Tendonitis or Tendinosis?

Tendonitis is an acute inflammatory response to injury of a tendon that produces the classical signs of heat, swelling, and pain (Ashe et al., 2004).  Normally the tendon fibers are aligned nicely parallel to each other as seen in the image. 

When the tendon fibers become irritated or damaged due to injury or overuse, these fibers are flooded with fibroblasts to help repair the tissues.  What happens when these fibroblasts flood the tissue is rarely inflammation.  The tissue surrounding the fibroblasts are essentially being broken down resulting in tendinosis which is a degenerative condition instead of an inflammatory condition (Cooper, 2014). 

Common sites associated with tendinosis

What to do about it.

If you are experiencing pain in the wrist or elbow, Immobilize the wrist to avoid damaging the tendons any further and allow them to recover.  In more severe cases, it’s recommended to immobilize the elbow as well. Utilize heat to help with discomfort, and cold packs at the end of the day.  Perform gentle active motion of the wrist without pain and progressively increase the motion as long as it doesn’t cause pain. Overall, you are going to need to avoid any activity that causes your symptoms to increase to allow the tissue to repair itself.

It is always recommended to see a doctor if the symptoms don’t subside or if your pain is severe.

References

Ashe, M., McCauley, T., Khan, K.M. (2004). Tendinopathies in the upper extremity: a paradigm shift, Journal of Hand Therapy (Vol 17). 

Cooper, C. (2014). Fundamentals of hand therapy: Clinical reasoning and treatment guidelines for common diagnoses of the upper extremity (2nd edition). Elsevier Mosby.