Tendinitis can turn simple movements, like lifting a cup of coffee or climbing stairs, into painful challenges. This condition, characterized by the inflammation of the thick fibrous cords that attach muscle to bone, frequently results from repetitive motion or overuse. Whether it manifests as tennis elbow, jumper’s knee, or shoulder pain, the dull ache and tenderness can significantly disrupt work, hobbies, and sleep. While rest is often the first advice given, the pain can persist, making medical intervention necessary to break the cycle of inflammation.

Treatment is essential to relieve pain and reduce the swelling that restricts movement. Without appropriate care, the tendon may not heal correctly, potentially leading to chronic issues or more severe tendon damage, such as a rupture. Because tendinitis can affect any tendon in the body and varies in severity from mild irritation to debilitating pain, treatment plans are tailored to the specific location and the patient’s activity level (Mayo Clinic, 2022).

Overview of treatment options for Tendinitis

The primary goals of treating tendinitis are to alleviate pain and reduce inflammation. By calming the irritated tissue, the body is better able to repair the tendon during periods of rest and physical therapy.

While the “RICE” method (Rest, Ice, Compression, Elevation) is a standard initial approach, pharmacological treatments are often required to manage significant discomfort. Medications are typically used to bridge the gap between acute injury and rehabilitation. For acute cases, short-term courses of anti-inflammatory drugs are standard. For chronic or resistant cases, doctors may consider more direct interventions, such as injections, to target the specific site of inflammation.

Medications used for Tendinitis

Non-steroidal anti-inflammatory drugs (NSAIDs) are the most common first-line treatment for tendinitis. Over-the-counter options such as ibuprofen and naproxen sodium are widely recommended. These medications address both the pain and the underlying inflammation. Clinical experience suggests that taking these medications on a schedule for a few days, rather than just when pain spikes, is often more effective for quieting acute flare-ups.

For patients who cannot take oral NSAIDs due to stomach issues or other health concerns, topical NSAIDs are an excellent alternative. Diclofenac gel or creams can be applied directly to the skin over the painful tendon. This allows the medication to penetrate the tissue locally with less absorption into the bloodstream. Acetaminophen may be used for pain relief, though it does not reduce inflammation.

If oral or topical medications fail to provide relief, corticosteroid injections are often the next step. A doctor injects a powerful steroid, such as cortisone or methylprednisolone, directly around the inflamed tendon. This typically provides rapid and significant pain relief that can last for several weeks or months. However, these injections are generally limited in frequency to avoid weakening the tendon tissue (American Academy of Orthopaedic Surgeons, 2021).

How these medications work

NSAIDs work by blocking the production of prostaglandins, which are chemical messengers in the body that trigger inflammation, swelling, and pain in response to injury. By inhibiting the enzymes (COX-1 and COX-2) responsible for creating these chemicals, NSAIDs effectively lower the “volume” of the inflammatory response.

Topical formulations function similarly but deliver the drug through the skin layers directly to the underlying muscle and tendon, minimizing the amount of drug that circulates through the rest of the body. Corticosteroids mimic the effects of cortisol, a hormone naturally produced by the adrenal glands. They are potent anti-inflammatories that suppress the immune system’s reaction at the specific site of the injection, drastically reducing swelling and pain (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023).

Side effects and safety considerations

While commonly used, NSAIDs carry risks, particularly for the digestive system. NSAIDs can cause stomach upset, heartburn, and sometimes ulcers or bleeding. Long-term use is discouraged due to potential kidney strain and cardiovascular risks. Topical NSAIDs have fewer systemic side effects but may cause skin irritation.

Corticosteroid injections need caution. Repeated injections can weaken the tendon, risking rupture. They can also temporarily raise blood sugar, which diabetics must monitor. Patients should seek immediate medical care for severe abdominal pain, black stools, or a sudden “pop” at the tendon site (possible rupture).

Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.

References

1. American Academy of Orthopaedic Surgeons. https://aaos.org
2. Mayo Clinic. https://www.mayoclinic.org
3. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov
4. MedlinePlus. https://medlineplus.gov