That persistent ache that won't quit.
Tendinitis is irritation or inflammation of a tendon — the tough cord that connects muscle to bone. It usually builds gradually from repetitive use rather than a single injury, and it has a way of getting worse when you ignore it and push through. The right approach finds the load that's driving it and addresses both the pain and the pattern.
Your doctor may call this tendinopathy or tendinosis depending on whether there is acute inflammation or longer-term degenerative change in the tendon.
Often seen within a few days — sometimes as soon as tomorrowRequest your first visit
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What tendinitis really is.
Tendons transmit the force your muscles generate to the bones they move. When a tendon is loaded more than it can recover from — through repetitive sport, training spikes, or cumulative work stress — it develops microscopic damage that the body struggles to repair fast enough. The result is pain, stiffness, and reduced strength at the tendon site.
The most commonly affected tendons are the Achilles (heel), patellar (knee), rotator cuff (shoulder), common extensor (elbow, often called tennis elbow), and common flexor (elbow, golf elbow). Each has its own biomechanical contributors, which is why treatment is more effective when the specific tendon and the loading pattern driving it are properly identified.
The good news
Tendinitis responds well to targeted care in the large majority of cases. With the right load management, physical therapy, and — when needed — image-guided treatment, most people return fully to their activity. Surgery is rarely required.
Tendinitis vs. tendinosis
Acute tendinitis involves inflammatory mediators and typically responds well to load reduction and anti-inflammatory treatment. Chronic tendinosis reflects degenerative change — failed healing rather than active inflammation — and responds better to progressive loading programs and, in resistant cases, regenerative options like PRP. Distinguishing the two changes the treatment plan meaningfully.
Common signs we treat.
Aching at the tendon with use
A dull, building ache right at the tendon — often warming up at the start of activity and worsening again if you keep going or rest afterward.
Stiffness after rest
The tendon feels tight and painful after sitting or sleeping — a classic pattern of tendon irritation that eases with gentle movement but flares with load.
Tenderness and mild swelling
Point tenderness directly on the tendon, sometimes with visible thickening or swelling — particularly notable in Achilles and patellar tendinopathy.
From hurting to healed.
We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.
Diagnose the cause
A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.
Calm it down
Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.
Image-guided injections
If pain persists, a precisely targeted injection delivered to the source under imaging.
Advanced options
For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.
Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.
Still have questions?
Tendinitis refers to acute tendon inflammation — typically early in the problem, with warmth and swelling. Tendinosis describes the longer-term degenerative form where the tendon has failed to heal normally, resulting in structural change without much active inflammation. The distinction matters for treatment: tendinosis generally responds better to progressive loading than to rest and anti-inflammatories alone.
Acute cases often settle within a few weeks with appropriate load management and treatment. Chronic or tendinosis presentations can take several months of consistent rehab. The timeline depends on how long the tendon has been irritated, what's driving it, and how consistently you follow the recovery program — including the harder part, which is modifying the activity that caused it.
Complete rest is rarely the right answer. The goal is to reduce the load that's aggravating the tendon while maintaining as much activity as possible. Tendons need controlled load to heal — the key is finding the right amount. A physical therapist can guide a progressive loading program that strengthens the tendon without re-irritating it.
A structured eccentric loading program is the most evidence-backed approach for most tendinopathies. Anti-inflammatory medication or a guided injection can help manage pain enough for rehab to progress. For resistant cases, PRP (platelet-rich plasma) therapy delivered under ultrasound guidance can support tissue repair at the tendon site.
Stop training around the pain.
Book with a board-certified pain physician near you — most patients are seen within days.
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