A Tyranny of Tendinopathies

Pain Clinc - Tendinitis - Hand

If science uncovered how profoundly Tendinopathy impacts our world and the quality of the lives of the people in it; it would make headline in the news. The amount of suffering caused by diagnosed Tendinopathies is astonishing once you become fully aware of the situation. Sadly, it will be some time before research navigates this topic, but in the meantime its important that we observe and talk about it.

We, humans, have a rich and recent history of misunderstanding Tendinopathy. If you go back 100 years or more, most Tendinopathy cases would’ve been diagnosed with Rheumatism. Hopefully, you know that Rheumatism is not a word of science; it is one of those old-fashioned words we developed during our struggle to understand something complex. Rheumatism is not a thing.

Even until a couple of decades ago, we called Tendinopathy ‘Tendinitis’, which turned out to be another big mistake. Any word that is suffixed with -itis is alluding to inflammation. So the word ‘tendinitis’ means inflamed tendons. Many people still feel comfortable with the term Tendinitis, yet it is proven to be something that doesn’t even exist. Once research verified the physical processes underlying tendon pain, scientists discovered that no inflammatory cells were involved in the process. So there is no such thing as Tendinitis!

Pain Clinc - Tendinitis Knee

The ‘opathy’ in Tendinopathy denotes disease or degeneration. Research into ‘Tendinitis’ uncovered tendon tissues within the body have partially degenerated, meaning tendon pain is caused by actual deterioration of the tendon tissue. This is why those in the know now refer to it as Tendinopathy rather than Rheumatism or Tendinitis. Yet, so many of us still think of tendon pain as an ‘inflammatory condition’ or ‘itis’, which clearly shows how excellent we are at bringing misunderstandings to the Tendinopathy table. 

Perhaps an even greater oversight that has yet to be documented by scientists, let alone understood by the public, is just how common Tendinopathies are. Millions of people suffering from Tendinopathy don’t realise that it’s causing their pain. Furthermore, millions more who are suffering from Tendinopathy have been misdiagnosed with some other condition to explain their pain, but it is a classic case of Tendinopathy.

One of the most significant challenges we face with the accurate and reliable diagnosis of Tendinopathy is that they are completely invisible in day-to-day medicine. All the X-Rays, blood tests, MRI scans, ultrasounds, and CT scans under the sun cannot pick up or identify Tendinopathy. Unless there is a significant calcification within the tendon, we become slightly better at diagnosing Tendinopathy; however, this accounts for only a tiny fraction of the overall cases of Tendinopathies.

The ‘opathy’ in Tendinopathy denotes disease or degeneration. Research into ‘Tendinitis’ uncovered tendon tissues within the body have partially degenerated, meaning tendon pain is caused by actual deterioration of the tendon tissue. This is why those in the know now refer to it as Tendinopathy rather than Rheumatism or Tendinitis. Yet, so many of us still think of tendon pain as an ‘inflammatory condition’ or ‘itis’, which clearly shows how excellent we are at bringing misunderstandings to the Tendinopathy table. 

Perhaps an even greater oversight that has yet to be documented by scientists, let alone understood by the public, is just how common Tendinopathies are. Millions of people suffering from Tendinopathy don’t realise that it’s causing their pain. Furthermore, millions more who are suffering from Tendinopathy have been misdiagnosed with some other condition to explain their pain, but it is a classic case of Tendinopathy.

One of the most significant challenges we face with the accurate and reliable diagnosis of Tendinopathy is that they are completely invisible in day-to-day medicine. All the X-Rays, blood tests, MRI scans, ultrasounds, and CT scans under the sun cannot pick up or identify Tendinopathy. Unless there is a significant calcification within the tendon, we become slightly better at diagnosing Tendinopathy; however, this accounts for only a tiny fraction of the overall cases of Tendinopathies.

For all its remarkable strengths, our current medical system struggles with conditions that present-day diagnostic tools cannot quickly identify. So Tendinopathy will likely continue being ignored and underdiagnosed until we find a more effective way to scan for or measure them; this is sad because they are not difficult to diagnose. In truth, It can easily be diagnosed by understanding the accurate location of tendons, carefully palpating for pain and a good understanding of the primary research on Tendinopathy. 

Many people diagnosed with Osteoarthritis, back pain, hip pain, shoulder pain, elbow pain, wrist pain, knee pain, and foot pain have Tendinopathy but aren’t aware of what is causing their pain. This is most surprising and yet most common in the case of patients with Osteoarthritis.

Many Osteoarthritis sufferers find that once they are in an intensive rehabilitation process, much of their pain resolves, I.e. Once the tendon pain is treated, the muscles around the joints are strengthened. The reliability of this approach for reducing arthritic pain is an excellent example of how we tend to diagnose whatever we see on the X-Ray/Scan and ignore other contributing factors.

 

For all its remarkable strengths, our current medical system struggles with conditions that present-day diagnostic tools cannot quickly identify. So Tendinopathy will likely continue being ignored and underdiagnosed until we find a more effective way to scan for or measure them; this is sad because they are not difficult to diagnose. In truth, It can easily be diagnosed by understanding the accurate location of tendons, carefully palpating for pain and a good understanding of the primary research on Tendinopathy. 

Many people diagnosed with Osteoarthritis, back pain, hip pain, shoulder pain, elbow pain, wrist pain, knee pain, and foot pain have Tendinopathy but aren’t aware of what is causing their pain. This is most surprising and yet most common in the case of patients with Osteoarthritis.

Many Osteoarthritis sufferers find that once they are in an intensive rehabilitation process, much of their pain resolves, I.e. Once the tendon pain is treated, the muscles around the joints are strengthened. The reliability of this approach for reducing arthritic pain is an excellent example of how we tend to diagnose whatever we see on the X-Ray/Scan and ignore other contributing factors.

In fairness, we are now quite good at diagnosing Tendinopathies in the upper limb and shoulder. People with wrist and elbow pain are identified as having RSI, and many know that their pain comes from the tendons. Due to calcification, rotator cuff tendons in the shoulder are commonly well diagnosed. Sadly, even in this area, we diagnose more accurately but still struggle to treat effectively. Cortisone shots and wrist braces are still being chronically overused despite evidence suggesting they are advised in all but a minority of cases.

The possibility that may be of most significant importance, dear reader, is that you may be suffering from Tendinopathy pain without realising it. Suppose you have been diagnosed with neck pain, shoulder pain, Headaches, back pain, and hip pain and have yet to receive treatment that works for you; there is a distinct possibility that you have undiagnosed tendon pain, a.k.a. Tendinopathy.

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