Chronic tendinopathy is a lasting inflammation of the tendons. It is different from acute tendinitis, which occurs suddenly and disappears after a period of rest and correct treatment. Tendinopathy is part of a group of musculoskeletal disorders and can affect athletes or people whose job requires performing repetitive acts. It is also due to bad postures or the over-straining of muscles, which in the long run, can cause the inflammation of one or more tendons. This inflammation can cause the damage or degeneration of the tendon and is at the origin of chronic tendinopathy. Some diseases or medications may also be responsible. Chronic tendonitis affects the tendons of the shoulder joints, knees, elbow, wrist, hip, but also the Achilles tendon.
Symptoms of chronic tendinopathy are:
- severe pain in the affected area;
- swelling, redness and increased heat in these areas;
- pain during mobilization;
- limitation of movement.
The diagnosis of chronic tendinopathy may be made after the description of pain, location and circumstances of their occurrence or aggravation. Active mobilization of the affected limb causes pain because the muscles and tendons are made to perform the movement, whereas in passive mobilization exerted by the examiner, pain is absent. In some cases, an X-ray will reveal the existence of a tendon calcification, particularly at the shoulder. Other times, an ultrasound or MRI will be performed to directly visualize the tendon.
The treatment of chronic tendinopathy varies depending on the location of the inflammation and its cause. The basic treatment is one that combines rest, painkillers containing paracetamol or anti-inflammatory drugs
. If pain persists, a doctor may give local corticosteroid injections, but their number should be limited. Rehabilitation is the step that follows and is achieved through physical therapy and regular massages, promoting the natural healing of the tendon. In very debilitating cases, a splint can be posed. Surgery is the last resort in cases where, despite correct treatment, the impact on the life of the individual remains severe.
Prevention of chronic tendinopathy is assured by adopting good practices such as systematic stretching sessions before/after sports. Repetitive motion and trauma should be avoided. At the onset of tendinitis, early rest associated with a good treatment line prevents progression towards chronic tendinopathy.