Tendinopathy

Tendon disorder typically involving pain and reduced load tolerance, without necessarily involving inflammation.

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Understanding the approach

Tendinopathy usually involves tendon pain and reduced capacity to tolerate load. Dominant inflammation is not always present, making it a broader term than tendinitis. It can affect structures such as the shoulder, elbow, hip or Achilles tendon.

Indications and assessment

Pain often occurs during or after particular activities, with local tenderness and sometimes morning stiffness. Examination distinguishes a tendon disorder from referred spinal pain. Lateral hip or shoulder pain does not automatically come from a disc, even when a scan also shows disc degeneration.

Benefits, limitations and precautions

Diagnosis is mainly clinical; ultrasound or MRI may assist when the presentation is unusual or rupture is suspected. Imaging abnormalities do not perfectly reflect pain. An acute pop with loss of strength requires a specific assessment for possible rupture.

Place in the care pathway

Management includes load modification and progressive strengthening. At TAGMED, shockwave treatment may be discussed for selected persistent indications, with evidence varying by tendon. Laser may be a selected adjunct; no modality guarantees accelerated structural repair.

Goals should be practical: walking farther, returning to a chosen activity or reducing symptoms that interfere with sleep. Improvement immediately after a session does not establish lasting benefit. Follow-up compares function with the starting point, records adverse effects and considers progress between appointments. An inadequate response should prompt a review of the clinical explanation or proposed approach, rather than an automatic extension of the same treatment.

Before starting, describe the outcome you want, treatments already tried and difficulties encountered. Ask how the response will be measured and when another option would be preferable. Available reports complement the discussion without replacing your current experience, priorities or preferences.

Frequently asked questions

Is complete rest necessary?

Often not. Reducing irritating loads and progressing appropriately is preferable to prolonged inactivity.

Is exercise pain always dangerous?

Not necessarily; intensity and the subsequent response should guide adjustments.

Are shockwaves routine?

No. Suitability depends on the tendon and response to other measures.

Does an abnormal scan require surgery?

No. Symptoms and function remain central.

Does spinal decompression treat the tendon?

That is not its purpose; a separate spinal source would need to be established.

Educational information from The Spine Page. This entry does not replace an individual assessment. Documentary version: October 12, 2026. Sylvain Desforges, B.Sc., D.O., N.D., osteopath and naturopath.