Inflammation and tendon disorders

Tendons are the bands of fibres that attach muscles to bones, producing the movement of our joints. They are a common injury that can cause great discomfort and lack of mobility for the sufferer and, over the last few decades, doctors have debated whether they are due to ‘degeneration’ or inflammation. For many years, the bias has been to the former and as Professor Cathy Speed explains in a new book due to be published by Springer, this may have led to patients missing out on effective early treatment of these conditions.

Due to be published in June, ‘Metabolic Influences on Risk for Tendon Disorders’ brings together contributors from across the world who are specialists in tendon injuries. Cathy’s chapter entitled ‘Inflammation in tendon disorders’ focuses on the role that inflammation plays.

The tendons can become stressed due to a number of causes, including repetitive activities, force, vibration and awkward postures and this causes an inflammatory response. The tendons can then become thickened, bumpy and greatly weakened if early intervention is not made.

The link between inflammation and degeneration has been a source of great debate, as tendons can sometimes become damaged without inflammation and yet other scientific studies have indicated that inflammation should be viewed as an early warning sign for tendon injury.

What are the most common areas for tendon injury?

Any area of the body can be affected, but tendon injuries are common in the shoulder, particularly the rotator cuff. The elbow is also particularly prone for tendon problems and tennis elbow is an inflammation of the tendon that attaches the forearm muscles to just above the elbow. There are also a number of specific tendon disorders and conditions that affect the hand and wrist.

What are the treatment options for tendon injuries?

Tendon disorders usually present as pain at the site of injury, often accompanied with tenderness when touched. There is often swelling and redness and movement in the afflicted body part is restricted.

Prevention is the best option for treatment and this requires addressing the possible cause, whether it is due to the work environment or choice of sporting activity. Other treatment options include the use of NSAIDs or non-steroidal anti-inflammatory drugs for pain relief, corticosteroid injections, application of ice or heat and physical therapy that covers stretching and strengthening exercises.

As Cathy explains, the scientific evidence now supports the strong role of inflammation in tendon injuries and so newer treatments should be orientated towards this. She believes that there are definitely subsets of patients who have a lot of inflammation and these are often overlooked in sorts clinics. So detection – particularly early – and meticulous clinical assessment is vital.

For more information on how Cathy treats tendon disorders, please call 01223 200 595 and speak to one of the Cambridge clinic team.