Tendinitis is the painful inflammation of a tendon and its ligaments, which attach the tendon to bone. It often results from the stress of repetitive movements. Acute or sudden tendinitis may become chronic or long-lasting if it is not treated. People get tendinitis most often in the shoulder (rotator cuff tendinitis), elbow (tennis elbow or golfer's elbow), wrist and thumb (de Quervain's disease), knee (jumper's knee), ankle (Achilles tendinitis), and hip. Calcific tendinitis, which happens when calcium deposits build up in a joint, often occurs in people who have a chronic disease, such as diabetes.
Tendinitis can happen because of:
People who are overweight have a higher risk of tendinitis because of the increased pressure on tendons, ligaments, and bones. Tendinitis may also accompany some inflammatory conditions (such as Reiter syndrome or ankylosing spondylitis), autoimmune disorders (such as type 1 diabetes), and some infections.
Your health care provider will give you a thorough physical examination and may take x-rays and other diagnostic tests.
Your health care provider may prescribe pain relievers or steroid injections. Treatment also may include ice, rest, or keeping the area still (such as with a sling). Massage, strengthening exercises, or physical therapy may help. Some studies show that high energy shock wave therapy improves symptoms and pain associated with tendinitis. In cases of severe tendinitis that is not healing from other treatments, surgery may be necessary.
Herbs are generally a safe way to strengthen and tone the body's systems. As with any therapy, you should work with your provider to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. herb per cup of hot water. Steep covered 5 - 10 minutes for leaf or flowers, and 10 - 20 minutes for roots. Drink 2 - 4 cups per day. You may use tinctures alone or in combination as noted.
Tell your doctor if your are pregnant or nursing -- before using any herbal products.
The following herbs may also help with inflammation, although they have not been tested for tendinitis.
Homeopathic remedies for tendinitis include creams or gels. Arnica cream by itself or in combination with Calendula officinalis, Hamamelis virginiana, Aconitum napellus, and Belladonna, applied three to six times a day, speeds healing and decreases discomfort. For acute (sudden) injuries, always start with Arnica.
Orally, the dose is usually 3 - 5 pellets of a 12X to 30C remedy every 1 - 4 hours until the symptoms get better.
Many naturally oriented doctors use injectable homeopathic medications, including Traumeel, which has shown promise in reducing inflammation in some studies.
In 1997, the National Institutes of Health reported that acupuncture may be an effective therapy for tennis elbow. In addition, two studies looking at the effect of acupuncture on this and other types of tendinitis found that acupuncture provides better pain relief than placebo.
Acupuncturists report that people with tendinitis frequently exhibit a primary deficiency in the liver meridian, with a relative excess in the gallbladder meridian. In addition to needling treatment on the liver meridian and the supporting kidney meridian, treatments using moxibustion (a technique in which the herb mugwort is burned over specific acupuncture points) may also be included. Needling and moxibustion may also be directly applied to painful areas and related sore points.
A technique known as balance method acupuncture may be effective in treating many musculoskeletal problems, including tendinitis.
Although no well-designed studies have examined the effectiveness of chiropractic treatment for tendinitis, chiropractors commonly treat this condition with ultrasound, electrical muscle stimulation, manual trigger point therapy (applying firm pressure by hand on a trigger point for several seconds and then stretching the muscle afterwards), and massage. People with stiff joints may also receive joint manipulation.
Tendinitis often has three stages:
Recurrences are common, particularly for athletes and people whose work requires repetitive motions.
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