Tendonitis

How to treat tendonitis yourself

For the first couple of days, follow the five steps known as PRICE therapy to help bring down swelling and support the injury:

Protection

Protect from further injury (for example by using a support).

Rest

Avoid activity for the first 48 to 72 hours following injury.

Ice

Apply ice wrapped in a damp towel for 15 to 20 minutes every two to three hours during the day for the first 48 to 72 hours following the injury. This should not be left on whilst the person is asleep.

Compression

Compress with a simple elastic bandage or elasticated tubular bandage, which should be snug but not tight, to help control swelling and support the injury. This should be removed before going to sleep.

Elevation

Keep the injured area elevated and supported on a pillow until the swelling is controlled. If the symptoms are in a leg,  elevating the leg for long periods of time should be avoided.

To avoid HARM in the first 72 hours after the injury, avoid the following:

• Heat - for example, hot baths, saunas, and heat packs
• Alcohol - increases bleeding and swelling and decreases healing
• Running - or any other form of exercise which may cause further damage
• Massage - may increase bleeding and swelling

When you can move the injured area without pain stopping you, try to keep moving it so the tendon doesn't become stiff.

Avoid strenuous exercise such as running for up to 8 weeks, as there's a risk of further damage.

How a pharmacist can help

A pharmacist can help with tendonitis. They can recommend the best painkiller for you. This might be tablets or a cream or gel you rub on the skin.

Paracetamol and ibuprofen can help to ease mild pain. Wait for 48 hours after your injury before taking ibuprofen, because it can slow down healing.

Check if it's tendonitis

There are tendons all over your body. They connect your muscles to bones, for example in your knees, elbows and shoulders.

The main symptoms of tendonitis are:

• pain in a tendon (for example, in your knee, elbow or shoulder) which gets worse when you move
• problem  moving the tendon
• feeling a grating or crackling sensation when you move the tendon
• swelling, sometimes with heat or redness
• a lump along the tendon

Types of tendonitis

There are many different types of tendonitis, depending on which area of the body is affected.

These include possible types of tendonitis for affected areas:

• knees:  patellar tendonitis (jumper's knee)
• elbows: tennis elbow or golfer's elbow
• shoulders: calcific tendonitis or supraspinatus tendonitis
• wrists and thumbs: de Quervain's disease
• heels: Achilles tendonitis
• upper arm: biceps tendonitis

When to get medical help

You should contact urgent and emergency care services or see your GP if:

• your symptoms don't improve within a few weeks
• you're in a lot of pain
• you think you've ruptured (torn) a tendon

A ruptured tendon usually causes sudden and severe pain. You might hear a popping or snapping sound during the injury.

Treatment from a GP

Your doctor may prescribe a stronger painkiller or cream or gel to bring down the swelling.

If your injury is severe or lasts a long time, you may be offered physiotherapy. You can also choose to book appointments privately.

• Find a physiotherapist

You may be referred to hospital for a scan if your doctor thinks you could have another injury, such as a broken bone.

Some people with long-term or severe tendonitis may be offered:

• steroid injections for short-term pain relief
• surgery to remove damaged tissue or repair a ruptured tendon
• shockwave therapy, which may help speed up healing
• platelet rich plasma injections (PRP), which may help speed up healing

You can't always prevent tendonitis

Tendonitis is most often caused by sudden, sharp movements or repetitive exercise, such as running, jumping or throwing.

There are things you can do to help reduce your risk of tendon injuries, these include:

Do:

• warm up before exercising and stretch afterwards
• wear suitable shoes for exercise
• take regular breaks from repetitive exercises

Do not:

• over-exercise tired muscles
• start a new sport without some training or practice
• stick to the same repetitive exercises

Tendonitis can also be caused by repetitive movements or having poor posture at work, for example, when using a keyboard and mouse. This is known as repetitive strain injury (RSI).

More useful links

• How to use your health services