Tendon Injury (Tendinopathy)
Tendon Injury (Tendinopathy)
Initial treatment for a tendon
injury (tendinopathy) typically includes rest and pain
Acetaminophen can reduce pain. Nonsteroidal
anti-inflammatory drugs (NSAIDs) can reduce both the pain and
inflammation you might have from a tendon injury. The goals of this early
treatment are to:
- Reduce pain and inflammation of the
- Restore normal motion and strength.
If you are still having pain, stiffness, and weakness after
initial treatment, your doctor may recommend some type of
physical therapy. Also, you may need to make
long-term changes in the type of activities you do or how you do them to
prevent your tendinopathy from returning. The goals of ongoing treatment are
- Reduce pain.
- Avoid further
degeneration or tearing of the tendon.
- Encourage regeneration of
the damaged tendon.
Treatment for tendinopathies
Take the following steps to treat tendinopathies:
- Rest the affected area,
and avoid any activity that may cause pain. Get enough sleep. To keep your
overall health and fitness, continue exercising but only in ways that do not
stress the affected area. Do not resume an aggravating activity as soon as the
pain stops. Tendons require weeks of additional rest to heal. You may need to
make long-term changes in the types of activities you do or how you do
- Apply ice or
cold packs as soon as you notice pain and tenderness in your muscles or near
a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for
72 hours. Continue applying ice (15 to 20 minutes at a time, 3 times a day) as
long as it relieves pain. Although heating pads may feel good, ice will relieve
pain and inflammation.
- Take pain relievers
if needed. Use
acetaminophen or nonsteroidal anti-inflammatory drugs
(NSAIDs), such as ibuprofen or naproxen, as
directed for pain relief. NSAIDs also reduce any inflammation
you might have in or around the tendon (tendinitis). NSAIDs come in pills and in a cream that you rub over the sore area. Do not rely on medicine to
relieve pain in order to continue overusing a joint.
- Do range-of-motion exercises each day. Gently move your joint
through its full range of motion, even during the time that you are resting the
joint area. This will prevent stiffness in your joint. As the pain goes away,
range-of-motion exercises and add other exercises to
strengthen the muscles around your joint.
- Gradually resume your activity at a lower intensity than you maintained before
your symptoms began. Warm up before and stretch after the activity. You can
also try making some changes. For example, if exercise has caused your
tendinopathy, try alternating with another activity. If using a tool is the
problem, try alternating hands or changing your grip. Increase your activity
slowly, and stop if it hurts. After the activity, apply ice to prevent pain and
- Avoid tobacco smoke. Tendon injuries heal
more slowly in smokers than in nonsmokers. Smoking delays wound and tissue
If these steps do not help to relieve pain, other treatment
may be considered. Your doctor may:
- Use a
corticosteroid injection to relieve pain and swelling.
But corticosteroid treatments usually are not repeated because of the potential
for tendon damage.
- Prescribe a brace, splint, sling, or crutches
for a brief period to allow tendons to rest and heal.
- Recommend a
cast to rest and heal a badly damaged tendon. Casting or surgery is typically
used to treat a ruptured tendon.
Medical researchers continue to study 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 topically (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). For more information, see the topic Calcium Deposits and Tendinitis (Calcific Tendinitis).
- Platelet-rich plasma (PRP). In this procedure blood is drawn from the patient, spun at high speeds to separate the blood cells called platelets, and 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 has not responded to nonsurgical treatment and is
William H. Blahd, Jr., MD, FACEP - Emergency Medicine
Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
October 16, 2012
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