From the Research
Treatment Options for Chronic Tendinitis
- Nonsteroidal anti-inflammatory drugs (NSAIDs) can provide short-term pain relief, but their long-term effectiveness is unclear 1, 2, 3, 4
- Corticosteroid injections can offer short-term pain relief, but they lack long-term efficacy and should be used selectively in resistant cases 1, 2, 3, 4
- Eccentric exercise-based physical therapy is a recommended first-line treatment for chronic tendinopathy, with evidence supporting its effectiveness in improving pain and function 1, 2, 3
- Alternative treatments such as prolotherapy, topical nitroglycerin, iontophoresis, phonophoresis, therapeutic ultrasound, extracorporeal shock wave therapy, and low-level laser therapy have less evidence of effectiveness, but may be considered as second-line options 1, 3
- Surgery can be successful in treating chronic tendinitis, but it should be reserved for patients who are recalcitrant to other more conservative options due to the higher complication rate 2, 3, 4
Factors Affecting Treatment
- The natural course of tendon healing and the clinical assessment of tendinitis should be considered when developing a treatment plan 5
- Patient counseling and correction of associated mechanical factors, if present, are important components of initial treatment 4
- Age-related degeneration and relative avascularity in the tendon may play an important etiologic role in chronic tendinitis, and should be taken into account when selecting a treatment option 4