Tendonitis is an inflammation of the tendon and ligaments that join muscle to bone in the human body. The most commonly affected areas are the shoulder (rotator cuff tendonitis), elbow (golfer’s elbow or tennis elbow), wrist and thumb, knee, ankle (Achilles tendonitis) and the hip. Some of the symptoms and signs of tendonitis include swelling, tenderness, warmth and redness, and pain that worsens during movement of the involved limb. It often presents in three stages: Stage 1 is a dull ache following activity, which often improves with rest; Stage 2 involves pain with slight movement (putting on clothing for example); and finally, Stage 3 which involves chronic pain. Common signs and symptoms of tendonitis include swelling, tenderness, heat and redness, pain that gets worse as you move the limb(s) and crepitus (grating, crackling or popping sounds and sensations experienced under the skin and joints).

Many cases of tendonitis result from overuse or repetitive movement injuries, lifting or carrying heavy objects, as well as extreme or repeated strain on joints in the body. Obese individuals have a higher risk of tendonitis due to the added weight endured by the skeletal structure. Sometimes, tendonitis can also be seen in conjunction with certain inflammatory conditions, auto immune disorders, and infections. Calcific tendonitis is seen more commonly in people who have chronic diseases (e.g. diabetes) and occurs when calcium deposits build up in a body joint. Because tendonitis may occur together with, or as a result of other ailments, a health care provider should perform a thorough physical examination of your body together with x-rays and/or other diagnostic testing as required.

Treatment options for tendonitis include drug therapies, complementary and alternative therapies, nutritional and supplementation therapies, acupuncture, chiropractic and homeopathic therapies.

Drug therapies generally involve the use of nonsteroidal anti-inflammatory drugs (NSAIDs) either by prescription or over the counter. They reduce pain and inflammation but do have some side effects. Sometimes your health care professional will recommend corticosteroid or lidocaine injections into the tendon. Because of the possibility of rupture, these injections are not used for weight bearing tendons. The use of colchicine is restricted to calcific tendonitis (where calcium builds up in the joint area).

Complementary and alternative therapies involve the use of physical therapy, temporary immobilization of the limb (usually in the form of slings or splints), rest, flexibility and strengthening exercises when possible, ultrasonography, and TENS (transcutaneous electrical nerve stimulation) to control pain.

Nutritional and Supplementation therapies may involve use of the following:

• Vitamin C 250-500 mg 2x/day – Aids in healing, increases immune function and reduced inflammation
• Calcium 1500 mg/day with Magnesium 750 mg/day – Aids in healing connective tissues and muscles
• Vitamin A 15,000 IU/day – Aids with immune function and healing
• Vitamin E 400-800 mg/day – Aids in reducing inflammation
• Omega 3 Fatty Acids 1,000-1,500 IU 2x/day – Aids in reducing inflammation

Some herbs may also help in the treatment of tendonitis. Because they can interfere with medications, it is important that you check with your physician before you add them to any treatment plan. They include:

• Bromelain 250-750 mg 3x/day between meals – This enzyme helps to reduce swelling and inflammation
• Curcumin 200-400 mg 3x/day between meals – This yellow pigment of tumeric helps to reduce inflammation

Other herbs such as white willow, licorice, cat’s claw, devil’s claw and boswellia may also aid in the treatment of inflammation, but they have not been tested for tendonitis.

Acupuncture can be used as an effective treatment for musculoskeletal problems, including tendonitis and several studies reported by the NIH have found that acupuncture provides better pain relief than a placebo. Check in your area for a reputable acupuncturist if you are interested in pursuing this type of therapy.

Homeopathic treatment remedies for tendonitis generally include topical gels and/or creams. Almost all use Arnica as the base. Internal doses of homeopathic medications are usually in pelleted form or some meds (such as Traumeel) may be injected by Homeopaths in order to reduce inflammation.

Additionally, items such as orthotics or heel lifts in shoes, elbow straps, contrast hydrotherapy (alternating hot/cold applications) and various treatments such as clay wraps or castor oil packs may provide some pain temporary relief and reduction in swelling of the affected limb.

Finally, chiropractic treatments may provide relief for tendonitis sufferers. Chiropractors commonly treat tendonitis with ultrasound, electrical muscle stimulation, manual trigger point therapy, massage and/or joint manipulation.

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168 Louis Campau Promenade NW, Suite 400
Grand Rapids, MI 49503

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