Tendon Pain and When Injections May Be Needed

Understanding Tendon Injuries and Treatment Options

Tendon pain is a common cause of discomfort that can interfere with daily activities, work, and exercise. Whether it’s shoulder pain from repetitive lifting, elbow pain from overuse, or Achilles pain that limits walking, tendon injuries often start subtly and worsen over time. While many cases improve with rest and conservative care, some forms of tendon pain may require injections to promote healing and relieve inflammation.

Understanding when injections are appropriate—and what types are available—can help patients make informed decisions about their care.

What Causes Tendon Pain?

Tendons are strong bands of tissue that connect muscles to bones. They are designed to tolerate stress, but repeated strain or sudden overload can lead to injury.

• Repetitive motion or overuse
• Poor biomechanics or posture
• Sudden increases in activity
• Age-related tendon degeneration
• Sports injuries or occupational strain

Unlike acute tendon tears, many patients experience tendinopathy, a chronic condition involving tendon degeneration rather than simple inflammation.

Common Types of Tendon Pain

• Rotator cuff tendons (shoulder pain)
• Lateral epicondyle (tennis elbow)
• Medial epicondyle (golfer’s elbow)
• Patellar tendon (jumper’s knee)
• Achilles tendon
• Hip and gluteal tendons

Symptoms often include localized pain, stiffness, weakness, and pain that worsens with activity.

First-Line Treatments for Tendon Pain

Most tendon injuries are initially treated conservatively, especially in early stages. Common treatments include:

• Activity modification and rest
• Physical therapy focused on eccentric strengthening
• Anti-inflammatory medications (when appropriate)
• Ice or heat therapy
• Bracing or supportive devices

When Are Injections Considered?

Injections may be recommended when:

• Pain persists despite weeks or months of conservative care
• Tendon pain limits function or quality of life
• Imaging shows degenerative tendon changes
• Inflammation is preventing effective rehabilitation

Types of Injections Used for Tendon Pain

Corticosteroid Injections

These injections reduce inflammation and pain around the tendon. They can be effective for short-term relief but must be used carefully, as repeated steroid injections may weaken tendon tissue over time.

Platelet-Rich Plasma (PRP) Injections

PRP uses a concentration of the patient’s own platelets to promote healing and tissue repair. Unlike steroids, PRP aims to stimulate long-term tendon recovery rather than suppress symptoms.

Prolotherapy

This treatment involves injecting an irritant solution to stimulate the body’s natural healing response and strengthen weakened tendon tissue.

Ultrasound-Guided Injections

Using imaging guidance improves accuracy and safety, ensuring medication is delivered precisely to the affected tendon area.

Are Tendon Injections Safe?

When performed by experienced clinicians and used appropriately, tendon injections are generally safe. Risks may include temporary soreness, infection (rare), or incomplete pain relief.

The Importance of Rehabilitation After Injections

Injections are most effective when combined with physical therapy, gradual return to activity, strengthening exercises, and correction of contributing movement patterns.

When to See a Specialist

If tendon pain lasts longer than a few weeks, worsens over time, or interferes with daily life, a specialist evaluation may be warranted.

Final Thoughts

Tendon pain can be frustrating and slow to heal—but effective treatments are available. Injections may play an important role when conservative care is not enough, especially for chronic or degenerative tendon conditions.