Management of Chronic Tendon Injuries.

Management of Chronic Tendon Injuries. Am Fam Physician. 2019 Aug 01;100(3):147-157 Authors: Kane SF, Olewinski LH, Tamminga KS Abstract Chronic tendon injuries are common athletic and occupational injuries that account for many physician visits. Tendons have a complex biology that provides a unique combination of strength, flexibility, and elasticity but also predisposes them to injury. The term tendinopathy is preferred to tendinitis because of the presence of a disordered and degenerative healing process-not inflammation-in the pathologic tendon. Insidious onset of pain and dysfunction is a common presentation for most tendinopathies, and patients typically report that a change in activity affected the use of the tendon. Diagnosis is typically based on history and physical examination findings, but radiography is an acceptable initial imaging modality. Ultrasonography and magnetic resonance imaging may be useful when the diagnosis is unclear. The mainstays of treatment are activity modification, relative rest, pain control, and protection. Early initiation of rehabilitative exercises that emphasize eccentric loading is also beneficial. Despite a lack of high-quality evidence, cryotherapy has a role in controlling pain. Nonsteroidal anti-inflammatorydrugs and corticosteroids have a role in treatment despite the lack of histologic evidence of inflammation. Short-term use of these drugs reduces pain and increases range of motion, whi...
Source: American Family Physician - Category: Primary Care Authors: Tags: Am Fam Physician Source Type: research