Tendonitis (patellar, wrist): what it is, causes and how to treat

That little pain in the shoulder, wrist or hip, which has been there for more than a week, is quite annoying.

It can be a tendonitis, an inflamed tendon. It is important that you treat tendonitis properly, as otherwise it can cause problems such as tendon rupture.


What is tendonitis?

Tendonitis is an inflammation in a tendon, a striated muscle that connects other muscles to the bones. They transfer muscle strength to the skeleton, allowing the body to move.

The tendons are rigid but flexible structures, however they do not have much elasticity. This makes the damage common.

Any of them can be affected, but the most common are those connected to the joints (knees, elbows, shoulders, hips, feet, ankles), as they move more often.

The inflammatory process is a reaction of the body to infections or (as in most cases of tendonitis) injuries. It is the body’s method of bringing more nutrients and immune cells to the region, ensuring recovery.

During inflammation, the area is hot and painful until everything is recovered.

Tendonitis can have numerous causes, such as overexertion, infections and trauma. As a result, they bring pain, discomfort and movement difficulties. When ignored, they can cause serious problems such as rupture of the affected tendon.

Tendonitis and bursitis: what’s the difference?

The difference between tendinitis and bursitis is the type of tissue affected.

While tendonitis is an inflammation of the tendons, bursitis is the inflammation of the bursa , a small bag filled with synovial fluid that stays in the joints and reduces the friction of the bone with the tendons and muscles.

Lubrication of synovial fluid is essential for joint movement to happen without pain, but when the bursa is inflamed, pain happens.

However, bursitis should not be confused with tendonitis. These are two different conditions.

Types of tendonitis

Tendonitis can be divided into 4 types, which vary according to the region of the tendon that is affected. Are they:

  • Entesitis : affects the central structure of the tendon;
  • Tenosynovitis : the inflamed region is the tendon synovial sheath . This is a structure that is around the tendon, protecting it, like a sheath;
  • Peritendinitis : inflammation affects the region where the tendon connects to the muscle;
  • Ossifying tendonitis : deposits crystals that solidify in the tendon, causing inflammation.

Which are the most common?

There are a number of different variations of tendonitis, since each region can be affected. We don’t list them all here, but some of the most common ones are:

Quervain syndrome

It is a type of tendonitis that affects the thumb tendon, often (as well as most tendonitis) caused by repetitive movements. It is a type of RSI.

Carpal tunnel syndrome

The carpal tunnel is an anatomical opening that is in the wrist, between the hand and the forearm, and is where nerves and tendons pass.

This syndrome refers to the compression of one of the nerves, the median .

The flexor tendons, responsible for the movement of the fingers, pass through the same tunnel and, therefore, they can be affected by the inflammation caused by the carpal tunnel syndrome, causing tendonitis in the region.

Calcaneal or Achilles tendonitis

This type of tendonitis affects the Achilles tendon , the one on the back of the heel, where supposedly the Spartan hero, whose only vulnerable point was the heel, was hit by a poisoned arrow that killed him.

It is a place where tendonitis often affects and, like others, requires rest and medication for treatment.

The ICD-10 code for this type of tendonitis is M76.6 .

Patellar tendonitis (in the knee)

Patellar tendonitis is one that affects the tendons of the knees, which help the muscles to extend the legs and that connect the tibia (the bone in the front of the leg) to the patella (the bone in the knee).

It usually affects athletes, especially those whose sport involves jumping, such as volleyball or basketball.

This type of tendonitis has the M76.5 code in the ICD-10 .

Tendonitis in the shoulder

The shoulders have three different tendons. The supraspinatus tendon , the subscapularis and the biceps tendon .

These are the tendons responsible for the movement of the arms and shoulder at the three angles at which it is possible to move it (forwards and backwards, to one side and to the other, up and down).

Hip tendonitis

Hip tendonitis can affect runners and is often caused by repetitive strain.

It affects the tendons that connect leg muscles to the hips and can cause stiffness that prevents people from running and sometimes even walking in a comfortable way.

Limestone tendonitis

This type of tendonitis occurs due to deposits of calcium crystals in the tendon, often in the shoulders.

The cause of this deposition is not known. It happens slowly and gradually, can cause discomfort and usually heals on its own, just like any other tendonitis.

Calcium is partially or totally absorbed, but in some cases it can take time to happen, causing pain and discomfort.

In ICD-10 , the code for this type of tendonitis is M75.3 when it affects the shoulder and M65.2 elsewhere.

Tendonitis in the hand

The hands house several tendons, responsible for each of the movements of the fingers. These movements can be repeated several times a day in an office environment, for example, or with games.

Therefore, the hands are parts of the body that are greatly affected by tendonitis, which manifests with pain and discomfort.

Tendonitis in the foot

The feet, as well as the hands, have several tendons responsible for their movements. Although tendonitis in them is not as common as in the hands, it can also happen, causing the common problems of the disease.

Tendonitis in the wrist

Just as working with computers – often in offices – can cause tendonitis in the fingers and hands, the pulse can also be affected. The inflamed tendons cause the classic symptoms of the disease: pain, discomfort, heat, redness, and others.

Other tendonitis

There are several other possible locations for tendonitis. Behind the knees, in the back, groin, wherever there is a tendon, inflammation is possible.

The inflammations can be caused by several situations and vary from case to case. Therefore, it is important to take care of your body and go to the doctor if there is tendon pain, to avoid more severe damage caused by the condition.

RSI and tendonitis

This condition is not exactly a type of tendonitis, as it does not only affect the tendons, but also muscles and nerves. But tendons are also affected, which puts tendonitis – when caused by repetitive strain – as a type of RSI.

RSI, or Repetitive Strain Injury, is a common injury in the workplace.

It is caused by repetitive movements and affects mainly (but not exclusively) the upper limbs. Shoulders, wrists and fingers are major victims of the inflammation caused by RSI. (Little curiosity: Did you know that your fingers have no muscles, only tendons?).

Causes: what causes tendonitis?

Tendonitis can be caused by several situations such as overexertion, passing through inadequate posture and diseases that affect the tendons. Traumas and infections can also be responsible for the condition, in addition to several other causes capable of affecting these structures.

Some of the causes of tendonitis are:

Repetitive effort

Repetitive strain is one of the main causes of tendonitis. Forcing the tendons in the same way for months or sometimes even years can damage them, which in turn leads to inflammation.

RSI is a condition often associated with office work, as the tendons of the fingers can be affected by typing and the use of the mouse and those of the wrists, by the position that the hands are when using the keyboard.

Exaggerated effort

Excessive effort can also cause damage that leads to inflammation in the tendons. Running, jumping, push-ups, lifting or holding weights in a way that forces the tendon fibers can cause the problem, especially when there is no rest or stretching.

Read more: Rhabdomyolysis: muscle necrosis due to stress

Bad posture

Poor posture can strain the tendons in your back, but there are several positions that can force others less related to the position we are in.

For example, lying on your elbow while reading or moving on your cell phone can strain your shoulder. Any position that has positioned your body in an unnatural way can cause tendonitis.

Immunological diseases

Certain autoimmune diseases can cause spontaneous inflammation in the tendons. This causes tendonitis as a consequence of the disease.

Rheumatological diseases

Rheumatological diseases, such as arthritis, can cause tendon problems, creating pain and inflammation.


In the same way that impacts can hurt muscles and bones, they can also cause damage to tendons, which, during recovery, can develop inflammation.


Infections can cause intense inflammation. If someone has tendons affected by bacteria, the immune system will attack them to try to cure the infection. Depending on how resistant the bacteria are, the inflammation can be severe and cause serious problems.

Risk factors

Most people, at some point in their lives, will experience tendon pain caused by inflammation. It is a common condition.

However, some people may experience tendonitis more easily, frequently and with intensity.

The main groups and risk factors for tendonitis are:


The effort caused by constant training of athletes often leads to tendonitis, which varies from region to sport.

Runners can have hip inflammation. Volleyball and basketball players, on their knees, while swimmers and throwers tend to feel their shoulders.

Sports injuries can also lead to the condition. In football, a cart that hits the Achilles tendon, for example, can damage it and cause tendonitis.


The stress increases the chances of you developing inflammation in the body as it increases the levels of epinephrine ( a hormone that increases the responses of the body to stress) in the blood.

Normally, the body releases cortisol (a stress hormone with an anti-inflammatory effect) along with adrenaline, which prevents inflammation caused by the muscle tension that the substance causes.

However, when the stress is constant, the opposite effect is not enough and inflammations can appear.

Muscle tension can also cause the tendons to become more tensioned, an unnecessary effort and one that can cause damage. As a result, tendonitis can arise.

Read more: How to control anxiety? 14 tips to avoid crises

Symptoms of tendonitis

Inflammation of the tendons can bring about some uncomfortable symptoms that may indicate the condition. Are they:


The region of the affected tendon is painful, especially when movements are performed. This pain usually radiates to the affected limb. For example, if tendonitis is in the shoulder, the pain can spread to the arm.

This pain is due to the use of an inflamed tendon. It becomes swollen and stiff, which makes the pain appear if moved.


Mild redness is common in cases of tendonitis. The affected area may become hot and red, but it is important to be careful with this symptom.

If the redness is very strong, it is possible that the damage is serious and the person should go to the hospital.


The word “inflammation” comes from the Latin ” inflammatio “, that is, to ignite, to set fire.

Inflammation is accompanied by heat in the affected tissue, which is an immune reaction that helps to eliminate possible bacteria that cannot survive at higher temperatures.


Like redness, tendonitis can cause mild swelling. However, if it is large, there may be damage to the muscle structures in the region and the doctor should be consulted.

Movement difficulty

One of the main symptoms of tendonitis is difficulty in movement . The tendon is one of the main structures related to movement and, when it is damaged and inflamed, it may have difficulty or even impossibility to fulfill its function.

There may be difficulty in raising the leg or arm, accompanied by a feeling of weakness in the region in certain positions.

How is tendonitis diagnosed?

The diagnosis of tendonitis can be made in some ways, but the physical examination is usually the main one, usually performed by the general practitioner , orthopedist or physiotherapist .

Physical exam

Physical examination is the main test for diagnosing tendonitis.

The doctor observes the way the part of the body affected by the symptoms moves, where and how it hurts, and through these observations, in addition to the touch, he can distinguish whether the affected region is the bone, muscle, nerve or tendon.

When it is confirmed that it is the tendon, the diagnosis of tendonitis can be made. However, some additional tests may be ordered to identify possible causes or to assess the extent of inflammation or damage.


Ultrasonography uses sound waves to build an image of the affected region. The images are not very detailed, but this exam is cheap and simple, in addition to having the ability to provide information that the physical exam alone cannot.


Magnetic resonance imaging offers clearer and more detailed images of the affected region, but the use of radioactive material is necessary for the images to appear clearly, in addition to being an expensive exam.

The information provided by an MRI is rarely necessary for the diagnosis and treatment of a simple tendonitis when there is no suspicion of any more dangerous condition.


The X-ray is usually not used for the identification of tendinitis because the tendons do not appear in this exam. However, it can show when there is an accumulation of calcium in a tendon, showing a possible calcareous tendonitis.

Is there any cure for tendonitis?

As long as the cause is curable, yes . In some cases, tendonitis is just a symptom of a more serious condition, such as an autoimmune disease, so all that is possible is to treat the inflammation, but in those cases it tends to reappear eventually.

However, when the cause of tendonitis is just exaggerated effort or performed incorrectly, the cure is simple and prevention is simple.

What is the treatment of tendonitis?

The main treatment for tendonitis is rest, but some medications can also help with inflammation, reducing the intensity of symptoms until the condition is gone.

In some cases, other treatments may be necessary.


Rest is the main method of treating tendonitis. Inflammation is nothing more than an effort by your immune system to repair what has been damaged or eliminate infections. Giving the time necessary for these repairs to be made resolves the situation.

Avoiding the affected tendon as much as possible is the best solution. The recommended minimum is 3 days, but 5 days of rest may be required for a full recovery.

Thereafter, prevention becomes key to preventing tendonitis from returning because of the same situation.


Anti-inflammatory drugs are used to treat tendonitis to reduce inflammation and, consequently, symptoms.

They are not always necessary, as the body is usually able to deal with inflammation easily, but in the most severe cases, medications help a lot.

Read more: Can pregnant women take acetaminophen? Know the dosage and risks


Cryotherapy is the application of ice. It increases vasoconstriction, which constricts blood vessels, reducing flow in the region.

This reduces inflammation and is used for acute cases (which are not frequent) caused, for example, by trauma.

The application of ice should be done for a maximum of 30 minutes to avoid damage from the cold, 4 to 6 times a day. Remember not to apply the ice directly to the skin. Use a cloth.


When tendonitis is ignored and the effort continues to be applied to a specific tendon, it is possible that it will rupture .

When the rupture is only partial, rest accompanied by immobilization may suffice, but if it is total (the tendon breaks completely), the treatment for this is surgery.

Surgery for the ruptured tendon aims to reconnect the fibers, thus enabling recovery.

The surgical method can also be used in cases of calcareous tendonitis, to remove the calcium deposit. It is usually not necessary, but it is an option.

The operation should be done in cases where the resting treatment is not effective and in cases where there is total tendon rupture.


Physiotherapy may be necessary if the tendon damage is severe.

Physiotherapy treatment can help the patient to recover movements in cases of tendon rupture – partial or total – or when the muscles atrophy due to long periods without exercise.

Muscle stretching and strengthening techniques are used, which helps to speed up the patient’s healing, in addition to preventing repetition of tendonitis or its causes.

The practice of physical therapy is important. A frequent mistake is that patients use only anti-inflammatory drugs that are stopped after the symptoms end.

This can resolve the acute case, but in these cases tendonitis usually returns after some time, sometimes stronger and more intense than before.

Physical therapy can also prevent tendonitis from developing into chronic tendonitis or tendinosis, which often leads to tendon rupture.

Medicines: what medicine is used for tendonitis?

Medicines for tendonitis are anti-inflammatory drugs (such as corticosteroids), to reduce inflammation, and analgesics, which decrease pain. Often the same drug has both effects. The main ones used are:


  • Paracetamol (Tylenol);
  • Ibuprofeno (Advil);
  • Acetylsalicylic acid ( Aspirin ).


  • Prednisona ( Meticorten ).


NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.

Home treatment

You can perform some home treatments in conjunction with medical treatment to help resolve tendonitis. Certain foods have anti-inflammatory properties and can aid recovery.

Ginger tea

Ginger tea helps to reduce inflammation. To do this, just boil 500mL of water with a small piece of ginger dipped inside it.

You can also use ginger as a spice for food.

Rosemary compress

Knead rosemary leaves , mix them in a spoon of olive oil and then use a gauze pad to compress the tendinitis site to reduce inflammation. Leave it like this for a few minutes.

How long to improve tendonitis?

Tendonitis, in milder cases, takes 1 to 3 weeks for full recovery. In cases where the tendon is severely damaged, it can take up to 10 weeks and when tendonitis becomes chronic, treatment can last from 3 to 9 months, depending on the progress of the disease and the quality of rest.

Exercises for tendonitis

The main exercise recommended for the prevention of tendonitis is stretching. It prepares the tendons for effort and prevents the condition. You must stretch your muscles before any physical exercise.

It is important to remember that exercises for the treatment of tendonitis should only be recommended by physical therapists, since only the professional knows exactly how to exercise the tendon without causing further damage.

Prognosis of tendonitis

The prognosis for tendonitis is usually positive. Rest is the main treatment and usually results in complete recovery of the tendon, which can be used again after a few days.

Tendonitis can take 1 to 3 weeks to heal when it is caused by tendon overload. However, it can take longer, depending on several factors such as the quality of rest, the condition of the tendon and the progress of the disease, which can take up to months.

Complications of tendonitis

There are not many complications for tendonitis, but it is important to remember that not treating the condition can have serious consequences.

Chronic tendonitis

Tendonitis can become chronic when left untreated. Inflammation mechanisms can begin before recovery from a previous inflammatory process, which does not allow the tendon to improve.

In such cases, treatment of the cause is necessary for the condition to be relieved.


Tendinosis is an evolution of an untreated tendonitis. In this state, the tendon is degenerating and about to rupture because of inflammation and stress.

It is essential that there is rest and physical therapy to avoid severe damage that may require surgery for recovery.

Tendon rupture

Tendonitis, if ignored, can lead to tendon rupture. This happens mainly when athletes continue to struggle despite the pain, but it can happen even without sports.

If you have tendon pain, rest is essential to prevent more serious damage. Tendon rupture may require surgery.

How to prevent tendonitis?

Preventing tendonitis is the best way to avoid the problem. Some of the habits you can have to avoid the condition are:


Especially before any physical exercise, stretching allows your body to prepare for efforts and protects your tendons from tendonitis, in addition, of course, from other damages that can affect the various structures of the body such as muscles and joints.


Resting is what allows your limbs, muscles and tendons to recover from exercise. For each training session, it is important to get some rest so that everything will recover and you will not be damaged by tiredness .

Even if you don’t exercise, rest is important as stress also increases your chances of developing inflammation.


The practice of physical exercises leaves the body better conditioned for efforts that may be necessary. This strengthens all parts of your body, including the tendons, which, with training, become more resistant.


Inadequate posture when sitting, lying down or driving are some of the main reasons why people develop tendonitis. Remember to keep your spine upright and your body in the correct position throughout the day.

Tendonitis is an inflammation in any of the tendons in the body, which is full of them.

It can cause pain and movement difficulties, and treatment usually involves resting to recover the affected tendon.

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