Tendonitis is defined as inflammation of the tendon or the wrapping of the tendon called Tenosynovitis. The tendon is a fibrous cord that attached muscle to bone. When the muscle contracts, it pulls on the tendon, which moves the bone. Most tendonitis occurs in middle age or older persons. Repetitive trauma is usually a factor. As we age the circulation also decreases and this also leads to an increase in tendonitis in the elderly. Tendonitis is common in Rheumatoid Arthritis, Diabetes and Gout. Old injuries can cause joints to malfunction also leading to Tendonitis.
The most common area is through the shoulder. The shoulder joint is different than most other joints. The shoulder joint hangs or is supported by tendons. There is very little compression in the joint, so it is rare for Osteoarthritis to occur. Since it hangs from the tendons, it is much more prone to Tendonitis. Sings and symptoms of Tendonitis is aggravated by activity and relieved by rest. Palpation over the involved area will usually have a sharp pain. Tendonitis can refer pain to other areas. A referral pain is pain in one area, coming from another source or area. For example, Tendonitis in the shoulder can cause pain down the arm to the elbow. Other common areas of Tendonitis are the elbow, commonly termed Tennis or Golfer’s Elbow, the wrist called De Quervain Tenosynovitis, hip and Achilles Tendon. History and examination usually make Tendonitis an easy diagnosis. X-rays can show some calcium deposits. This indicates a chronic Tendonitis problem. Medical treatment consists of rest, immobilization and extreme cases, and non-steroidal anti-inflammatory drugs like Aspirin and Tylenol. Cortisone shots are reserved for extreme cases.
Natural medicine consists of assessing the joint to determine if it is working properly. Improper mechanics in a joint will cause Tendonitis. To continue to medicate when the joint is malfunctioning will only cause the situation to get worse. All it is is covering up the problem. Physical therapy to control inflammation consists of transverse friction massage. Transverse friction massage can reduce inflammation and break down adhesions that often form in Tendonitis. Transverse friction massage at first can irritate but this seems to go away after about one-to-three treatments. The patient is also instructed to do this technique at home. Transverse frictional massage consists of massaging the tendon cross-sectionally and building up to five-to-ten minutes a day. We have found this technique beneficial for tendonitis.
Ice. The individual is also given instructions on daily ice. If the individual is an athlete or circumstances prevent someone from stopping activity, icing should be done before and after activity. The more severe the Tendonitis, the more frequency of icing. Icing is done for ten-to-thirty minutes at a time, depending on what area and technique of icing are used. Ice massage seems to be the most beneficial, but ice packs are also good. The key is consistency.
Electrical stimulation has shown to decrease inflammation and promote healing. This is applied to the Tendonitis. The more severe the Tendonitis, the more frequent electrical stimulation is used. Electrical stimulation and ice are usually applied at the same time.
Depending upon the area, the patient is instructed to rest the area. If the Tendonitis is in the shoulder, the patient is instructed not to raise the arm up. This causes the tendon to ride under the Clavicle and shoulder and irritates the tendon. As pain and inflammation subside, the patient is instructed to mildly stretch the tendon, increasing the stretch day by day. When the patient is stretching without significant pain, light resistance exercises can be started. The resistance is gradually increased until a return to normal activity is achieved. It is a good idea, especially when first starting either stretching or resistance exercises, to ice the tendon for ten minutes before and after the routine.
Tendons do not have a very strong blood supply and therefore heal very slowly. It is the blood supply that brings oxygen and nutrients to allow healing. Long-term chronic Tendonitis can cause scarring and adhesions. These can be very difficult to deal with and may have to be broken up before proper healing can occur. Transverse friction massage can help do this.