Tendinopathy encompasses disorders of the tendons resulting in pain, swelling and reduced function. It typically affects the elbow, shoulder, knee and ankle and has an increased prevalence in athletes or workers who carry out the same repetitive activity, over-working one joint. It is also associated with diabetes and thyroid disease. Symptoms vary from localised pain to general joint stiffness and reduced function. Swelling, heat and redness are fairly classical characteristics and active use of the muscle groups supported by the tendon causes discomfort. The underlying pathology is poorly understood but is thought to represent a chronic cycle of inflammation and incomplete repair following tendon micro-injury.
Diagnosis involves careful examination of the affected joint and a thorough clinical history. Ultrasound imaging can be useful and MRI scans often help with the diagnosis.
Treatment is predominantly non-operative with physical therapy, use of orthotics and braces and anti-inflammatory medication. In the vast majority of cases, this will be sufficient over time to allow repair of the tendon and resolution of symptoms.
In refractory cases injections can be helpful. Steroid injections do not have a long term benefit in the treatment of tendinopathy but may help the acute symptoms and allow someone suffering from tendinitis to perform their physiotherapy more effectively. There has been recent interest in the use of platelet rich plasma for promoting repair of the tendon. The evidence is relatively sparse at present but encouraging results have been documented.
Very occasionally in chronic debilitating refractory cases, open debridement of the tendon and removal of the damaged tissue with potential repair may be advised.
If you would like to discuss management of tendinopathy with one of our specialists, please contact the office on 01483 938750 or email firstname.lastname@example.org.
PRP ACP for tendon disorders brochure