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Tendonitis

Disease Details

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Description: Tendonitis is the inflammation or irritation of a tendon, often caused by repetitive motion or overuse.
Type: Tendonitis is not typically inherited and does not have a genetic transmission pattern. It usually results from overuse, injury, or strain on the tendons.
Signs And Symptoms: Symptoms include tenderness on palpation, swelling, and pain, often when exercising or with a specific movement.
Prognosis: Initial recovery from overuse tendinosus is usually within two to three months, and 80% will recover fully within three to six months.
Onset: The onset of tendonitis can be sudden or gradual, often triggered by overuse, repetitive motion, or an acute injury to the tendon. It is characterized by pain and inflammation in the affected tendon, which might be exacerbated by movement.
Prevalence: Tendonitis, also known as tendinitis, is a condition characterized by the inflammation of a tendon. The prevalence of tendonitis varies based on specific tendons and population groups, but it generally affects about 2-5% of the population. It is more common in adults over the age of 40 and in individuals who engage in activities that involve repetitive motions or overuse of certain tendons. The prevalence can be higher in athletes and people whose occupations require repetitive movements.
Epidemiology: Tendon injury and resulting tendinopathy are responsible for up to 30% of consultations to sports doctors and other musculoskeletal health providers. Tendinopathy is most often seen in tendons of athletes either before or after an injury but is becoming more common in non-athletes and sedentary populations. For example, the majority of patients with Achilles tendinopathy in a general population-based study did not associate their condition with a sporting activity. In another study the population incidence of Achilles tendinopathy increased sixfold from 1979–1986 to 1987–1994. The incidence of rotator cuff tendinopathy ranges from 0.3% to 5.5% and annual prevalence from 0.5% to 7.4%.
Intractability: Tendonitis is typically not considered intractable. With proper treatment, including rest, physical therapy, anti-inflammatory medications, and sometimes corticosteroid injections, most people experience significant improvement and recovery. However, if left untreated or if repetitive strain continues, it can become a more chronic issue.
Disease Severity: Tendonitis, also known as tendinitis, generally falls under mild to moderate severity but can become severe if not treated properly. It is the inflammation of a tendon, often causing pain and tenderness near a joint.

- **Mild to Moderate Severity**: Most cases involve discomfort and restricted movement, typically resolving with rest, ice, and anti-inflammatory medications.
- **Severe Cases**: If untreated, it can lead to chronic pain, tendon degeneration, or rupture, potentially requiring surgical intervention.

NAN typically stands for "Not a Number" in data contexts and does not directly pertain to the severity of a disease. If "nan" in your context means 'not applicable,' it's likely referring to an absence of additional specific information or parameters regarding tendonitis severity.
Healthcare Professionals: Disease Ontology ID - DOID:971
Pathophysiology: As of 2016, the pathophysiology of tendinopathy is poorly understood. While inflammation appears to play a role, the relationships among changes to the structure of tissue, the function of tendons, and pain are not understood and there are several competing models, none of which have been fully validated or falsified. Molecular mechanisms involved in inflammation includes release of inflammatory cytokines like IL-1β which reduces the expression of type I collagen mRNA in human tenocytes and causes extracellular matrix degradation in the tendon. In a 2020 systematic review, it was noted that while various inflammatory markers were present in two thirds of the reviewed articles, the heterogenicity of data and lack of comparable studies meant no conclusion about a common pathophysiology from this systematic review.There are multifactorial theories that could include: tensile overload, tenocyte related collagen synthesis disruption, load-induced ischemia, neural sprouting, thermal damage, and adaptive compressive responses. The intratendinous sliding motion of fascicles and shear force at interfaces of fascicles could be an important mechanical factor for the development of tendinopathy and predispose tendons to rupture.The most commonly accepted cause for this condition is seen to be an overuse syndrome in combination with intrinsic and extrinsic factors leading to what may be seen as a progressive interference or the failing of the innate healing response. Tendinopathy involves cellular apoptosis, matrix disorganization and neovascularization.Classic characteristics of "tendinosis" include degenerative changes in the collagenous matrix, hypercellularity, hypervascularity, and a lack of inflammatory cells which has challenged the original misnomer "tendinitis".For chronic tennis elbow, histological findings include granulation tissue, microrupture, degenerative changes, and there is no traditional inflammation. As a consequence, "lateral elbow tendinopathy or tendinosis" is used instead of "lateral epicondylitis".
Examination of pathologic tennis elbow tissue reveals noninflammatory tissue, so the term "angiofibroblastic tendinosis" is also used.Cultures from tendinopathic tendons contain an increased production of type III collagen.Longitudinal sonogram of the lateral elbow displays thickening and heterogeneity of the common extensor tendon that is consistent with tendinosis, as the ultrasound reveals calcifications, intrasubstance tears, and marked irregularity of the lateral epicondyle. Although the term "epicondylitis" is frequently used to describe this disorder, most histopathologic findings of studies have displayed no evidence of an acute, or a chronic inflammatory process. Histologic studies have demonstrated that this condition is the result of tendon degeneration, which causes normal tissue to be replaced by a disorganized arrangement of collagen. Therefore, the disorder is more appropriately referred to as "tendinosis" or "tendinopathy" rather than "tendinitis".Colour Doppler ultrasound reveals structural tendon changes, with vascularity and hypo-echoic areas that correspond to the areas of pain in the extensor origin.Load-induced non-rupture tendinopathy in humans is associated with an increase in the ratio of collagen III:I proteins, a shift from large to small diameter collagen fibrils, buckling of the collagen fascicles in the tendon extracellular matrix, and buckling of the tenocyte cells and their nuclei.
Carrier Status: Tendonitis is not a condition related to carrier status, as it is not a genetic disorder. It is an inflammation or irritation of a tendon, often caused by repetitive motion, overuse, or injury.
Mechanism: Tendonitis, also known as tendinitis, involves the inflammation of a tendon, which is the tissue connecting muscle to bone. The mechanism of tendonitis typically involves repetitive overuse, acute injury, or degenerative changes, leading to microtears in the tendon fibers.

At the molecular level, tendonitis is characterized by a series of inflammatory responses:
1. **Cytokine Release**: Pro-inflammatory cytokines such as interleukins (e.g., IL-1β) and tumor necrosis factor-alpha (TNF-α) are released, promoting inflammation.
2. **Matrix Metalloproteinases (MMPs)**: MMPs are enzymes that degrade the extracellular matrix, leading to tissue remodeling and, potentially, tendon degeneration.
3. **Reactive Oxygen Species (ROS)**: Increased oxidative stress can damage tendon cells and extracellular matrix components.
4. **Cellular Infiltration**: Infiltration of immune cells (e.g., macrophages and neutrophils) occurs, contributing to the inflammatory milieu.
5. **Tenocyte Activity**: Tenocytes (tendon cells) become activated and may produce excessive collagen and other matrix components, resulting in thickening and fibrotic changes within the tendon.

These molecular events collectively drive the pain, swelling, and impaired function characteristic of tendonitis.
Treatment: Treatment of tendon injuries is largely conservative. Use of non-steroidal anti-inflammatory drugs (NSAIDs), rest, and gradual return to exercise is a common therapy. A meta-analysis revealed that exercise using weights or a resistance band is more effective than using bodyweight alone. In addition, having rest days is more effective than exercising every day. Resting assists in the prevention of further damage to the tendon. Ice, compression and elevation are also frequently recommended. Physical therapy, occupational therapy, orthotics or braces may also be useful. Initial recovery is typically within two to three days and full recovery is within three to six months. Tendinosis occurs as the acute phase of healing has ended (six to eight weeks) but has left the area insufficiently healed. Treatment of tendinitis helps reduce some of the risks of developing tendinosis, which takes longer to heal.There is tentative evidence that low-level laser therapy may also be beneficial in treating tendinopathy. The effects of deep transverse friction massage for treating tennis elbow and lateral knee tendinitis is unclear.
Compassionate Use Treatment: For tendonitis, compassionate use treatments and off-label or experimental treatments can vary, as these approaches are typically considered when standard treatments have failed. Some possible options include:

1. **Platelet-Rich Plasma (PRP) Therapy**: PRP involves injecting a concentration of a patient’s own platelets to accelerate healing of injured tendons. It is considered experimental but has shown some promise in clinical studies.

2. **Stem Cell Therapy**: This involves using stem cells to promote repair and regeneration of the tendon. It is still largely experimental and not widely available.

3. **Extracorporeal Shockwave Therapy (ESWT)**: Though primarily used for conditions like plantar fasciitis, it’s sometimes used off-label for tendonitis to stimulate healing.

4. **Tenex Health TX**: A minimally invasive procedure that uses ultrasound and a specialized instrument to remove scar tissue from the tendon. This is an emerging treatment still under study but used off-label in some cases.

5. **Low-Level Laser Therapy (LLLT)**: Also known as cold laser therapy, this treatment uses low-intensity lasers or light-emitting diodes to reduce pain and inflammation and promote tendon healing. It is not yet fully endorsed by major medical communities for tendonitis.

Consult with healthcare professionals for more details and to evaluate suitability, as these treatments may vary in effectiveness and availability.
Lifestyle Recommendations: For tendonitis, lifestyle recommendations include:

1. **Rest and Activity Modification**: Avoid activities that exacerbate the condition. Rest the affected area to allow healing.
2. **Ice Application**: Apply ice packs to the affected area for 15-20 minutes several times a day to reduce pain and swelling.
3. **Proper Ergonomics**: Ensure that workspaces and daily activities are ergonomically designed to reduce strain on tendons.
4. **Stretching and Strengthening Exercises**: Engage in gentle stretching and strengthening exercises tailored to the specific tendon affected, often guided by a physical therapist.
5. **Footwear and Support**: Wear appropriate footwear and use orthotics if needed to support proper biomechanics.
6. **Healthy Weight Maintenance**: Maintain a healthy weight to reduce stress on tendons, particularly in lower extremities.
7. **Gradual Increase in Activity**: When resuming activities, increase intensity and duration gradually to prevent recurrence.
Medication: For tendonitis, over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation. In more severe cases, a doctor may prescribe stronger NSAIDs or corticosteroid injections. Always consult with a healthcare professional for the appropriate treatment.
Repurposable Drugs: For tendonitis, some repurposable drugs include:

1. **Naproxen**: A nonsteroidal anti-inflammatory drug (NSAID) that can reduce inflammation and pain.
2. **Ibuprofen**: Another NSAID effective for pain relief and inflammation reduction.
3. **Diclofenac**: Applied topically or taken orally, this NSAID can help alleviate symptoms.
4. **Corticosteroids**: These can be injected directly into the affected tendon to reduce severe inflammation.

Please consult a healthcare professional for advice tailored to your specific condition.
Metabolites: In tendonitis, metabolites can include inflammatory markers such as prostaglandins, cytokines (like interleukins), and enzymes (like matrix metalloproteinases). These metabolites are involved in the inflammatory response and tissue remodeling associated with the condition.
Nutraceuticals: Nutraceuticals that may support tendon health and potentially alleviate tendonitis include:

1. **Omega-3 Fatty Acids**: Found in fish oil, they have anti-inflammatory properties that can help reduce pain and swelling.
2. **Curcumin**: The active component of turmeric, known for its strong anti-inflammatory and antioxidant effects.
3. **Collagen Supplements**: Specifically Type I collagen, can improve tendon health and repair.
4. **Vitamin C**: Essential for collagen synthesis and repair of connective tissues.
5. **Proteolytic Enzymes**: Such as bromelain and papain, may help with reducing inflammation and promoting healing.

Always consult with a healthcare provider before starting any new supplement regimen.
Peptides: Peptide-based treatments for tendonitis are being studied for their potential to promote healing and reduce inflammation. One promising peptide is BPC-157, which has shown some evidence of aiding tendon repair in preclinical studies. However, more research is needed to confirm their effectiveness and safety for widespread clinical use in tendonitis treatment.

Regarding nanotechnology (nan), nanomaterials and nanoparticle-based drug delivery systems are being explored to enhance the treatment of tendonitis. These technologies aim to improve the targeted delivery of anti-inflammatory and regenerative agents directly to the affected tendon, potentially increasing the efficacy and reducing side effects of treatments.

Both peptides and nanotechnology represent emerging areas of interest and have not yet become standard treatments for tendonitis.