing. This is usually performed under ultrasound control so that the appropriate area is targeted. As the patient's own blood is injected, there are no side effects. The procedure does result in a pain flare for several days as the blood irritates the tendon, however platelet derived growth factor, which is contained in platelets within blood, is thought to commence the healing process. Success is usually seen in 70–80% of cases.

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