Tendinitis: Wikis

  

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Tendinitis
Classification and external resources
ICD-10 M77.9
ICD-9 726.90
DiseasesDB 31624
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).

Contents

Diagnosis

Symptoms can vary from aches or pains and local stiffness, to a burning that surrounds the whole joint around the inflamed tendon. Swelling may happen along with heat and redness, but not in all cases, there may be visible knots surrounding joint. 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 muscles tighten from 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.

Treatment

Treatment of tendon injuries is largely conservative. 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. This helps reduce some of the chronic long-term risks of tendinosis, which takes longer to heal.

Steroid injects have not been shown to have long term benefits and are equivalent to NSAIDs in the short term.[3] In chronic tendinitis laser therapy has been found to be better than conservative treatment at reducing pain, however no other outcomes were accessed.[4]

Research

Autologous blood injection is a technique where the area of tendintis is injected with the patient's own blood in order to stimulate tendon healing. 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, is thought to commence the healing process. The treatment has been tested in two small trials for tennis elbow.[5][6]

See also

References

  1. ^ Khan, KM; Cook JL, Kannus P, Maffulli N, Bonar SF (2002-03-16). "Time to abandon the "tendinitis" myth: Painful, overuse tendon conditions have a non-inflammatory pathology". BMJ 324 (7338): 626–7. doi:10.1136/bmj.324.7338.626. PMID 11895810.& PMC 1122566. http://bmj.bmjjournals.com/cgi/content/full/324/7338/626. 
  2. ^ Wilson, JJ; Best TM (Sep 2005). "Common overuse tendon problems: A review and recommendations for treatment" (PDF). American Family Physician 72 (5): 811–8. PMID 16156339. http://www.aafp.org/afp/20050901/811.pdf. 
  3. ^ Gaujoux-Viala C, Dougados M, Gossec L (December 2009). "Efficacy and safety of steroid injections for shoulder and elbow tendonitis: a meta-analysis of randomised controlled trials". Ann. Rheum. Dis. 68 (12): 1843–9. doi:10.1136/ard.2008.099572. PMID 19054817. 
  4. ^ "BestBets: Laser therapy in the treatment of tendonitis". http://www.bestbets.org/bets/bet.php?id=852. 
  5. ^ Edwards SG, Calandruccio JH. (2003). "Autologous blood injections for refractory lateral epicondylitis". J Hand Surg [Am]. 28 (2): 272-8. PMID 12671860. 
  6. ^ Connell DA, Ali KE, Ahmad M, Lambert S, Corbett S, Curtis M (June 2006). "Ultrasound-guided autologous blood injection for tennis elbow". Skeletal Radiol. 35 (6): 371–7. doi:10.1007/s00256-006-0081-9. PMID 16552606. 

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