Two of the significant conditions that people experience with tendons are tendonitis and tendinosis. Because they have similar-sounding names, they are often confused with each other. Each reflects a distinctly different condition with a tendon, requiring different treatments. We’ll review each of these two conditions individually below.
The term “tendinopathy” is a general term used to describe any disease or dysfunction involving a tendon. It encompasses both tendonitis and tendinosis as well as longitudinal tendon tears. It is also a term that sometimes is used, less correctly, to refer to a tendon condition that fails to heal.
Tendonitis and tendinosis are both conditions that can cause pain. The pain can be associated with a tendon located in your shoulder, elbow, hip, knee, ankle or foot. Tendon pain is different from arthritis, which refers to inflammation of a joint which also can cause musculoskeletal pain.
Many of us have heard of tendonitis, also commonly known as tendinitis. Tendons are the tough cords of tissue that connect muscles to bones. When those tendons become irritated, they can become inflamed.
Tendonitis is most often caused by overuse leading to inflammation. The result is swelling, pain, and discomfort. Tendons with this condition don’t have any microscopic damage when inspected by ultrasound. This lack of microscopic damage is one indicator that the condition may be tendonitis and not tendinosis.
Treatment for Tendonitis (Tendinitis)
Treating tendonitis involves treating the inflammation of tendon tissue, which is the underlying problem. Typically, you can recover from tendonitis in several days to six weeks.
Treatments of tendonitis may include:
- Resting the affected tendon and joint, and avoiding the repetitive motion that originally caused the pain.
- Icing the area for 15 to 20 minutes, several times a day until the inflammation subsides.
- Short-term use of over-the-counter anti-inflammatories.
- A splint, brace, or orthotics.
If the pain persists, however, you should make an appointment with your musculoskeletal health care specialist. They may determine that a corticosteroid injection may be the right treatment to decrease the inflammation and relieve the condition. This may be coupled with physical therapy and exercises to strengthen the tendons and muscles and preserve range of motion.
Tendinosis is primarily a degeneration of tendon tissue, usually without inflammation – although in some cases, it may also involve inflammation. It may also be referred to as Chronic Tendon Disease.
Tendinosis is a long-term condition where the tendon is chronically damaged and weakened. Tendinosis results in a breakdown of the tendon’s collagen – which is the primary structural protein of skin, tendons and other connective tissue.
Tendinosis is caused by repetitive motions creating micro tears, or tiny breaks in the tendon. This condition usually requires a more significant level of medical attention than does tendonitis. The degeneration of tendinosis results from overuse without enough rest to permit healing. An ultrasound or an MRI scan can distinguish the chronic degenerative changes of tendinosis as opposed to tendonitis’s swelling and inflammation.
Treatment for Tendinosis
Treating tendinosis involves treating the degeneration of tendon tissue, which is the underlying problem. When diagnosed at an early stage, tendinosis can be treated in six to 10 weeks. But once it reaches a chronic stage, treatment can often take three to six months. Tendons take a long time to heal because the blood supply to tendons is typically low.
Treatments and maintenance of tendinosis may include:
- A physical therapy program to stretch the tendon and strengthen the surrounding muscles.
- If pain persists, PRP therapy may be effective in stimulating a healing response using an injection of prepared healing factors from your own blood.
- If pain persists for more than three months, your doctor may recommend a minimally-invasive, outpatient procedure called ultrasonic percutaneous tenotomy. This procedure uses a thin metal probe that vibrates at 20,000 rpm to gently dissolve and remove damaged tendon tissue.