Tendinitis can happen because of:
Your risk for tendinitis may be higher if you have any of the following health issues:
Your doctor will give you a physical examination and may take x-rays and other diagnostic tests.
Your doctor may prescribe pain relievers or steroid injections. Treatment also may include ice, rest, or keeping the area still, such as with a sling. Massage, strengthening exercises, or physical therapy may help. Some studies show that high energy shock wave therapy improves symptoms and pain associated with tendinitis. If you have severe tendinitis that is not healing from other treatments, you may need surgery.
Herbs help strengthen and tone the body's systems. As with any therapy, you should work with your doctor to diagnose your problem before starting treatment. You may use herbs as dried extracts (capsules, powders, teas), glycerites (glycerine extracts), or tinctures (alcohol extracts). Unless otherwise indicated, make teas with 1 tsp. (5 g) herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers, and 10 to 20 minutes for roots. Drink 2 to 4 cups per day. You may use tinctures alone or in combination as noted.
Tell your doctor if you are pregnant or nursing before using any herbal products.
The following herbs may also help reduce inflammation, although they have not been tested for tendinitis.
Homeopathic remedies for tendinitis include creams or gels. Arnica cream by itself, or in combination with Calendula officinalis, Hamamelis virginiana, Aconitum napellus, and Belladonna, applied 3 to 6 times a day, speeds healing and reduces discomfort. For acute (sudden) injuries, always start with Arnica.
Orally, the dose is usually 3 to 5 pellets of a 12X - 30C remedy every 1 to 4 hours until the symptoms improve.
Many naturally-oriented doctors use injectable homeopathic medications, including Traumeel, which has shown promise in reducing inflammation in some studies.
The National Institutes of Health has reported that acupuncture may help treat tennis elbow. In addition, two studies looking at the effect of acupuncture on tendinitis found that acupuncture provides better pain relief than placebo.
Acupuncturists say that people with tendinitis frequently have a primary deficiency in the liver meridian, with a relative excess in the gallbladder meridian. In addition to needling treatment on the liver meridian and the supporting kidney meridian, treatments using moxibustion, a technique in which the herb mugwort is burned over specific acupuncture points may also be included. Needling and moxibustion may also be directly applied to painful areas and related sore points.
A technique known as balance method acupuncture may be effective in treating many musculoskeletal problems, including tendinitis.
Although no well-designed studies have looked at chiropractic care for treating tendinitis, chiropractors commonly treat this condition with ultrasound, electrical muscle stimulation, manual trigger point therapy (applying firm pressure by hand on a trigger point for several seconds and then stretching the muscle afterward), and massage. People with stiff joints may also receive joint manipulation.
Tendinitis often has 3 stages:
Tendinitis often comes back, particularly for athletes and people whose work requires repetitive motions.
Albert JD, Meadeb J, Guggenbuhl P, et al. High-energy extracorporeal shock-wave therapy for cacifying tendinitis of the rotator cuff: a randomized trial. J Bone Joint Surg Br. 2007;89(3):335-341.
Cacchio A, Paoloni M, Barile A, et al. Effectiveness of radial shock-wave therapy for calcific tendinitis of the shoulder: single-blind, randomized clinical study. Phys Ther. 2006;86(5):672-682.
Fray C, Zamora J. The effects of obesity on orthopaedic foot and ankle pathology. Foot Ankle Int. 2007;28(9):996-999.
Fredberg U, Stengaard-Pedersen K. Chronic tendinopathy tissue pathology, pain mechanisms, and etiology with a special focus on inflammation. Scand J Med Sci Sports. 2008;18(1):3-15.
Gelineck J, Salomonsen M, Hviid C. Retropharyngeal tendinitis: radiographic and magnetic resonance imaging findings. Acta Radiol. 2006;47(8):806-809.
Gobel H, Heinze A, Ingwersen M, et al. Effects of Harpagophytum procumbens LI 174 (devil's claw) on sensory, motor und vascular muscle reagibility in the treatment of unspecific back pain. Schmerz. 2001;15:10-18.
Harvie P, Pollard TC, Carr AJ. Calcific tendinitis: natural history and association with endocrine disorders. J Shoulder Elbow Surg. 2007;16(2):169-173.
Kimmatkar N, Thawani V, Hingorani L, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee -- a randomized double blind, placebo controlled trial. Phytomedicine. 2003;10:3-7.
Lathia AT, Jung SM, Chen LX. Efficacy of acupuncture as a treatment for chronic shoulder pain. J Altern Complement Med. 2009;15(6):613-618.
Rahman MH, Khan SZ, Ramiz MS. Effect of therapeutic ultrasound on calcific supraspinatus tendinitis. Mymensingh Med J. 2007;16(1):33-35.
Skjong C, Meininger A, Ho S. Tendiopathy Treatment: Where is the Evidence? Clin Sports Med. 2012;31(2):329-350.
Rees JD, Maffulli N, Cook J. Management of tendinopathy. Am J Sports Med. 2009 Sep;37(9):1855-1867.
Zubler C, Mengiardi B, Schmid MR, Holder J, Jost B, Pfirrmann CW. MR arthrography in calcific tendinitis of the shoulder: diagnostic performance and pitfalls. Eur Radiol. 2007;17(6)1603-1610.