What is Tendinosis?

Tendinosis describes pain and inflammation in a tendon, the structure that enables bones and joints to move when muscles contract.

The condition is caused by small tears that occur in the tendon tissue, which causes the number of tendon repair cells to increase. This can lead to a reduction in tensile strength which, in turn, increases the likelihood of the tendon rupturing.

Some of the primary features of tendinosis include degeneration of the callagenous matrix; a lack of cells involved in inflammation and an increase in the amount of blood vessels.

Tendinosis may affect tendons in the shoulder, knee, wrist, elbow, finger, thigh or heel. Tendon tears can be caused by injury incurred through sport, for example, and overuse of a tendon can lead to repetitive strain injury.

Some of the main symptoms of this condition are described below:

• Swelling that impairs movement of the tendon
• Intense pain in the tendon, especially on movement of the affected area
• Joint stiffness
• A grating or crackling sensation as the tendon moves
• Weakness in the affected area
• Development of a lump along the tendon
• If the condition persists, the tendon may eventually tear completely and a gap may be felt along the tendon. Movement of the affected area is then further impaired.
• If the sheath that surrounds the tendon is affected rather than the tendon itself, the term used is tenosynovitis

Treatment

Treatment approaches to tendinosis include taking pain relief medications and making lifestyle changes such as adjusting posture when sitting or strengthening the joints through exercise.

There are various other approaches to managing this condition and they differ depending on the severity of symptoms and which tendon is affected.

Some measures people can take if they have tendinosis include:

• Stopping whichever activity has caused the condition such as typing or playing a sport. This should prevent further damage and inflammation.
• Resting the affected tendon to reduce inflammation.
• Applying some form of support such as a splint, brace or bandage to help reduce movement.
• Visiting a physiotherapist, who uses techniques to relieve pain and help people regain function of the affected area. Some of these techniques include exercises, massage, lasers and ultrasound.
• Applying ice packs to cause vessel constriction and prevent abnormal neovascularisation or blood vessel formation at the affected tendons.
• Taking dietary supplements such as amino acids has been reported to improve symptoms, although no evidence yet exists to support this.
• Taking anti-inflammatory medications such as ibuprofen, diclofenac or aceclofenac.

Usually, tendinosis improves over time and surgery is not required, but in some severe cases surgery is considered as an option.

Corticosteroids can be injected into the joint spaces to reduce inflammation. These injections can relieve pain but they can cause side effects such as thinning of the skin.