John E. Blank, M.D., Hand Surgery, Tuckahoe OrthopaedicsBy John E. Blank, MD

A painful condition that can occur in anyone as a result of muscle-tendon unit overload at its origin, insertion or beneath its synovial sheath, tendinitis plagues several thousand people. Typically, tendinitis is an irritation or inflammation of the sheath that surrounds the tendon that causes pain and loss of motion. Let’s examine how we can properly treat tendinitis.

The First Step For Proper Treatment

Treatments are similar across the forms of tendinitis. First, if there is an active cause, like a repetitive motion that can be eliminated, that comes first. Occupational exposures and hobbies, as well as sporting activities should be examined to see if they are causing the problem. Once the cause is eliminated, the region should be rested, sometimes in a splint. Swelling can be reduced with ice as well as anti-inflammatory medication. These are all first-line treatments for cases of tendinitis.

Additional treatment options could include outpatient therapy with different modalities; gentle strengthening and stretching can be used to reduce inflammation and regain movement. In other cases, ultrasound may be performed, deep tissue massage treatments may be prescribed, and in some cases, topical steroids in conjunction with ultrasound or electrical stimulation are administered. Sometimes patients will take oral steroids, but a steroid injection goes right to the source of the pain. This treatment course is only used after others have been exacerbated, and most doctors will not administer steroid injections more than 3 times per year for any given problem.

Surgical Options for Tendinitis

Surgical options are available for most cases of tendinitis. Surgery is commonly indicated when typical courses of conservative treatment have failed and a patient continues to complain of pain with diminished function. The sheath that the tendon travels down can be opened and divided. This is very common in wrist and hand tendinitis and entrapments. The opening of the sheath alleviates the inflammation, and therefore, the pain allowing for improved tendon movement and overall hand function.

There are also surgeries available for elbow problems, like in tennis elbow and golfer’s elbow. The surgery addresses the fact that the patient has fewer fibers attaching the muscle to the bone. By releasing the remaining fiber attachments, surgery can actually help with the pain and movement of the elbow.

When to See a Doctor

It’s important not to take a “no pain, no gain” approach to arm pain. If you have pain that is activity-related, cools down at rest and presents as a sharp pain, it could be tendinitis. A chronic pain can be duller after you partake in an activity for a while. Everyone will describe his or her pain differently, but the common denominator is that the pain is persistent.

To talk to one of our physicians about properly treating your tendinitis, contact us today.


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