Tennis elbow, rotator cuff injuries, and Runner’s Knee are frequently diagnosed as tendonitis. However, more often than not, these injuries are actually something called tendonosis, and knowing the difference is important in knowing how best to treat the condition.
Your tendons are bands of thick and fibrous tissue that holds your muscles to your bones. Tendons are strong and able to withstand heavy loads, but they can become injured and painful. Tendon injuries are frequently misunderstood and frustrating to deal with, both for the patient and their practitioner. One reason these injuries are so difficult is that they seem to take forever to heal. However, a second reason is that tendon injuries are often improperly diagnosed and treated.
The confusion is between two conditions: tendonitis and tendonosis. Here’s the difference:
Tendonitis
Tendonitis is an acute condition caused by a strain, trauma, pull, tear, or overexertion to the tendon. It involves inflammation, often with swelling, warmth, and redness. In many cases, you know the exact moment when you injured the tendon. If you look at the tendon microscopically, there are inflammatory cells present, and tears or damage to the tendon is obvious.
Treatment for tendonitis may include anti-inflammatory drugs, icing the tendon, rest, and in some cases, a steroid injection to calm the inflammation. If the tendon has suffered a pronounced tear or rupture, surgery may be necessary to repair the tendon.
Tendinosis
In contrast, tendinosis is a chronic condition that doesn’t involve inflammation. It tends to be caused by overuse and can result in conditions such as tennis elbow, Achilles tendinosis, some rotator cuff injuries, and runner’s knee. If you look at the tendon microscopically, you’ll find that it has many tiny tears and disorganized fibers.
Treating tendinosis with an anti-inflammatory regimen doesn’t tend to be very effective, because it typically doesn’t involve inflammation. Instead, rest and physical therapy to stretch and strengthen the tendon can be helpful. Tendinosis can take what feels like forever to heal, and that’s because the tiny tears have to repair themselves and the tendon fibers have to reorganize and regain their original strength.
If you’re unsure whether your tendon problem is tendinitis or tendonosis, it can be diagnosed with a simple ultrasound, in which any inflammation will be apparent, leading to a diagnosis of tendonitis.
Whether you have tendonitis or tendonosis, acupuncture can be an important part of the healing process. For tendonitis acupuncture needles placed near the inflamed tendon, can increase the circulation of inflammation-fighting white blood cells significantly and clear the heat associated with inflammation. If you have tendinosis, acupuncture can help increase circulation to the area in general, as well as to speed the healing process. Furthermore, in both conditions, acupuncture can effectively decrease the pain, as acupuncture has been shown to affect your brain in a way that ramps up your body’s own pain relief mechanisms.
The bottom line is that knowing the difference between tendonitis and tendonosis can help determine the appropriate treatment. In addition, acupuncture can be a key part of that treatment to relieve pain, reduce inflammation if necessary, increase the circulation of healing blood and nutrients to the area, and speed up the healing process.