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Tendonitis

Medically reviewed by Drugs.com. Last updated on Jun 23, 2025.

What is tendonitis?

Harvard Health Publishing

Tendons are tough, flexible, fibrous bands of tissue that connect muscles to bones. When tendons become inflamed or irritated the condition is called tendonitis. Tendons can be small, like the delicate, tiny bands in the hands, or large, like the heavy, ropelike cords that anchor the calf or thigh muscles. In most cases, the cause of tendonitis is unknown; when a cause can be identified, the condition usually happens for one of two reasons.

Other causes include rheumatoid arthritis and reactive arthritis, which may cause tendon as well as joint inflammation. Rarely, tendonitis is caused by an infection such as gonorrhea. Tendonitis is most common in the shoulder, elbow, knee, wrist, and heel, although it can happen anywhere that tendons are found in the body. For uncertain reasons, tendonitis is also common in people with diabetes. In recent years, a rare cause of tendonitis (or other tendon disease, including rupture) has been recognized: the use of certain antibiotics, including ciprofloxacin or levofloxacin. Why this happens is unknown.

Tendonitis in the shoulder. The most common form of tendonitis in the shoulder is rotator cuff tendonitis. It often involves the tendon of the supraspinatus muscle, which attaches to the upper portion of the upper arm bone (humerus) at the shoulder joint. Less commonly, the tendon of the infraspinatus muscle or other tendons of the rotator cuff is affected. In most cases, the supraspinatus tendon is injured by overuse, typically in an occupation or sport that requires the arm to be elevated repeatedly. People at risk include carpenters, painters, welders, swimmers, tennis players, and baseball players. The average patient is a male laborer older than 40, and the shoulder pain is on the same side as his dominant hand (for example, right shoulder pain in a right-handed person).

Tendonitis in the elbow. Two forms of tendonitis commonly involve the elbow: lateral epicondylitis and medial epicondylitis. Both are very common overuse injuries among athletes involved in golf, or throwing and racquet sports.

Tendonitis in the knee. Jumper's knee, the most common form of knee tendonitis, involves either the patellar tendon at the lower edge of the kneecap or the quadriceps tendon at the upper edge of the kneecap. It is a common overuse injury, especially in basketball players and distance runners.

Tendonitis in the wrist. In the wrist, tendonitis commonly appears in the form of de Quervain's disease, a condition that causes pain in the back of the wrist at the base of the thumb. Although de Quervain's disease usually occurs in people who repeatedly grasp or pinch with the thumb, it sometimes develops during pregnancy or for no known reason.

Achilles tendonitis. This form of tendonitis affects the Achilles tendon, the large ropelike tendon attached to the heel bone at the back of the foot. Achilles tendonitis usually is caused by overuse, especially in sports that require running or repeated jumping, and it accounts for 15% of all running injuries. Achilles tendonitis also may be related to faulty running technique or to poorly fitting shoes, if the back of the shoe digs into the Achilles tendon above the heel. Less often, Achilles tendonitis is related to an inflammatory illness such as ankylosing spondylitis, reactive arthritis, gout, or rheumatoid arthritis.

Symptoms of tendonitis

In general, tendonitis causes pain in the tissues surrounding a joint, especially after the joint is used too much during play or work. In some cases the joint may feel weak, and the area may be red, swollen, and warm to the touch.

When tendonitis is caused by an infection such as gonorrhea, there may be other symptoms, including rash, fever, or a discharge from the vagina or penis.

Other symptoms vary according to which tendon is affected:

Diagnosing tendonitis

After reviewing your medical history, including any previous joint injuries, your doctor will ask you specific questions about your pain:

During the physical exam, your doctor will look for tenderness, swelling, redness, muscle weakness, and limited motion in the area of the sore tendon. Your doctor also may ask you to move in certain ways, such as raising your arm above your head or bending your wrist. Pain is typically worse when you move the joint near the infected tendon than when your doctor moves your joint. These moves may hurt, but they are very important to help your doctor figure out which tendon is affected. In most cases, the diagnosis can be made based on your medical history and symptoms, together with your occupational and sports history and the results of your physical examination.

Some people may need blood tests to look for other causes of inflammation around the joints, such as gout or rheumatoid arthritis. X-rays also may be taken to confirm that there is no fracture, dislocation, or bone disease. In people with Achilles tendonitis or rotator cuff tendonitis, ultrasound or magnetic resonance imaging (MRI) scans may be used to help evaluate the extent of tendon damage.

Expected duration of tendonitis

Depending on the location and severity of tendonitis, symptoms may last for a few days or for several weeks. If there is continued overuse or aggravation of the injured site, pain may worsen and persist for several months.

Preventing tendonitis

In many cases, tendonitis can be avoided by taking a few simple precautions. Some helpful strategies include:

Treatment options

The following list of medications are related to or used in the treatment of this condition.

View more treatment options

Treating tendonitis

The quicker your tendonitis is treated, the sooner you'll recover full strength and flexibility. Your doctor first may recommend that you apply ice packs to the painful area for 20-minute periods, three or four times a day. You also should ice the area immediately after any activity that aggravates your pain (such as tennis or running). To relieve pain and swelling, your doctor may suggest that you take ibuprofen (Advil, Motrin, and others), aspirin, or another nonprescription anti-inflammatory medication, for up to several weeks. You also will need to rest the area for a few days to a few weeks to allow your body to repair itself. For example, people with golfer's elbow usually need to rest the affected elbow for at least one month. If an infection is causing the tendonitis, an antibiotic is recommended.

Depending on the location and severity of tendonitis, you may need temporary splinting, bracing, or a sling (for tendonitis in the upper extremity). However, it is important to gently and regularly move the joint to avoid getting a stiff or "frozen" joint.  This is particularly important for tendonitis involving the shoulder.

When tendonitis is related to a condition such as rheumatoid arthritis or reactive arthritis, treatment of the underlying condition may improve the tendon inflammation and prevent recurrence.

For more serious cases of noninfectious tendonitis, your doctor may inject a corticosteroid drug or local anesthetic into the affected tendon. He or she also may refer you to a physical therapist for more specialized local treatments such as deep heat treatments using ultrasound, friction massage, or water therapy to improve joint mobility. The physical therapist also will guide you through a rehabilitation program that will help you to regain strength, motion, and function. The length of time for rehabilitation varies depending on the type and severity of tendonitis. For example, Achilles tendonitis and epicondylitis may require several months to resolve.

Surgery is rarely needed to treat tendonitis. It is reserved for cases that do not respond to other types of treatment or when there is significant tendon damage that is unlikely to improve with any other treatment.

When to call a professional

Call your doctor whenever you have a significant joint problem such as severe pain, redness, swelling, or loss of joint function. Also, call your doctor if less-severe joint pain is persistent.

Prognosis

With proper treatment, the affected tendon usually recovers completely. However, incomplete rehabilitation or a hasty return to activity can slow the healing process or lead to re-injury.

Additional info

National Institute of Arthritis and Musculoskeletal and Skin Diseases
https://www.niams.nih.gov/

American Academy of Orthopaedic Surgeons (AAOS)
https://orthoinfo.aaos.org/

American Physical Therapy Association
https://www.apta.org/

American College of Rheumatology
https://www.rheumatology.org/

Arthritis Foundation
https://www.arthritis.org/


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