Heal Your Chronic Tendon Pain

the latest research on tendinopathy and tendinosis

A photo of a woman lifting weights with a physical therapist guiding her.


Scan our list of tendinopathy treatments to see what you might want to try.

A diagram of collagen structure, showning the way it is composed of amino acid strands  that form collagen fibers.


Read about what happens in tendinopathy on the cellular level to better understand your injury.

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Check back to our Research News blog from time to time for the latest research in the field.

What Is Tendinopathy?

Did your tendon pain start from some specific activity and gradually became so much worse that the pain now accompanies all kinds of activities? The pain might burn, sting, or ache. Sometimes the pain can start without knowing the cause, but often it is associated with a repetitive motion activity such as typing, tennis, playing the drums, or running. You can often tell that the pain is located specifically in a tendon, and you can point to the spot.

Chronic tendon injuries like those described above are called tendinosis or tendinopathy. These words refer to an accumulation over time of small-scale injuries that don't heal properly, resulting in a chronic injury of failed healing. Although you can't see the tendinopathy injury on the outside of your body, researchers can see the injury on the cellular scale by viewing slides of  tendons under the microscope. Tendinopathy can occur in many different areas, such as the wrist, forearm, elbow, shoulder, knee, and heel.

A photo showing a runnr bending over to hold his painful Achilles tendon.
A computer keyboard with someone's hands resting on the keyboard with one hand holding the other wrist as if it hurts.

How Does It Happen?

Tendons are rope-like structures that attach muscles to bones. Ligaments are similar structures that attach bones to other bones. When muscles and bones move, they exert stresses on the tendons and ligaments that are attached to them.

When your muscles move in new ways or do more work than usual, your muscles and tendons can sustain some damage on a cellular scale. If the increase in demand is made gradually, muscle and tendon tissues will usually heal, strengthen, and adapt to new loads. Athletes use these principles to build strength with good training programs..

You can, however, do some activity that injures a tendon on a microscopic scale and then do more injury before the tendon heals. If you continue the injurious activity, you will gradually accumulate these micro-injuries. When enough injury accumulates, you'll feel pain. This kind of injury that comes on slowly with time and persists is a chronic injury. The process of failed healing is described in more detail on the page titled Why Failed Healing.

What To Do If You Think You Have Tendinopathy

See A Specialist: If you have not done so already, you should see a specialist for diagnosis and treatment. Sports medicine doctors and physiatrists are often good choices for chronic tendon injuries, and they will likely refer you to a physical therapist. A rheumatologist and/or a functional medicine doctor can also be helpful. You can use websites like this one to learn more about your injury and treatments for it, and that knowledge will help you work with your doctor to design a program tailored to your specific case.

Get A Diagnosis: Diagnosis of tendinopathy is usually made through evaluation of medical history and symptoms, a physical exam, and imaging with MRI or ultrasound. If you have tendinopathy in multiple areas, make sure you don't have a collagen disorder like Ehlers Danlos Syndrome, or an inflammatory condition like ankylosing spondylitis, or an autoimmune issue.

Stay Informed: Read about new research into tendinopathy treatments and general health. Some doctors are more up-to-date on the research than others, so arming yourself with information is helpful. Medicine in general tends to be better at treating acute issues than chronic ones; you'll need to take an active role in your care to get the best results.

An MRI machine with a patient on the table heading into the machine and a technician standing by to assist.

Tendon Injury Terminology


Tendinopathy is a term that implies nothing about the pathology of the injury. The role of inflammation on the cellular level in tendinopathy is currently under study, but some inflammatory processes have been shown to exist. Tendinopathy has become the preferred term for chronic tendon pain.


The suffix "osis" implies a pathology of chronic degeneration without inflammation. Tendinosis refers to an accumulation over time of microscopic tendon injuries that don't heal properly and that lead to chronic pain. Tendinosis had been a common diagnostic term until tendinopathy became the preferred word..


The suffix "itis" means inflammation, so the term tendinitis refers to an acute tendon injury accompanied by inflammation. This term is not used for chronic tendon pain but instead for acute injuries. Tendinitis injuries can progress to chronic tendinopathy over time.


Paratenonitis refers to inflammation of a thin sheath of tissue called the paratenon that surrounds some tendons, such as the Achilles.


Tenosynovitis refers to inflammation of the synovial sheath that surrounds some tendons, such as the flexor tendons in the hands..

Chronic vs Acute

Chronic injuries occur slowly over time and persist, as opposed to acute injuries that occur suddenly, such as tendon ruptures (partial or complete).