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Tendonitis
Can tendinitis be treated with a cortisone injection?
Can a cortisone injection be used for tendinitis? From a clinical perspective, for tendinitis, other conservative treatments such as physical therapy, massage, and oral medications can be used. When treatments like phototherapy are ineffective or not yielding results, a cortisone injection is certainly an option. As long as it is accurately targeted, the results of a cortisone injection are very satisfactory. In some cases of tendinitis, a cortisone injection can even achieve a curative effect. Thus, after tendinitis, a cortisone injection can definitely be used for treatment.
How to relieve tendonitis pain?
Tendonitis pain can usually be alleviated through the following methods: First, during the acute strain period, the RICE principle can be applied, which stands for Rest, Ice, Compression, and Elevation of the affected limb. Second, you can take some non-steroidal anti-inflammatory painkillers. Third, you can consider undergoing injection therapy. Fourth, treatment with traditional Chinese medicine can also be considered, as it is very effective in treating tendonitis. Fifth, some physical therapies can also be considered, such as heat therapy, microwave therapy, and transdermal drug delivery. It is worth mentioning shockwave therapy, which has been extensively verified clinically and is very effective in treating tendonitis. Therefore, tendonitis pain is not to be feared, as the above methods can be tried for treatment.
Why does tendonitis recur?
Tendonitis, if not well-rested, can easily recur. It mostly occurs during activities, work, or exercise, presenting with pain, swelling, and limited mobility. Tendonitis primarily involves the tendons, which are very hard connective tissues connecting bones and muscles. Tendonitis is mainly caused by the excessive use of muscle fibers and repetitive strain leading to degenerative changes in tendon collagen fibers. This accumulation of degeneration in tendon collagen fibers is commonly referred to as tendinopathy. Examples include common types such as Achilles tendonitis, patellar tendonitis, quadriceps tendonitis, or injuries to the rotator cuff, and lateral epicondylitis of the humerus. Long-term repetitive friction and fatigue can easily cause repeated episodes in these areas. Strict immobilization, along with physical therapy, massage, electric stimulation, and heat application can help alleviate symptoms. Additionally, taking blood-activating and pain-relieving medications, and when necessary, undergoing injective treatments can effectively prevent recurrences and promote relief, reducing symptoms.
How to treat tendinitis?
Treatment of tendonitis is divided into four types. The first is conventional treatment, which involves following the RICE principle during the acute phase. The second is medication, which includes the use of non-steroidal drugs and the option of local injections, but repetitive injections are not recommended as they can lead to tendon rupture, such as the rupture of the Achilles tendon often caused by such treatment. The third approach is for patients with chronic conditions where the affected area has developed adhesions and conservative treatment is ineffective. In such cases, surgical treatment should be considered, though the drawbacks include significant trauma, pain, and a long recovery period. The fourth method involves physical therapy, including heat therapy, ultrasound treatment, and microwave treatment. Thus, the basic treatments for tendonitis encompass these four approaches.
The difference between tendinitis and gout
The difference between tendinitis and gout is significant; these are two completely different diseases, although their symptoms are similar, including redness, swelling, heat, pain, and functional impairment. Tendinitis generally involves the muscles and tendons and is a type of aseptic inflammation caused by various reasons. In contrast, gout is due to abnormal metabolism of purines in the body, leading to the accumulation of gouty tophi in the joints, producing inflammatory symptoms. Therefore, tendinitis and gout are fundamentally different diseases.
The difference between tendinitis and tenosynovitis
Actually, tendinitis and tenosynovitis are essentially two aspects of the same condition. The term tendinitis usually refers to the part where the muscle transitions into the tendon, whereas tenosynovitis generally refers to the fibrous sheath over the tendon surface. Thus, tendinitis and tenosynovitis often coexist; tendinitis can lead to tenosynovitis, and conversely, tenosynovitis can also affect tendinitis, causing or exacerbating it. Therefore, in clinical practice, there usually is not a clear distinction between tendinitis and tenosynovitis. It is common during surgeries for stenosing tenosynovitis to observe that the tendon is also congested and swollen, and even adhered to the tendon sheath. Thus, tendinitis and tenosynovitis are generally considered the same disease, merely referred to by two different names. However, if strictly distinguished, there is a certain difference, which lies in the location: tendinitis refers to the tendon itself, while tenosynovitis refers to the sheath outside the tendon.
How to treat shoulder tendinitis?
Shoulder tendinitis is commonly seen in supraspinatus tendinitis, infraspinatus tendinitis, and long head of the biceps tendinitis. The treatment is mainly conservative. During the acute phase of tendinitis, resting, immobilization, and wearing protective gear are recommended. Secondly, oral intake of non-steroidal anti-inflammatory drugs can be considered. Thirdly, traditional Chinese medicines can be taken orally or applied topically. Fourthly, injection therapy can be considered, which usually has good effects. Fifthly, physical therapy is an option, including heat therapy and microwave therapy, with a special recommendation for shockwave therapy, which is very effective for tendinitis throughout the body. If conservative treatment is ineffective, surgical treatment may be necessary, tailored to the specific tendon involved.
How to treat the symptoms of tendinitis
The symptoms of tendinitis firstly include pain, which develops from mild to severe and can be alleviated by rest. However, the pain reoccurs or escalates with physical activity or increased intensity of movement. Additionally, the greater the activity, the shorter the relief period. The second symptom is restricted movement primarily due to pain. Pain causes limitations when moving the limb in certain ways or directions, increasing the pain and thereby causing movement restrictions. Typically, tendinitis presents a fixed tender point usually located at the site of injury, with possible radiating pain around the tender point. Swelling is generally not prominent; the primary characteristic of tendinitis is severe pain, with no significant changes in the skin and minimal or very light swelling. As for treatment, conservative approaches are commonly chosen, such as standard treatments involving immobilization, rest, and protecting the affected area. Oral non-steroidal drugs might be used along with localized treatments, or physical therapies like microwave and shockwave therapies, which are quite effective. If symptoms do not improve or worsen despite rigorous conservative treatment, surgical intervention may be necessary. The specific surgical techniques vary and are determined by the surgeon.
Treatment of Tendonitis
The causes of tendinitis usually fall into the following three categories: The first is acute injury, commonly referred to as tendon strain. The initial step is to stop any activity, followed by immobilization of the affected tendon area. Immobilization typically involves allowing the part to be completely relaxed, under no pressure, and is usually for a period of three weeks. The second cause is chronic overuse, which is the most common reason for tendinitis. It frequently occurs at sites of bony protrusions or where there is a tunnel, and this can easily lead to constrictive tendinitis. Treatment might start with rest, followed by non-steroidal anti-inflammatory drugs if rest is ineffective. Then, injection treatments are considered, typically around three times; symptoms or pain from tendinitis will significantly reduce or even disappear. If there is no improvement after three injections, a fourth should not be attempted, and surgical treatment to release the tendon and alleviate the constriction may be considered. The last cause is due to a purulent infection. This condition requires symptomatic treatment, initially with antibiotics, followed by cultures and sensitivity tests of the effusion. If the infection occurs adjacent to the tendon or in the tendon sheath, surgery might be necessary to perform drainage again. In summary, the treatment of tendinitis largely depends on the specific cause and involves different approaches.
Can tendinitis be treated with an injection?
Tendonitis can be treated with injections, which provide both anti-inflammatory and pain-relieving effects, often resulting in a very satisfactory therapeutic outcome. However, there are some considerations to keep in mind when performing these injections: First, the injection site must be free of infection and dermatitis; the skin must be clean and intact. Second, it is best to avoid injecting the medication near the attachment points of muscles or tendons on bones. In some cases, such as with femoral condyle osteoarthritis, injections near these points are necessary, but care should be taken not to inject directly into the attachment points to prevent tendon rupture at those sites, which are currently irreplaceable with current scientific techniques. Third, do not exceed three tendonitis injections. Many patients may recover after one or two injections, but some might go for a third if they do not feel significant improvement. If there is no noticeable benefit after three injections, or if the treatment is ineffective, the injection therapy might not be suitable for you, and other treatments should be considered. Therefore, while tendon injections can be an option for tendonitis, it is essential to apply the correct methods.