tendinosis

Question

I’ve been experiencing chronic pain in my shoulder for several months now, and after seeing an orthopedic specialist, I was diagnosed with tendinosis. While I understand that tendinosis involves damage to the tendons, I’m still unsure of the details. Could you explain in more detail what tendinosis is, how it develops, and what it means for my health in the long term?

From what I understand, tendinosis is different from tendinitis, as it involves degeneration of the tendon tissue rather than inflammation. How does tendinosis occur, and what causes the tendons to become damaged over time? Is it often linked to repetitive strain or overuse, or can other factors like aging, poor blood flow, or injury contribute to the development of tendinosis?

What are the symptoms of tendinosis? I’ve noticed that my pain is persistent, especially when I move my arm in certain ways, but it’s not as acute or swollen as it would be with tendinitis. How can I differentiate between tendinosis and other tendon injuries like strains or sprains? Are there any specific tests or imaging techniques, such as ultrasound or MRI, that can confirm the diagnosis?

What treatment options are available for tendinosis? I’ve heard that rest, physical therapy, and ice can help, but are there other treatments, such as medications or injections, that can promote healing? How effective are treatments like corticosteroid injections, platelet-rich plasma (PRP), or shockwave therapy in addressing tendinosis?

How long does it typically take to recover from tendinosis, and what are the chances of developing chronic issues if left untreated? Are there any surgical options available if conservative treatments don’t work, and what does surgery for tendinosis usually involve?

Lastly, what steps can I take to prevent tendinosis from recurring? Are there lifestyle changes, exercises, or stretches that can help keep my tendons healthy and prevent further degeneration? Should I make any changes to my exercise routine or workplace activities to avoid straining my tendons in the future?

Dr. Ayush Varma · Answer

I'm here to provide Ayurvedic insights regarding your concern with shoulder tendinosis. In Ayurveda, we view tendon health as integral to maintaining a balanced Vata dosha, which primarily governs movement and tissue integrity. Tendinosis is indeed characterized by degenerative changes in the tendon tissue, usually arising from repetitive stress or overuse, leading to microtears and impaired healing over time. Factors such as aging, poor blood circulation, and inadequate nutrition can contribute to this condition by compromising the strength and resilience of the tendons.

Symptoms typically include persistent pain with certain movements, reduced range of motion, and sometimes stiffness without the acute inflammation seen in tendinitis. Since your pain is not severe but persistent, it aligns more closely with tendinosis. While imaging techniques like ultrasound or MRI are helpful for diagnosis by revealing tendon structure and changes, the most important aspect remains the clinical evaluation.

In Ayurveda, treatment focuses on restoring balance and healing. Begin with rest and gentle movements to avoid further strain. Incorporating oil-based therapies such as warm sesame oil or herbal formulations like Mahanarayana oil for local massage can promote circulation and healing. Practices like Shirodhara and Panchakarma can help in detoxification and rejuvenation, whereas incorporating gentle strengthening and stretching exercises for your shoulder can optimize function gradually.

Proper hydration, a balanced diet rich in anti-inflammatory foods, and adequate protein intake to support tissue repair are crucial. Avoiding activities that exacerbate your pain and gradually reintroducing them under guidance can help.

Taking preventive measures such as practicing good posture, ergonomic adjustments at your workspace, and avoiding repetitive overhead activities will also protect your tendons moving forward. Focus on exercises that enhance flexibility and strength, such as yoga or Pilates, while prioritizing balance in your daily activities to manage Vata dosha effectively. If your condition doesn't improve, consulting a healthcare professional specializing in Ayurveda and orthopedics can provide you with a more integrated approach.

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