The muscles and the bones are attached with tendons, which are thick fibrous cords. The inflammation and irritation of these tendons leads to a condition called tendinitis. The joint nearby is also inflamed and is tender and painful. Strain on tendons due to overuse or injury to them leads to tendinitis. It is most commonly seen in the shoulders, wrists , elbows, knees, and heels. Thus, the other names of tendinitis are tennis elbow, pitcher’s shoulder, golfer’s elbow, jumper’s knee and swimmer’s shoulder. There are different types of tendinitis based on where in the body it is affected. Some include:
Pathophysiology of TendinitisTendons connect the muscles to the bones. Any force felt on the muscle is transmitted through the tendons. Thus the tendons are always under stress or mechanical load. Continuous load to the tendons causes tendinitis and hematologic findings include tendon inflammation, fibrinoid necrosis, and mucoid degeneration. The proliferation of fibroblasts is also observed.
Repetitive action of a particular joint or muscle putting stress on the respective tendons might lead to tendinitis. Jobs or hobbies that involve repetitive motions cause tendinitis. Ergonomically safe techniques should be used while performing continuous straining sports movements or day to day job related activities. Improper techniques overloads the tendons causing the condition.
Secondly, with age, the tendons become less flexible, thereby more prone to injuries.If tendinitis is not treated appropriately, it leads to rupture of the tendon known as tendinosis, which requires a surgery. Tendinosis caused due to degenerative changes in the tendon combining with defective new blood vessel formation.
Tendinitis is diagnosed by physical examinations alone. X-rays or other imaging tests are performed to rule out other conditions.
Treatment options relieves the pain and reduces inflammation. The techniques include rest, ice, and over-the-counter pain relievers, but none of these aid in curing tendinitis. An exercise regimen involving the stretching and strengthening of the affected tendon can provide some relief from the symptoms.
A few of the medications useful in treating tendinitis include pain relievers, corticosteroids, and platelet-rich plasma. Finally, when all the other treatment options do not help, surgery is preferred. Surgery for tendinitis involves the following:
Mesenchymal stem cells are found to be successful in treating tendinitis. Stem cell therapy alleviates pain caused by tendonitis and regenerates the affected tendon, thereby restoring the normal integrity of the tendons. Platelet-rich plasma in combination with MSC aids in augmenting the regenerative capacity. The process involves the activation of one’s own adult stem cells and other paracrine growth factors to act on the affected area and stimulates healing and speedy repair of the affected tendon.