No, Do Not Refer Patients with Tendinitis to ENT
Tendinitis is a musculoskeletal condition that should be managed by primary care physicians, orthopedic specialists, or sports medicine physicians—not ENT (Ear, Nose, and Throat) specialists. ENT specialists manage conditions of the ear, nose, throat, airway, and head/neck structures, not tendon disorders 1.
Why This Referral is Inappropriate
ENT specialists treat completely different anatomical systems. According to the American Academy of Pediatrics guidelines on specialist referrals, ENT (otolaryngology) specialists manage:
- Complicated infections of the ear, nose, sinuses, pharynx, airway, and neck 1
- Congenital malformations of head and neck structures 1
- Sensory impairments including hearing loss and vocal fold paralysis 1
- Airway endoscopy for stridor evaluation 1
None of these conditions include tendinitis or any musculoskeletal tendon pathology 1.
Appropriate Management of Tendinitis
Initial Primary Care Management (First 3-6 Months)
Most patients (approximately 80%) with overuse tendinopathies fully recover within 3-6 months with appropriate conservative outpatient treatment 1.
Your initial approach should include:
- Relative rest to decrease repetitive loading while avoiding complete immobilization that causes muscle atrophy 1, 2, 3
- Cryotherapy with melting ice water through a wet towel for 10-minute periods for acute pain relief 1, 2, 3
- Eccentric strengthening exercises, which are effective and may reverse degenerative changes 1, 2, 3
- NSAIDs for short-term pain relief (though they don't affect long-term outcomes) 1, 2, 3
- Topical NSAIDs as an alternative with fewer systemic side effects 1, 2, 3
When to Consider Specialist Referral
If conservative management fails after 3-6 months, refer to orthopedic surgery—not ENT 1, 2, 3.
According to the American Academy of Family Physicians, surgery is an effective option for carefully selected patients who have failed three to six months of conservative therapy 1.
Common Pitfall to Avoid
The most critical error would be referring a patient with tendinitis to ENT, as this specialist lacks the training and expertise to manage tendon pathology. This would delay appropriate care and potentially worsen outcomes 1. Tendinitis requires musculoskeletal expertise, not head and neck surgical expertise 1.