How is Tendonitis Diagnosed?
DiagnosisYour doctor will ask about your symptoms and take your medical history to help determine the source of your discomfort. During a physical exam, your doctor may press on the painful area to isolate the tender or swollen tendon, measure the joint’s range of motion, and test your arm or grip strength.
Imaging tests may help to diagnose tendonitis and rule out other problems:
- X-ray - Primarily shows bone and bone-related problems, but can also show changes in the bone at the tendon attachment and calcium deposits within an injured tendon
- Magnetic resonance imaging (MRI) - Shows small tears and injuries in soft tissues, including tendons, ligaments, cartilage, and muscle
- Ultrasound scan - Used to image soft tissue and certain types of tendonitis. Ultrasounds can also be used to help guide interventions such as injections.
How is Tendonitis Treated?
TreatmentsThe goal of treating tendonitis is to allow an inflamed tendon to heal so you can gradually go back to using it. The first step is rest—avoid activities or movements that irritate the tendon.
You can also apply a cold pack for 20 minutes several times a day to reduce swelling and pain. If pain persists after two weeks of home treatment, physicians at NewYork-Presbyterian may recommend different options based on your diagnosis.
Medications
Two types of medication are commonly used to treat tendonitis:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) - These over-the-counter medications include ibuprofen, naproxen, and aspirin. They can reduce pain and swelling.
- Steroid injection - For certain types of tendonitis, your doctor may recommend a cortisone injection to reduce inflammation in the tendon and provide temporary pain relief
- Topical medication - Nitric oxide and glyceryl trinitrate are rubbed into the skin over the injured tendon
Physical therapy
A physical therapist can teach you exercises to help heal your tendonitis and work with you on strategies to prevent re-injury. Many therapeutic exercises require precise movements, so it’s important to learn how to do them correctly from a physical therapist who can help you. Your physical therapy program may include:
- Stretching - To keep tendons flexible and better able to withstand strain
- Strengthening - To stabilize joints and help prevent re-injury
- Evaluating your movement - Adjusting your sports equipment or form to avoid awkward motions, or changing your home or work environment to reduce repetitive tasks
Interventional Procedures and Surgery
For most people, tendonitis heals with rest and physical therapy. It may take up to a year for a full recovery. Surgery is usually the last resort for tendonitis treatment when pain persists after several months and interferes with daily life.
Surgical procedures vary depending on the location of the injured tendon and the type of damage. Ask your doctor about additional experimental approaches, including:
- Percutaneous needle tenotomy (needling of a tendon) - Uses needle and fluid to break up scar tissue and calcifications to aid in the healing of chronic tendonitis
- Ultrasonic waves - Also called shock wave therapy, this approach can relieve pain caused by calcium build-up in a tendon
- Platelet-rich plasma (PRP) - A technique used to separate platelets from a sample of your blood and inject them into the injured tendon, usually done in conjunction with percutaneous needle tenotomy
- Surgical debridement and repair - Arthroscopically cleans up debris on the tendon and surrounding tissue and repairs any underlying tearing of the tendon
FAQs
FAQsHow long does tendonitis last?
Mild tendonitis can heal within two weeks if treated promptly with rest and cold packs. If you keep using the sore tendon, or if the injury is severe, healing takes longer—up to six months or more.
What does tendonitis feel like?
Tendonitis can feel like an ache, tenderness, or pain at the point where a muscle attaches to a bone near a joint. Pain may radiate from this point down the muscle when you use the affected joint.
How can I sleep with tendonitis?
If tendonitis is in your shoulder, elbow, or wrist, avoid sleeping on the affected side. Sleep on your back and use pillows to support the painful joint. For tendonitis in the knee, sleep on your back with a pillow under your knees.
What happens if tendonitis goes untreated?
If tendonitis goes untreated, the strained tendon may weaken and develop microscopic tears (tendinosis). Eventually, the tendon may rupture (a large tear). Tendinosis is a much more serious condition that requires surgery to repair.
What does tendonitis look like?
You may notice swelling, warmth, or redness at the point where the tendon attaches to the bone. However, the most common symptoms are aching and tenderness with no obvious visible changes.
Trust NewYork-Presbyterian for Tendonitis Treatment
Orthopedic specialists at NewYork-Presbyterian are well-versed in joint care and sports medicine. Schedule an appointment today for a comprehensive evaluation of your tendonitis symptoms. Our physicians, surgeons, and other specialists also treat bone disease, tumors, trauma, and disorders affecting the foot, ankle, hand, elbow, hip, knee, shoulder, and spine.