Tendonitis or Tendinosis: How to Tell the Difference?

Pain from tendons, the tissue that connects bones and muscles, is common. The reflex may be to call it tendonitis, but in fact, there’s often a different condition at work: tendinosis. Here’s how to tell the difference and why it’s important.

Tendon pain is common in active individuals, whether from strenuous jobs or recreation. It’s almost automatic to assume persistent tendon pain is tendonitis, but while symptoms may overlap, it can also be due to tendinosis.

Treatment strategies for each condition differ significantly, so it’s important to know which you’re dealing with. The professionals at 360 Orthopedics in Sarasota, Venice, and Lakewood Ranch, Florida, frequently deal with tendon conditions and injuries through our sports medicine specialty.

Let’s look at tendonitis versus tendinosis, their similarities and differences, and why it’s important to make a distinction between the two.

Defining tendonitis

Whenever you see the medical suffix “itis,” you know there’s an inflammatory process. When a tendon becomes inflamed, it’s usually due to an injury or short-term overuse, situations like:

Repetitive motions over a brief span of activity
Intense use of the tendon
New or unaccustomed physical activity
Minor trauma, like a contact or impact injury

Tendonitis creates symptoms such as:

Sudden-onset pain
Swelling at the site
Redness or warmth around the injury
Pain that continues or worsens with activity and improves with rest

Most cases of tendonitis come on quickly, in days following the injury event, rather than over weeks and months.

Characteristics of tendinosis

In contrast to “itis,” the suffix “osis” represents an abnormal condition or tissue deterioration. Tendinosis usually refers to a chronic degradation of a tendon, rather than an inflammatory condition.

Tendinosis can develop from recurring or untreated tendonitis, though it can also develop slowly over time without a clear connection to an injury. Its common symptoms include:

Persistent pain lasting weeks, months, or longer
Tendon stiffness develops overnight and is felt in the morning
Tenderness in the tendon
Thickened tendon
Pain that accompanies activity lasts during rest
You may experience reduced function or strength in joints involving the injured tendon

Common sites for tendinosis include the Achilles tendon, elbow, knee, and rotator cuff.

Why the difference is important

Primary care for tendonitis focuses on reducing inflammation. This includes nonsteroidal anti-inflammatory drugs as well as corticosteroids in injected or oral forms.

These therapies have little effect on tendinosis conditions, and steroid injections may accelerate the deterioration of tendon tissue, compounding the problem. Instead, tendinosis requires support for healing, regenerating, and strengthening tendon tissue.

Delaying the diagnosis can prolong your pain and increase the risk of tendon tears, both partial and complete.

Is it tendonitis or tendinosis?

Tendonitis tends to be an acute, short-term condition, while tendinosis has a longer recovery and is more likely to become chronic. The right care for your condition depends on an accurate diagnosis.

Contact 360 Orthopedics by calling your nearest office to schedule an examination if your tendon pain doesn’t resolve within a few days. Schedule your visit today.