The muscles and the bones are attached with tendons, which are thick fibrous cords. The inflammation and irritation of these tendons leads to a condition called tendinitis. The joint nearby is also inflamed and is tender and painful. Strain on tendons due to overuse or injury to them leads to tendinitis. It is most commonly seen in the shoulders, wrists , elbows, knees, and heels. Thus, the other names of tendinitis are tennis elbow, pitcher's shoulder, golfer's elbow, jumper's knee and swimmer's shoulder. There are different types of tendinitis based on where in the body it is affected. Some include:
- Achilles tendinitis: It is the inflammation of the tendon between the heel and the calf muscle. It is common in sports injury caused by shoes that doesn’t fit well or no proper support to the foot.
- Supraspinatus tendinitis: It is the inflammation that happens on the top of the shoulder joint and leads to pain when the arm is moved.
- Tennis elbow: It involves pain in the outer side of the elbow. The pain radiates towards the wrist.
- Medial epidondylitis or golfer's elbow: It is the pain on the inner side of the elbow and it does not allow the patient to lift their arms against any force.
- De Quervain's stenosing tenosynovitis: It is the inflammation of the tendons that cover the thumb to the wrist.
- Tendinitis of the wrist: As the name suggests it is the inflammation of the tendons in the wrist affecting mostly the badminton players and production line players.
What are the Symptoms of Tendinitis
The symptoms of tendinitis include:
- Pain or dull ache in the affected limb or joint while moving
- Mild swelling
Pathophysiology of Tendinitis
Tendons connect the muscles to the bones. Any force felt on the muscle is transmitted through the tendons. Thus the tendons are always under stress or mechanical load. Continuous load to the tendons cause tendinitis and thepathologic findings include tendon inflammation,fibrinoid necrosis, and mucoid degeneration. Proliferation of fibroblasts is also observed.
What are the Causes of Tendinitis
Repetitive action of a particular joint or muscle putting stress on the respective tendons might lead to tendinitis. Jobs or hobbies that involve repetitive motions cause tendinitis. Ergonomically safe techniques should be used while performing continuous straining sports movements or day to day job related activities. Improper techniques overloads the tendons causing the condition.
Secondly, with age, the tendons become less flexible, thereby more prone to injuries.If tendinitis is not treated appropriately, it leads to rupture of the tendon known as tendinosis, which requires a surgery. Tendinosis caused due to degenerative changes in the tendon combining with defective new blood vessel formation.
How is Tendinitis Diagnosed
Tendinitis is diagnosed by physical examinations alone. X-rays or other imaging tests are performed to rule out other conditions.
How is Tendinitis Treated
Treatment options relieves the pain and reduces inflammation. The techniques include rest, ice, and over-the-counter pain relievers, but none of these aid in curing tendinitis. An exercise regimen involving the stretching and strengthening of the affected tendon can provide some relief from the symptoms.
A few of the medications useful in treating tendinitis include pain relievers, corticosteroids, and platelet-rich plasma. Finally, when all the other treatment options do not help, surgery is preferred. Surgery for tendinitis involves the following:
- Dry needling: This technique makes small holes in the tendon by using a needle to stimulate healing factors involved in tendon healing.
- Ultrasonic treatment:The scar tissue in the tendon is removed using ultrasonic sound waves.
Stem Cell-based Tendinitis Treatment
Mesenchymal stem cells are found to be successful in treating tendinitis. Stem cell therapy alleviates pain caused by tendinitis and regenerates the affected tendon, thereby restoring the normal integrity of the tendons. Platelet-rich plasma in combination with MSC aids in augument the regenerative capacity. The process involves the activation of one’s own adult stem cells and other paracrine growth factors to act on the affected area and stimulates healing and speedy repair of the affected tendon.