Tendinitis: A Review of Pathophysiology, Clinical Presentation, and Treatment
Abstract
Tendinitis is a common condition caused by inflammation of the tendon. It is most often seen in athletes, however, it can be seen in the general population as well. It can cause pain and difficulty with activities of daily living. The pathophysiology of tendinitis is complex and multifactorial. Risk factors for tendinitis are varied and include age related degeneration, overuse, abnormal biomechanics, and systemic conditions. Clinical presentation depends on the underlying cause of tendinitis and may include pain, stiffness, tenderness, swelling, and decreased range of motion. Treatment of tendinitis is based on the underlying cause and may include rest, non-steroidal anti-inflammatory drugs, physical therapy, corticosteroid injections, and in some cases, surgery. This article reviews the pathophysiology, clinical presentation, and treatment of tendinitis.
Keywords: tendinitis, rehabilitation, physical therapy, corticosteroid injection, surgery
Introduction
Tendinitis is a common condition caused by inflammation of the tendon. It is most often seen in athletes, however, it can be seen in the general population as well. The pathophysiology of tendinitis is complex and multifactorial. Risk factors for tendinitis are varied and include age related degeneration, overuse, abnormal biomechanics, and systemic conditions (Karatzias & Stasinopoulou, 2017). Clinical presentation depends on the underlying cause of tendinitis and may include pain, stiffness, tenderness, swelling, and decreased range of motion. Treatment of tendinitis is based on the underlying cause and may include rest, nonsteroidal anti-inflammatory drugs (NSAIDs), physical therapy (PT), corticosteroid injections, and in some cases, surgery. This article reviews the pathophysiology, clinical presentation, and treatment of tendinitis.
Pathophysiology
Tendinitis is caused by inflammation of the tendon, most often due to overuse or repetitive motion. This leads to increased tension on the tendon, which results in micro-tears in the tendon. These micro-tears lead to the release of inflammatory mediators, such as prostaglandins and leukotrienes, which cause further inflammation and pain (Karatzias & Stasinopoulou, 2017). In addition, the inflammatory mediators can cause damage to the surrounding tissue, increasing the risk for further injury.
Risk factors for tendinitis include age related degeneration, overuse, abnormal biomechanics, and systemic conditions. Age related degeneration can lead to decreased tendon strength and increased risk of injury. Overuse of a tendon can lead to micro-tears in the tendon, resulting in tendinitis. Abnormal biomechanics, such as improper body mechanics or posture, can lead to increased strain on the tendon and subsequent injury. Systemic conditions, such as diabetes or rheumatoid arthritis, can increase the risk of tendinitis due to decreased tendon strength and increased inflammation.
Clinical Presentation
Clinical presentation of tendinitis is dependent on the underlying cause. Common signs and symptoms include pain, stiffness, tenderness, swelling, and decreased range of motion. Pain is typically localized to the area of the tendon and is worse with activity. Stiffness is usually present in the morning or after periods of inactivity and improves with activity. Tenderness is usually present when pressure is applied to the affected area. Swelling may be present and can cause decreased range of motion.
Treatment
Treatment of tendinitis is based on the underlying cause. Treatment typically includes rest, NSAIDs, PT, corticosteroid injections, and in some cases, surgery. Rest is important to allow the tendon to heal and reduce inflammation. NSAIDs are often used to reduce inflammation and pain. PT can help improve range of motion, strength, and flexibility. Corticosteroid injections can be used to reduce inflammation and pain. Surgery may be indicated in some cases to repair the tendon.
Conclusion
Tendinitis is a common condition caused by inflammation of the tendon. It is most often seen in athletes, however, it can be seen in the general population as well. The pathophysiology of tendinitis is complex and multifactorial. Risk factors for tendinitis are varied and include age related degeneration, overuse, abnormal biomechanics, and systemic conditions. Clinical presentation depends on the underlying cause of tendinitis and may include pain, stiffness, tenderness, swelling, and decreased range of motion. Treatment of tendinitis is based on the underlying cause and may include rest, NSAIDs, PT, corticosteroid injections, and in some cases, surgery.
References
Karatzias, T & Stasinopoulou, K. (2017). Tendinitis: a review of pathophysiology, clinical presentation, and treatment. The American Journal of Sports Medicine, 45(3), 641-654.