Tendonitis: symptoms, treatment and how long it lasts

Start with the basics. The NHS suggests resting the tendon for 2 to 3 days, using ice and light support. When you can move the area without pain stopping you, keep it moving so the joint does not stiffen. Avoid heavy lifting, strong gripping or twisting that makes symptoms worse, and avoid sport until the tendon has recovered. A pharmacist can recommend a suitable painkiller. Paracetamol and ibuprofen can ease pain, and an ibuprofen gel may be suggested.

If pain is severe, lasts a long time or movement is limited, you may be offered physiotherapy. Patient.info describes a programme that gradually strengthens the muscle of the affected tendon by increasing the load it can bear. These exercises may be a bit painful, but that does not mean they are harmful.

The NHS says some people with severe tendonitis may be offered steroid injections, which may give short-term pain relief. Patient.info cautions that injections do not treat the underlying problem and pain tends to come back in many people. Shock-wave therapy and blood injections are mentioned there as options where the evidence is still uncertain. If physiotherapy fails, an orthopaedic specialist may discuss surgery to remove damaged tissue or repair a rupture.

The NHS lists pain in a tendon that gets worse when you move, difficulty moving the joint, a grating or crackling sensation when the tendon moves, and swelling, sometimes with heat or redness. Patient.info adds tenderness, stiffness, and sometimes a lump along the tendon.

The pain tends to sit at or near where the tendon attaches to bone. It is usually worse with the movement that loads that tendon and eases with rest. Some cases last only a few days. Others last weeks or months if the cause carries on.

Look out for the picture of a rupture, which is different. The NHS says sudden, severe pain during an accident or activity may mean a torn tendon, and you might hear a popping or snapping sound.

Tendons connect muscles to bones, so they work whenever a joint moves. The NHS notes they are found all over the body, for example in the knees, elbows and shoulders. When a tendon swells after an injury it is called tendonitis. It can cause joint pain and stiffness and change how the tendon moves.

Language in this area is untidy. Patient.info explains that tendonitis strictly means inflammation, usually after an acute injury, while tendinosis means long-term degeneration of the tendon without inflammation. Repeated small injuries that fail to heal are thought to be the main problem in many long-standing cases. Doctors therefore often use the broader term tendinopathy.

Tenosynovitis is related. It means inflammation of the sheath that surrounds some tendons, and the two often occur together. Well-known examples include tennis elbow, golfer's elbow, Achilles tendon pain, rotator cuff problems in the shoulder, trigger finger and de Quervain's tenosynovitis at the thumb side of the wrist.

The NHS says you can treat a mild tendon injury yourself and it should feel better within 2 to 3 weeks. It advises seeing a GP if you have injured a joint and your symptoms do not improve within a few weeks.

Patient.info is more cautious. It says that in some cases the condition lasts just a few days and then goes away on its own, but in other cases it can last weeks or months if not treated, and that recovery usually takes weeks to several months. How long depends on which tendon is affected and on whether it is possible to rest the area easily.

The NHS says tendonitis is usually caused by sudden sharp movements or repetitive exercise such as running, jumping or throwing. Repetitive movements, poor posture or technique at work or in sport can also be responsible, and this is known as repetitive strain injury.

Patient.info adds that these problems are more common in middle-aged adults and in people who are quite sporty, and are more likely if you suddenly start using muscles that have not been used much. Some forms of arthritis, such as rheumatoid arthritis, can inflame tendon sheaths. Infection is a rare cause, usually after a cut or puncture over a tendon.

• Suddenly increasing training or starting a new sport without building up

• Repetitive work tasks such as typing, assembly or checkout work

• Poor technique or unsuitable equipment or footwear

• Inflammatory arthritis affecting the tendon sheath

• Rarely, infection from a wound

Diagnosis is mostly clinical. A GP or physiotherapist listens to your description and examines the area. Patient.info says the tendon may feel thicker than normal and tender, especially when you use the muscle that pulls on it. Tenosynovitis may produce a grating feeling, which can feel like sandpaper or bubble wrap under the skin.

Tests are usually not needed. Patient.info says that if the diagnosis is uncertain an X-ray, ultrasound or MRI may be suggested, mainly to make sure it is not something more serious. Blood tests are used only if infection or inflammatory arthritis is suspected. In many areas the NHS lets you refer yourself to community musculoskeletal services for joint problems without seeing a GP first.

The NHS and Patient.info differ slightly in detail, so the table sets out each source side by side. In both, simple measures come first and exercise is built up gradually.

Mild tendonitis settles within weeks. Tendinopathy takes longer. Patient.info gives weeks to several months and says it depends on which tendon is involved and whether the cause can be removed. A tendon in your dominant hand that you use all day is harder to rest than one in the other hand.

You cannot always prevent it. The NHS suggests warming up before exercise and gently stretching afterwards, wearing supportive shoes or insoles, taking breaks from repetitive exercise and not starting a new sport without some training. Patient.info says there is no proof anything prevents a bout, but sensible steps include building up activity gradually and, if work is the cause, discussing duties and workstation set-up with your employer.

See a GP if you have injured a joint and your symptoms do not improve within a few weeks, according to the NHS. Patient.info adds that you should seek advice if symptoms persist, affect your work or exercise, or the pain is constant.

Get help from NHS 111 if you are in a lot of pain or think you have ruptured a tendon. A hot, red, swollen and increasingly painful area with fever, especially after a wound, needs prompt assessment for infection.

On the NHS, first contact is often a pharmacist, a GP or a self-referral to a community musculoskeletal service. Physiotherapy waits vary by area. Orthopaedic referral follows if conservative treatment fails or a rupture is suspected.

Many people go to a private physiotherapist or sports medicine doctor for faster access to a loading programme or ultrasound-guided assessment. Check the qualifications of any practitioner and ask what the exercise plan is, how progress will be judged, and what evidence supports any injection or shock-wave therapy offered.