Merck Manual

Please confirm that you are not located inside the Russian Federation

honeypot link

Tendinitis and Tenosynovitis

By

Deepan S. Dalal

, MD, MPH, Brown University

Reviewed/Revised Mar 2024
VIEW PROFESSIONAL VERSION
GET THE QUICK FACTS

Tendinitis is inflammation of a tendon. Tenosynovitis is tendinitis accompanied by inflammation of the protective covering around the tendon (tendon sheath).

  • The cause is not always known.

  • Tendons are painful, particularly when moved, and sometimes swollen.

  • The diagnosis is usually based on symptoms and results of a physical examination.

  • Using a splint, applying heat or cold, and taking nonsteroidal anti-inflammatory drugs can help.

The cause of tendinitis is often unknown. Tendinitis usually occurs during middle or older age, as the tendons weaken and become more susceptible to injury and inflammation. (Weakening of the tendon, called tendinopathy, usually results from many small tears that occur over time. Affected tendons may gradually or suddenly tear completely.) Tendinitis also occurs in younger people who exercise vigorously (who may develop rotator cuff tendinitis Rotator Cuff Tendinitis Tendinitis is inflammation of a tendon. Tenosynovitis is tendinitis accompanied by inflammation of the protective covering around the tendon (tendon sheath). The cause is not always known. Tendons... read more —see also Rotator Cuff Injury/Subacromial Bursitis Rotator Cuff Injury/Subacromial Bursitis The muscles that help hold the upper arm in the shoulder joint (the rotator cuff muscles) can get pinched (shoulder impingement syndrome), become inflamed (tendinitis), or can tear partially... read more ) and in people who do repetitive tasks.

Certain tendons are particularly susceptible to inflammation:

Certain joint diseases, such as rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis is an inflammatory arthritis in which joints, usually including those of the hands and feet, are inflamed, resulting in swelling, pain, and often destruction of joints.... read more Rheumatoid Arthritis (RA) , systemic sclerosis Systemic Sclerosis Systemic sclerosis is a rare, chronic autoimmune connective tissue disorder characterized by degenerative changes and scarring in the skin, joints, and internal organs and by blood vessel abnormalities... read more Systemic Sclerosis , gout Gout Gout is a disorder in which deposits of uric acid crystals accumulate in the joints because of high blood levels of uric acid (hyperuricemia). The accumulations of crystals cause flares (attacks)... read more Gout , diabetes Diabetes Mellitus (DM) Diabetes mellitus is a disorder in which the body does not produce enough or respond normally to insulin, causing blood sugar (glucose) levels to be abnormally high. Symptoms of diabetes may... read more , and reactive arthritis Reactive Arthritis Reactive arthritis (previously called Reiter syndrome) is a spondyloarthritis causing inflammation of the joints and tendon attachments at the joints, often related to an infection. Joint pain... read more Reactive Arthritis , can increase the risk of tenosynovitis. In people with gonorrhea Symptoms Gonorrhea is a sexually transmitted infection caused by the bacteria Neisseria gonorrhoeae, which infect the lining of the urethra, cervix, rectum, or throat, or the membranes that cover... read more Symptoms , especially women, gonococcal bacteria can cause tenosynovitis, usually affecting the tissues of the shoulders, wrists, fingers, hips, ankles, or feet.

Symptoms of Tendinitis and Tenosynovitis

The inflamed tendons are usually painful when moved or when pressed. Moving the joints near the tendon, even a little, may cause pain, depending on how severe the tendinitis is. Occasionally, the tendons or their sheaths swell and feel warm.

If tendinitis lasts a long time, calcium may become deposited. The area around the shoulder joint is often affected. In addition to being painful, the shoulder may feel stiff and weak. It may snap or catch when moved.

Diagnosis of Tendinitis and Tenosynovitis

Treatment of Tendinitis and Tenosynovitis

  • Rest or immobilization, heat or cold, followed by exercises

  • Nonsteroidal anti-inflammatory drugs (NSAIDs)

  • Sometimes injections of corticosteroids

Sometimes corticosteroids (such as betamethasone, methylprednisolone, or triamcinolone) and anesthetics (such as lidocaine) are injected into the tendon sheath. Rarely, the injection causes pain hours later because the corticosteroid temporarily forms crystals inside the joint or sheath. This pain lasts less than 24 hours and can be treated with cold compresses and pain relievers.

Chronic, persistent tendinitis can occur in rheumatoid arthritis Rheumatoid Arthritis (RA) Rheumatoid arthritis is an inflammatory arthritis in which joints, usually including those of the hands and feet, are inflamed, resulting in swelling, pain, and often destruction of joints.... read more Rheumatoid Arthritis (RA) and may have to be treated surgically to remove inflamed tissues. Physical therapy Physical Therapy (PT) Physical therapy, a component of rehabilitation, involves exercising and manipulating the body with an emphasis on the back, upper arms, and legs. It can improve joint and muscle function, helping... read more to increase range of motion and rehabilitate muscles and tendons may be needed after surgery. Surgery is occasionally needed to remove calcium deposits or repair the tendon from areas of long-standing tendinitis, such as the area around the shoulder joint. Occasionally, surgery is done to release scars that limit function or to remove part of a bone that is rubbing against a tendon.

Rotator Cuff Tendinitis

Tendinitis may develop in the tendons of the muscles that help move, rotate, and hold the shoulder in place (rotator cuff).

Rotator cuff tendinitis (see also Rotator Cuff Injury/Subacromial Bursitis Rotator Cuff Injury/Subacromial Bursitis The muscles that help hold the upper arm in the shoulder joint (the rotator cuff muscles) can get pinched (shoulder impingement syndrome), become inflamed (tendinitis), or can tear partially... read more ) is the most common cause of shoulder pain. It causes pain when the arm is raised (particularly between 40° and 120°) or when people dress. People often have pain during the night, especially when they lie on the affected arm.

Symptoms of rotator cuff tendinitis may occur suddenly and be severe, especially after physical activity, or they may develop more slowly and be milder.

Drugs Mentioned In This Article

Generic Name Select Brand Names
Adbeon, Alphatrex, Beta 1 Kit, Beta Derm , Betanate , Betatrex, Beta-Val, BSP 0820, Celestone, Del-Beta , Diprolene, Diprolene AF, Diprosone, Luxiq Foam, Maxivate, ReadySharp Betamethasone, RRB Pak, Sernivo, Valisone
A-Methapred, Depmedalone-40, Depmedalone-80 , Depo-Medrol, Medrol, Medrol Dosepak, Solu-Medrol
Aristocort, Aristocort A, Aristocort Forte, Aristocort HP, Aristo-Pak, Aristospan, Arze-Ject-A, Azmacort, Children's Nasacort Allergy 24HR Nasal Spray, Cinalog, Cinolar, Flutex, Hexatrione, Kenalog, Kenalog in Orabase, Kenalog-10, Kenalog-40, Kenalog-80, Nasacort, Nasacort Allergy, Nasacort AQ, Oralone, SP Rx 228 , Tac-3 , Triacet , Triamonide , Trianex , Triderm , Triesence, XIPERE, Zilretta
7T Lido, Akten , ALOCANE, ANASTIA, AneCream, Anestacon, Aspercreme with Lidocaine, AsperFlex, Astero , BenGay, Blue Tube, Blue-Emu, CidalEaze, DermacinRx Lidocan II, DermacinRx Lidocan III, DermacinRx Lidogel, DermacinRx Lidorex, DERMALID, Dologesic, Ela-Max, GEN7T, Glydo, Gold Bond, Icy Hot , LidaFlex, LidaMantle, Lido King Maximum Strength, Lidocan, LIDOCANNA, Lidocare, Lidoderm, LidoDose, LidoDose Pediatric, Lidofore, LidoHeal-90, LIDO-K , LidoLite, Lidomar , Lidomark, LidoPure, LidoReal-30, LidoRx, Lidosense 4 , Lidosense 5, Lidosol, Lidosol-50, LIDO-SORB, Lidotral, Lidovix L, LIDOZION, Lidozo, Lidtopic, Lidtopic Max, LMX 4, LMX 4 with Tegaderm, LMX 5, LTA, Lubricaine, Lubricaine For Her, Lydexa, MENTHO-CAINE , Moxicaine, Numbonex, Professional DNA Collection Kit, Proxivol, ReadySharp Lidocaine, RectaSmoothe, RectiCare, Regenecare HA, Salonpas Lidocaine, Senatec, Solarcaine, SOLUPAK, SUN BURNT PLUS, Suvicort, Topicaine, Tranzarel, VacuStim Silver, Xyliderm, Xylocaine, Xylocaine Dental, Xylocaine in Dextrose, Xylocaine MPF, Xylocaine Topical, Xylocaine Topical Jelly, Xylocaine Topical Solution, Xylocaine Viscous, Zilactin-L, ZiloVal, Zingo, Zionodi, ZTlido
Indocin, Indocin SR, TIVORBEX
ColciGel, Colcrys , GLOPERBA, LODOCO, MITIGARE
NOTE: This is the Consumer Version. DOCTORS: VIEW PROFESSIONAL VERSION
VIEW PROFESSIONAL VERSION
quiz link

Test your knowledge

Take a Quiz!
iOS ANDROID
iOS ANDROID
iOS ANDROID
TOP