Tendinosis, as opposed to acute tendonitis, is a chronic degenerative disorder, involving tiny tears in the connective tissue of the tendons, the bands that connect muscle to bone. This condition can occur anywhere in the body, but most often affects the shoulder, knee, biceps and Achilles tendons. This condition frequently affects athletes and happens when too much stress is placed on the tendon as a result of overuse, improper movement technique or traumatic injury.
Tendinosis, unlike tendonitis, occurs gradually, but recurrent tendonitis may lead to the chronic deteriorative condition. Tendinosis is essentially a buildup of microscopic injuries that don't heal properly. Over time, symptoms of pain, swelling and stiffness may appear and worsen. Unfortunately, because tendons heal more slowly than muscles, physical rehabilitation for the condition may be relatively lengthy.
Risk Factors for Tendinosis
Risk factors for tendinosis include prolonged repetitive motion. A wide range of occupational or recreational activities involve such movements. Individuals at risk for developing this disorder include:
- Athletes or sports enthusiasts
- Computer programmers, writers, data entry processors
- Manual laborers or assembly line workers
- Sign language interpreters
Taking prescribed antibiotics in the fluoroquinolone family, such as Cipro and Levaquin, also presents a serious risk factor for tendon injury for which the FDA now requires a "black box" warning.
Treatments for Tendinosis
Once tendinosis is diagnosed through physical examination and imaging tests, there are several treatment options available. For many patients, simple remedies like ice applications, oral anti-inflammatory medications and may be sufficient to relieve symptoms. Frequently these simple home remedies are helpful in combination with physical therapy, particularly eccentric exercise, and the following minimally invasive medical interventions:
- Injections of corticosteroids
- Injections of nonsteroidal anti-inflammatories
- Injections of sclerosing agents
- Extracorporeal shock wave treatments
Physical therapists not only help patients by alleviating symptoms, but instruct them in motion techniques that may be more efficient and less taxing on the body. If symptoms persist for 3 months with these conservative treatments, however, surgical intervention may be required.
Complications of Tendinosis
The most common complication of tendinosis is a ruptured tendon, a sudden serious injury resulting in severe pain, swelling and disability, that requires urgent care. While the injury may, in some cases, be treated noninvasively, most often surgery is necessary to relieve pain and improve function.
Prevention of Tendinosis
Individuals can minimize their risk of developing tendinosis by using ergonomic equipment on the job and employing proper movement techniques in their everyday lives. They will also reduce their risk by taking frequent breaks and not remaining in one position too long, by paying attention to early signs of pain or stiffness, and by avoiding antibiotics that increase risk of developing the disorder.