8/10/2019 What Is the Difference Between Tendonitis, Tendinosis, and Tendinopathy?

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What Is the Difference Between

Tendonitis, Tendinosis, and
Tendinopathy?
By Gabriella Ode, MD
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Published: 03/01/2019  |  Peer Reviewed

A tendon is a fibrous band of tissue that connects a muscle to a bone. Doctors have many names for describing when
tendon tissue is inflamed, injured or damaged, including tendonitis, tendinosis, and tendinopathy as well as
paratenonitis, tenosynovitis, and tendon tear (rupture).

Knowing these names and understanding the conditions they refer to can help patients understand their treatment plan
and take steps to prevent future tendon problems.

Below are descriptions of the terms used to describe common tendon conditions.

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Tendonitis
Once used to describe almost any tendon pain, medical professionals now only use the term tendonitis to describe
acute inflammation of the tendon due to small (micro) tears (the suffix “itis” indicates inflammation).1 Common
symptoms include localized pain, swelling, and warmth.2

 Read about Achilles Tendonitis and Tendon Injuries

Tendonitis may develop as a result of a sudden, acute injury or repeated micro-traumas to a tendon or group of
tendons. Recommended treatments to reduce inflammation may include resting the affected joint and taking over-the-
counter non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (e.g. Motrin, Advil), or naproxen (e.g. Aleve,
Naprosyn). Patients with tendonitis typically recover within several weeks.

Research suggests tendon inflammation is uncommon,1 and what is often diagnosed as tendonitis, may actually be
tendinosis1-6 (defined below). Chronic tendonitis may lead to tendinosis.1

Tendinosis
Tendinosis is the non-inflammatory degeneration of a tendon. This
COMPARISON FACTOR TENDONITIS TENDINOSIS

degeneration can include changes to the structure or composition of the Recovery time in acute cases 2 to 3 days 2 to 3 months

tendon. These changes often result from repetitive strain-injuries to a Recovery time in chronic cases 4 to 6 weeks 3 to 6 months

tendon without adequate time to heal.1-2

Long-term outlook with non- Almost 99% of cases recover Up to 80% of cases recover
surgical treatment completely completely

Treatment goals Decrease inflammation by: Rest, Encourage formation of collagen

anti-inflammatory medication and other proteins by: Physical

Key differences between tendonitis and tendinosis: (short-term course), icing the
tendon intermittently, and/or use
therapy, exercise, and/or surgery (in
some cases)
of cast or splint

Long-term outlook after surgery Almost 95% of cases recover after 70 to 85% of cases recover after

Unlike tendonitis, tendinosis may take several months to treat. surgery surgery

Recovery time after surgery 3 to 4 weeks 4 to 6 months

Treatment methods for tendinosis and tendonitis may vary. For

Tendonitis and tendinosis have different treatment
example, some experts argue that tendinosis should not be treated
goals and recovery times. (larger view)
with NSAIDs or corticosteroids. They believe these drugs inhibit the
normal reconstruction of the tendon and weaken its structure, causing long-term healing problems.7-8

Tendinosis usually affects people who engage in high intensity activities or sports requiring repeated tendon movement.

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Tendinopathy
Tendinopathy is typically used to describe any problem involving a tendon. The suffix “pathy” is derived from Greek and
indicates a disease or disorder. Therefore, tendinopathy literally means a disease or disorder of a tendon.

While most experts define tendinopathy as an umbrella term to describe all tendon conditions, others may use it to
describe a chronic tendon condition that fails to heal.9 For example, a runner who has suffered a repetitive hamstring
tendon strain that does not heal properly may be diagnosed with tendinopathy.

 See Chronic High (Proximal) Hamstring Tendinopathy

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8/10/2019 What Is the Difference Between Tendonitis, Tendinosis, and Tendinopathy?

To avoid confusion, patients who are diagnosed with tendinopathy should ask their doctors to specify the details of their
tendon injuries.

Paratenonitis

The Achilles tendon is surrounded by a thin sheath of tissue called the paratenon. The tendons in the wrists and hand are surrounded by a different type of
tissue, called a synovial sheath.

Certain tendons in the body, like the Achilles tendon, have a surrounding thin sheath of tissue, called the paratenon.
Other tendons such as those in the wrists and hand are surrounded by a different type of tissue, called a synovial
sheath.

When the paratenon becomes inflamed it is called paratenonitis

When the synovial sheath surrounding the tendon becomes inflamed, it is called tenosynovitis

 Read about De Quervain’s Tenosynovitis

While tenosynovitis may be diagnosed with diagnostic tests, paratenonitis cannot be definitively diagnosed without a
biopsy. Treatment for both paratenonitis and tenosynovitis involve reducing inflammation and restricting movement of
the affected tendon.

 Read about Nonsurgical Treatment for De Quervain’s Tenosynovitis

Complete and Partial Tendon Ruptures

When a tendon tears, it is also called a rupture. If a tendon is torn in two pieces it is called a complete rupture, and if
some of the tendon still remains intact it is called a partial rupture.

Some physicians make a distinction between acute and chronic tendon ruptures.

An acute tendon rupture is a one-time event that can result in immediate pain and decreased function of the
affected joint and may be followed by swelling or bruising. An acute rupture is typically recognized and typically
treated within two weeks of injury.
Chronic tendon ruptures may result from:
A partial rupture that slowly worsens over a prolonged period, or
An acute rupture that goes untreated for several weeks (many experts believe this time varies between 4 to 6
weeks, depending on the tendon).10

Depending on the patient, the affected joint, the severity of the tear, and the duration of symptoms, a doctor may
recommend either surgery, immobilization using a splint; or a period of rest to treat the tendon rupture.
References
1. Bass E. Tendinopathy: why the difference between tendinitis and tendinosis matters. Int J Ther Massage Bodywork. 2012;5(1):14-7.

2. Cooper, C. (2014). Elbow, Wrist, and Hand Tendinopathies. In Fundamentals of Hand Therapy (pp. 383–393). Elsevier. "https://doi.org/10.1016/b978-0-323-09104-6.00028-6-6

3. Ahmad Z, Siddiqui N, Malik SS, Abdus-samee M, Tytherleigh-strong G, Rushton N. Lateral epicondylitis: a review of pathology and management. Bone Joint J. 2013;95-B(9):1158-64.

Complete Listing of References

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