Tendonitis?

Question

I was just diagnosed with tendonitis today. The hospital gave me info, but it wasn't much. I looked it up on webmd and couldn't really find too much. I want to know what exactly should I do. All the paper told me was to wear the brace they gave me and take motrin for pain and inflammation. What else can I do to help make this better?

It's the right wrist. The part of the body I use most often.

Answer 1

Here is some infromation on what you can do. My ex had to have the surgery, and he never was the same afterwards. Try some of these...

What is the treatment for wrist tendonitis?


Immobilization
Placing the wrist in a splint or a cast is usually the first treatment step. Wrist tendonitis is due to recurrent irritation of the tendon and its sheath. By resting the tendon, the inflammation should decrease.
Find a Wrist Splint

Ice the Injury
Applying an ice pack intermittently to the area of inflammation may also be beneficial. Icing wrist tendonitis can help to cool inflammation and also stimulates blood flow to the area of tendonitis.

Anti-Inflammatory Medications
Nonsteroidal anti-inflammatory medications will help control symptoms of pain, but more importantly they help in the treatment of wrist tendonitis to decrease inflammation and swelling of the soft-tissues. These treatment medications will decease the inflammatory response which is the cause of the pain.

Cortisone Injection
Cortisone is a more powerful anti-inflammatory treatment option that is given by injection directly to the site of inflammation. Cortisone injections are safe, but can weaken tendons over time if too many injections are given.

Surgery
Surgery is only done when these other treatment methods have failed to solve the problem. If that is the case, the area of tight tendon sheath that cause the painful and difficult tendon movements can be released. The inflammatory tissue can also be removed in an effort to create more space for the tendon to move freely.

Answer 2

It means the tendon has become inflamed and the anti-inflammatory will be of the most help. The doctor could also give you prednisone but the side-effects are rarely worth it.

As the others have said ... it will take time. Try to rest the area as much as possible. Topical creams like the Icy Hot can help but rest and Advil will do it's thing if you just let it.

takes time

Answer 3

The information you have is correct. The only things you can do for tendonitis is rest it, and take Motrin to reduce the inflammation. It may hurt for several days---the anti-inflammatories (Motrin) are an important part of the healing process. Keep resting the area for a few days even after it feels better, because it is really easy to make it flare up again.

Answer 4

yea i had a small case of that in my left elbow....the doctor didnt give me much either but my dad had a problem with his knees so he gave me this cream called icy hot and i put it on my elbow about 3 times a day then took some tynol if the pain was too much...and it hasnt been hurting in over 2 months....hopefully that works for u 2.....

Answer 5

is it your wrist? wherever it is just rest is. the muscle needs to reconnect to the bone. it is very painfull if you don't rest it.

Answer 6

thats what my gf has... i think

Answer 7

Emergency Department Care:

The goal of treatment is to reduce pain and to return to activity. Treatments for tendinopathy are listed below.
Rest or decrease activity level. No clear recommendations are available for the duration of rest; however, patients should restrict activities that cause pain.

Ice is recommended for the first 24-48 hours.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective in relieving tendinopathy pain. However, because the vast majority of tendinopathies are not inflammatory, whether NSAIDs are more effective than other analgesics is unclear.
Splinting and/or immobilization
Sling for rotator cuff tendonitis
Strengthening and stretching exercises can be performed once the pain has subsided. Eccentric strength training can be effective in treating tendinopathies.
Heel padding for Achilles tendinopathy (decreases tension on tendon during heel strike)
Peritendinous lidocaine/corticosteroid injection
Consider this injection for patients with tendonitis in whom conservative therapy with rest, immobilization, and anti-inflammatory agents has failed.

The efficacy of locally injected steroids is debated.

Never inject into the Achilles tendon because cases of Achilles tendon rupture have been reported following a single injection of corticosteroid.

Avoid repetitive corticosteroid injections in any site, as well as injection directly into a tendon, because of the risk of tendon rupture.
Consultations: An ED consultation seldom is necessary for tendonitis.
MEDICATION Section 7 of 10
Author Information Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Bibliography




The goals of pharmacotherapy are to control pain and decrease inflammation.


Drug Category: Nonsteroidal anti-inflammatory drugs (NSAIDs) -- Used for the relief of mild to moderate pain. Although the effects of NSAIDs in the treatment of pain tend to be patient specific, ibuprofen usually is the drug of choice (DOC) for initial therapy. Other options include flurbiprofen, naproxen, ketoprofen, and indomethacin.Drug Name
Ibuprofen (Motrin, Advil, Ibuprin, Nuprin) -- Usually DOC for treatment of mild to moderate pain if no contraindications are present.
Inhibits inflammatory reactions and pain, probably by decreasing activity of the enzyme cyclooxygenase, which results in inhibition of prostaglandin synthesis.
Adult Dose 400 mg PO q4-6h, 600 mg PO q6h, or 800 mg PO q8h while symptoms persist; not to exceed 3.2 g/d
Pediatric Dose 6 months to 12 years: 20-40 mg/kg/d PO divided tid/qid; start at lower end of dosing range and titrate upward; not to exceed 2.4 g/d
>12 years: Administer as in adults
Contraindications Documented hypersensitivity; cross-sensitivity to other NSAIDs may occur; peptic ulcer disease; recent GI bleeding or perforation; renal insufficiency; high risk of bleeding
Interactions Coadministration with aspirin increases risk of inducing serious NSAID-related adverse effects; probenecid may increase concentrations and possibly toxicity of NSAIDs; may decrease effects of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions Category D in third trimester of pregnancy; caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in anticoagulation abnormalities or during anticoagulant therapy
Drug Name
Naproxen (Naprosyn, Aleve) -- For relief of mild to moderate pain. Inhibits inflammatory reactions and pain by decreasing activity of enzyme cyclooxygenase, which results in decrease of prostaglandin synthesis.
Adult Dose 200-250 mg PO q6-8h or 500 mg PO bid; not to exceed 1.25 g/d; may increase to 1.5 g/d for limited periods
Pediatric Dose <2 years: Not established
>2 years: 2.5 mg/kg/dose PO; not to exceed 10 mg/kg/d
Contraindications Documented hypersensitivity; peptic ulcer disease; recent GI bleeding or perforation; renal insufficiency; high risk of bleeding
Interactions Coadministration with aspirin increases risk of inducing serious NSAID-related adverse effects; probenecid may increase concentrations and possibly toxicity of NSAIDs; may decrease effects of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions Category D in third trimester of pregnancy; acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur; patients with preexisting renal disease or compromised renal perfusion risk acute renal failure; leukopenia occurs rarely, is transient, and usually returns to normal during therapy; persistent leukopenia, granulocytopenia, or thrombocytopenia warrants further evaluation and may require discontinuation of drug
Drug Name
Ketoprofen (Orudis, Actron, Oruvail) -- For relief of mild to moderate pain and inflammation.
Administer small dosages initially to patients with small body size, elderly patients, and those with renal or liver disease.
When administering this medication, doses >75 mg do not increase therapeutic effects. Administer high doses with caution and closely observe patient for response.
Adult Dose 25-50 mg PO q6-8h prn; not to exceed 300 mg/d
Pediatric Dose <3 months: Not established
3 months to 12 years: 0.1-1 mg/kg PO q6-8h
>12 years: Administer as in adults
Contraindications Documented hypersensitivity; GI disease; cardiovascular disease; renal or hepatic impairment; patients receiving anticoagulants
Interactions Coadministration with aspirin increases risk of inducing serious NSAID-related adverse effects; probenecid may increase concentrations and possibly toxicity of NSAIDs; may decrease effects of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions Category D in third trimester of pregnancy; caution in congestive heart failure, hypertension, and decreased renal and hepatic function; caution in anticoagulation abnormalities or during anticoagulant therapy
Drug Name
Flurbiprofen (Ansaid) -- Has analgesic, antipyretic, and anti-inflammatory effects. May inhibit cyclooxygenase enzyme, causing inhibition of prostaglandin biosynthesis that in turn may result in analgesic and anti-inflammatory activities.
Adult Dose 200-300 mg/d PO divided bid/qid
Pediatric Dose Not established
Contraindications Documented hypersensitivity
Interactions Coadministration with aspirin increases risk of inducing serious NSAID-related adverse effects; probenecid may increase concentrations and possibly toxicity of NSAIDs; may decrease effects of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; monitor PT closely (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions Category D in third trimester of pregnancy; acute renal insufficiency, interstitial nephritis, hyperkalemia, hyponatremia, and renal papillary necrosis may occur; patients with preexisting renal disease or compromised renal perfusion risk acute renal failure; leukopenia occurs rarely, is transient, and usually returns to normal during therapy; persistent leukopenia, granulocytopenia, or thrombocytopenia warrants further evaluation and may require discontinuation of drug
Drug Name
Indomethacin (Indocin, Indochron E-R) -- Rapidly absorbed; metabolism occurs in liver by demethylation, deacetylation, and glucuronide conjugation; inhibits prostaglandin synthesis.
Adult Dose 25-50 mg PO bid/tid
75 mg SR PO bid; not to exceed 200 mg/d
Pediatric Dose 1-2 mg/kg/d divided PO bid/qid; not to exceed 4 mg/kg/d or 150-200 mg/d
Contraindications Documented hypersensitivity; GI bleeding or renal insufficiency
Interactions Coadministration with aspirin increases risk of inducing serious NSAID-related adverse effects; probenecid may increase concentrations and possibly toxicity of NSAIDs; may decrease effects of hydralazine, captopril, and beta-blockers; may decrease diuretic effects of furosemide and thiazides; may increase PT when taking anticoagulants (instruct patients to watch for signs of bleeding); may increase risk of methotrexate toxicity; phenytoin levels may be increased when administered concurrently
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions Category D in third trimester of pregnancy; acute renal insufficiency, hyperkalemia, hyponatremia, interstitial nephritis, and renal papillary necrosis may occur; increases risk of acute renal failure in patients with preexisting renal disease or compromised renal perfusion; reversible leukopenia may occur (discontinue if persistent leukopenia, granulocytopenia, or thrombocytopenia)
Drug Category: Corticosteroids -- Have both anti-inflammatory (glucocorticoid) and salt-retaining (mineralocorticoid) properties. Glucocorticoids have profound and varied metabolic effects. In addition, these agents modify the body's immune response to diverse stimuli.Drug Name
Dexamethasone acetate (Decadron, AK-Dex, Alba-Dex, Dexone) -- Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reducing capillary permeability. Dosage varies with degree of inflammation and size of affected area.
Adult Dose 4-16 mg intralesionally (0.5-1 mL) mixed with equal or double volume of 1% local anesthetic (ie, lidocaine)
Pediatric Dose <12 years: Not established
>12 years: Administer as in adults
Contraindications Documented hypersensitivity; active bacterial or fungal infection
Interactions Effects decrease with coadministration of barbiturates, phenytoin, and rifampin; decreases effect of salicylates and vaccines used for immunization
Pregnancy B - Usually safe but benefits must outweigh the risks.
Precautions Increases risk of multiple complications, including severe infections; monitor adrenal insufficiency when tapering drug; abrupt discontinuation of glucocorticoids may cause adrenal crisis; hyperglycemia, edema, osteonecrosis, myopathy, PUD, hypokalemia, osteoporosis, euphoria, psychosis, myasthenia gravis, growth suppression, and infections are possible complications of glucocorticoid use
Drug Name
Methylprednisolone acetate (Solu-Medrol, Depo-Medrol, Medrol) -- Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability.
Use 0.5-1 mL (40 mg/mL) mixed with equal or double volume of 1% local anesthetic (ie, lidocaine). Dosage varies with degree of inflammation and size of affected area.
Adult Dose Tendon sheath inflammation: 4-30 mg intralesionally
Pediatric Dose Not established
Contraindications Documented hypersensitivity; viral, fungal, or tubercular skin infections
Interactions Coadministration with digoxin may increase digitalis toxicity secondary to hypokalemia; estrogens may increase levels of methylprednisolone; phenobarbital, phenytoin, and rifampin may decrease levels of methylprednisolone (adjust dose); monitor patients for hypokalemia when taking medication concurrently with diuretics
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions Hyperglycemia, edema, osteonecrosis, PUD, hypokalemia, osteoporosis, euphoria, psychosis, growth suppression, myopathy, and infections are possible complications of glucocorticoid use
Drug Name
Hydrocortisone acetate (Solu-Cortef, Cortef) -- Decreases inflammation by suppressing migration of polymorphonuclear leukocytes and reversing increased capillary permeability.
Use 0.5-1 mL (25 or 50 mg/mL) mixed with equal or double volume of 1% local anesthetic (ie, lidocaine). Dosage varies with degree of inflammation and size of affected area.
Adult Dose 5-12.5 mg intralesionally
Pediatric Dose Not established
Contraindications Documented hypersensitivity; viral, fungal, or tubercular skin infections
Interactions Corticosteroid clearance may decrease with estrogens; may increase digitalis toxicity secondary to hypokalemia
Pregnancy C - Safety for use during pregnancy has not been established.
Precautions Caution in hyperthyroidism, osteoporosis, peptic ulcer, cirrhosis, nonspecific ulcerative colitis, diabetes, and myasthenia gravis
FOLLOW-UP Section 8 of 10
Author Information Introduction Clinical Differentials Workup Treatment Medication Follow-up Miscellaneous Bibliography





Further Inpatient Care:


Patients with symptoms resistant to conservative therapy rarely require arthroscopic or open surgical treatment for tendon decompression and tenodesis.
Further Outpatient Care:


Follow-up care with patient's primary care provider within 1-2 weeks is appropriate in most cases of tendinopathy.
Specialty follow-up care with orthopedics may be indicated for patients with symptoms resistant to conservative therapy.
Complications:


Chronic disability
Tendon rupture
Adhesive capsulitis (ie, frozen shoulder)
Prognosis:


In general, the prognosis is very good with rest and conservative therapy.
Patient Education:


Quadriceps strengthening exercises for patellar tendinopathy
Change in training routine and/or equipment, if indicated
Runners with Achilles tendinopathy should wear proper footwear, run on softer surfaces, and avoid hills.
Patients with tennis elbow should maintain proper backhand technique, use a less tightly strung racket, and play on slower surfaces.
Range-of-motion exercises are recommended for patients with rotator cuff tendinopathy to avoid complication of adhesive capsulitis.
For excellent patient education resources, visit eMedicine's Foot, Ankle, Knee, and Hip Center and Hand, Wrist, Elbow, and Shoulder Center. Also, see eMedicine's patient education articles Tendinitis and Tennis Elbow.
http://www.emedicine.com/emerg/topic570.htm