Tendonitis

Tendonitis Treatment using Low Level Laser Therapy

What is tendonitis?

Tendonitis (Tendinopathy) is inflammation or irritation of a tendon — any one of the thick fibrous cords that attaches muscle to bone. The condition causes pain and tenderness around a joint. The tendon is surrounded by a sheath that protects and lubricates the tendon. This sheath is lined by a layer of cells called the synovium. Occasionally, the tendon will become inflamed (called tendonitis or tendinopathy) or the tendon sheath will become inflamed (called tenosynovitis). These conditions together are known as tendonitis and result in pain, stiffness and sometimes swelling.

While tendonitis can occur in any of your body’s tendons, it is most common around your shoulders, elbows, wrists, fingers, back, hips, knees, ankles and heels.The symptoms usually include pain, stiffness and swelling.

If tendonitis is severe and leads to the rupture of a tendon, you may need surgical repair. But tendonitis can be successfully treated with rest and non-invasive Low Level Laser Therapy.

What causes tendonitis?

Although tendonitis can be caused by a sudden injury, the condition is much more likely to stem from the repetition of a particular movement over time, especially when using poor body position. Most people develop tendonitis because their jobs or hobbies involve repetitive motions, which put stress on the tendons needed to perform the tasks. Using proper technique is especially important when performing repetitive sports movements or job-related activities. Improper technique can overload the tendon — which can occur, for instance, with tennis elbow — and lead to tendonitis. http://drmirkin.com/fitness/why-ice-delays-recovery.html

How is tendonitis diagnosed?

Diagnosing tendonitis is based primarily on a physical exam and a medical history. Your doctor will look for swelling and tenderness in the area that is bothering you. He or she will rule out infection if there is no heat and redness associated with the swelling and tenderness. He or she will ask you about the pain and about what types of activities you are involved in. That is usually enough for the doctor to diagnose tendonitis. If the diagnosis is in question or if the doctor suspects that you may have an underlying inflammatory disease, he or she may run some routine laboratory tests and X-rays.

An ultrasound or magnetic resonance imaging (MRI) scan will show the degenerative changes in the tendon, but is rarely required.

What is the treatment for tendonitis?

Traditionally, treatments for tendonitis consist of temporary pain relief using anti-inflammatory medication, rest, and icing the area. While ice numbs the pain it also prevents healthy blood flow which is essential to providing oxygen and nutrients to the area to heal it, and remove waste products and CO2. Ice should therefore not be applied to injuries after the acute phase (the first day). http://drmirkin.com/fitness/why-ice-delays-recovery.html

Rest: Rest is essential to tissue healing. You may have to stop performing the offending activity that increase pain or swelling for a short period of time. Don’t try to work or play through the pain to avoid further injuring the tendon.

Although rest is a key part of treating tendonitis, prolonged inactivity can cause stiffness in your joints. After a few days of completely resting the injured area, gently move it through its full range of motion to maintain joint flexibility. You can do other activities and exercises that don’t stress the injured tendon e.g. water exercise may be well tolerated.

Activity modification: The activity that caused the injury should be modified in such a way as to relieve the stress on the tendon. For example, if running gave you Achilles tendonitis, you may need to reduce your mileage, wear different shoes and then increase your mileage slowly.

Splints: Sometimes splints are used to keep the affected joint in alignment during activities so stress is taken off the tendon (such splints and wraps are available for tennis elbow). Splints may also be used during the initial resting period to allow the tendon to heal.

Corticosteroid (cortisone) injections are sometimes used to assist in the treatment of tendonitis. These can be painful and the procedure carries risks such as increase in pain (“steroid flare”), skin discolouration at the injection site, nerve damage, infection, to name a few. Repeated injections may weaken a tendon, increasing your risk of rupturing the tendon. In [articular certain tendons should not be injected with steroids because it puts the tendon as risk of rupture (the Achilles for example).

Surgery: Rarely surgery may be needed to relieve the symptoms of tendonitis. Surgery would also be necessary if the affected tendon tore or ruptured.

Low Level Laser Therapy (LLLT)

LLLT is the application of red and near infrared light over injuries to stimulate cellular repair. LLLT has a powerful anti-inflammatory effect as well as a healing effect on the inflamed tendons and surrounding inflamed soft tissues. LLLT is completely safe and has no effect on normal tissues. LLLT treats the underlying cause of the injury unlike pain medication which just masks the pain.

Inflammation is the body’s response to injury to attempt to heal it. But often the inflammatory reaction is excessive and this has a paradoxical inhibitory effect on the body’s natural healing mechanisms. This then perpetuates pain and dysfunction in the affected area. By improving circulation and increasing cellular repair functions LLLT provides an environment for your body’s own natural healing processes to be activated and restored. Once normal immune processes are restored, the excessive inflammation is reduced and healing can begin.

LLLT does not exert any physical force on the affected tendon. Manipulation of the injured tendons just aggravates the problem, so you don’t want to actually handle the tendons, but instead decreasing the inflammation enables faster healing.

LLLT stimulates blood flow and lymphatic drainage, improved delivery of O2 and nutrition to the area, oxygen utilisation, removal of oxygen-free radicals and other waste products, and tissue healing. Read more on how Low Level Laser Therapy works.

You will be encouraged to move the affected area within range of movement/pain but not exert stretch or force during the healing phase.

The end result is resolution of inflammation and restoration of healthy tendons and local soft tissues. Once tissues are healed, pain is eliminated and normal range of motion and function is restored. Then muscle and tendon strength and flexibility can be addressed with graduated exercises and stretching.

LLLT has no known side effects, is safe and effective. By treating the underlying problem, LLLT results in relief of pain and restoration of function.

Physical therapy: A physical therapist can teach techniques to stretch the affected tendon after it has healed, thereby reducing the likelihood of re-injury. He or she can also assess your body mechanics and teach you better ways to perform the activities that give you trouble. Shoe inserts (orthotics) may be needed to adjust your running form, relieving pressure on your knee and Achilles tendons.