Tendon Injury

Symptoms of tendinopathy can include:

• Pain, tenderness, redness, warmth, and swelling near the injured tendon. Pain may get worse when you're active. Symptoms may affect just the spot where the injured tendon is located, or they may be spread out from the joint area.
• Crepitus, or a crunchy sound or feeling when the tendon is used. This is usually uncomfortable or painful.
• Pain and stiffness that may be worse during the night or when you get up in the morning.
• Stiffness in the joint near the affected area. Movement or mild exercise of the joint usually reduces the stiffness.

A tendon injury typically gets worse if the tendon isn't allowed to rest and heal. Too much movement may make your symptoms worse or bring the pain and stiffness back.

Your doctor will review your medical history and daily activities and do a physical exam. These are done to check your overall health, any areas of pain and tenderness, and your range of motion and strength.

Your exam may also include checking your nerve function (feeling and reflexes) and blood circulation (pulses). If your symptoms are related to use of a tool or sports equipment, your doctor may want you to show how you use it.

If your medical history and physical exam point to a tendon injury, you will probably not need more testing.

If your symptoms are severe or have not improved with treatment, more tests may be helpful. These may include:

X-rays.

These can show any bone-related problems or calcification in tendons or joint structures.

MRI (magnetic resonance imaging).

An MRI can show small tears and areas of tendon, ligament, cartilage, and muscle injury.

Ultrasound.

This test can show thickening, swelling, or tears in soft tissues such as the bursae and tendons.

Treatment for a tendon injury (tendinopathy) most often starts with home care. The goals of this early treatment are to:

• Reduce pain and inflammation of the tendon.
• Restore normal motion and strength.

Home treatment may include:

• Resting the affected area. Avoid any activity that may cause pain. Get enough sleep.
• Using ice or cold packs as soon as you notice pain and tenderness in your muscles or near a joint.
• Taking pain relievers if needed. Use acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen.
• Doing range-of-motion exercises each day.
• Gradually resuming your activity at a lower intensity than you were doing before your symptoms began.
• Avoiding tobacco smoke.

Other treatment

If these steps don't help to relieve pain, there are other treatments you can try. The goals of these treatments are to:

• Reduce pain.
• Avoid further damage or tearing of the tendon.
• Encourage healing of the damaged tendon.

Your doctor may:

• Prescribe physical therapy.
• Use a corticosteroid shot to relieve pain and swelling. But corticosteroid treatments usually aren't repeated because they can damage the tendon.
• Prescribe a brace, splint, sling, or crutches for a short time to allow tendons to rest and heal.
• Recommend a cast to rest and heal a badly damaged tendon. Casting or surgery is often used to treat a ruptured tendon.

Experimental treatment

Medical researchers keep studying new ways to treat tendon injuries. Talk to your doctor if you are interested in experimental treatments. Some of the treatments being studied include:

• Nitric oxide and glyceryl trinitrate, applied to the skin over the injury.
• Ultrasonic, or shock, waves directed at the injured tendon (shock wave therapy) for pain caused by calcific tendinitis (calcium built up in the tendons).
• Platelet-rich plasma (PRP). In this procedure, blood is taken from the patient. The blood is spun at high speeds to separate the blood cells called platelets. Then the platelets are injected back into the body at the injury site.

Arthroscopic surgery or open surgery (using one larger incision) is sometimes used to treat calcific tendinitis that hasn't responded to nonsurgical treatment and is causing pain.