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Dr. Chrysoula I. Liakou MD, PhD
- Treated online: Yes, usually. Tendonitis is identified from the activity history and a guided movement check on video, a staged loading programme and anti-inflammatory treatment agreed, and physiotherapy arranged; a snap with sudden weakness or a hot swollen joint with fever is in-person care.
- What it is: overload of a tendon, usually after a jump in training, a new repetitive task or a return to sport, at the Achilles, kneecap, outer elbow (tennis elbow), shoulder cuff, wrist or hip; tendon pain accounts for about 1 in 3 sports injuries.
- How long: a recently irritated tendon settles in 2 to 6 weeks with sensible load changes; established tendinopathy needs a progressive loading programme of about 12 weeks, with full robustness taking longer and flare-ups along the way normal.
- Load, not rest: complete rest lowers a tendon's capacity so the same activity hurts more on restarting; trim the provoking load to a tolerable level, use isometric holds to settle pain, then rebuild with slow heavy loading.
- Injections and antibiotics: corticosteroid injections ease tendon pain for weeks but tennis elbow trials show worse results at 1 year than rehabilitation; fluoroquinolone antibiotics (names ending in -floxacin) can cause tendon pain and rupture, sometimes weeks after the course.
- Emergency: call 112 if a snap or pop is followed by inability to walk, push off or lift, or if a hot, swollen joint comes with fever, confusion or feeling very unwell.
Get in-person care today, not an online appointment, if you felt a sudden snap or pop and now cannot push off, grip or lift normally (possible tendon rupture), or if any joint is hot, swollen and you feel feverish: septic arthritis can destroy a joint within days. If tendon pain starts while you are taking a fluoroquinolone antibiotic (names often ending in “-floxacin”), stop straining that limb and seek prompt medical advice. In an emergency, call 112.
Can an online doctor treat tendonitis?
Yes, in most cases. Tendonitis is diagnosed from its story (pain that starts with a change in activity, hurts at the start of movement and eases as you warm up) plus a guided movement check on camera.[1] The doctor can build a load-management plan and prescribe where suitable; sudden snaps and hot swollen joints need in-person care.
How an online consultation helps with tendonitis
- The load detective work: Tendon pain almost always follows a change: new mileage, a heavier programme, different shoes, a new keyboard setup. Finding that change is the diagnosis, and it happens by conversation.
- A plan with stages, not a rest order: You leave with a calm-it-down phase and a build-it-up phase, with exercises matched to your tendon and your week.
- Honest talk about injections and quick fixes: What steroid injections genuinely do, where they backfire, and why the boring programme beats them at a year.
- Rupture and arthritis screening: The patterns that are not tendinopathy (snaps, hot joints, multiple swollen tendons) get caught and routed to the right place.
What the doctor checks in an online tendonitis consultation
Position the camera so the doctor can see the painful area and how you move it. In a tendonitis consultation, the doctor will typically check:
- The load history: what changed in the weeks before the pain (volume, intensity, technique, equipment, a new job task), because tendinopathy is nearly always a change-of-load story.[1]
- The pain pattern: classic tendinopathy is sore starting a movement, eases as you warm up, and aches after; morning stiffness in the tendon is a reliable severity gauge.
- Guided provocation tests: a heel raise for the Achilles, resisted wrist extension for tennis elbow, a thumb-tuck tilt for De Quervain’s, watched on camera.
- Where exactly it hurts: pressing on the tendon itself versus the joint line or muscle, which you do under direction; tendon pain is usually precisely local.
- The not-tendonitis screen: snaps with loss of function, hot swollen joints, fever, multiple simultaneous painful tendons, psoriasis or bowel disease in the background, and current fluoroquinolone antibiotics.[3]
- Your goals and deadlines: a race, a season, a manual job, so the loading plan is built around what the tendon must eventually tolerate.
You leave with a named diagnosis, a staged programme, a way to judge weekly progress, and a review point at four to six weeks if the trend is not clearly upward.
What is tendonitis?
Tendonitis is pain and impaired function in a tendon, the cord anchoring muscle to bone.[4] Doctors increasingly call it tendinopathy, because in persistent cases the problem is usually not raging inflammation but a tendon whose structure has reacted to more load than it could handle.[1] That distinction matters: it explains why rest alone fails and progressive loading works.
The load-capacity model, in one paragraph
Every tendon has a current capacity, built by what you regularly ask of it. Ask much more than that (a running surge, a week of DIY, a new racquet) and the tendon reacts: painful, stiff in the morning, sore to start moving. Stop using it entirely and its capacity falls further, so the same task hurts more when you return: the trap that catches most people. The way out is the middle path: trim load to a level the tendon tolerates, then raise its capacity step by step with structured exercise. This model, not “fighting inflammation”, is what modern treatment is built on.[1]
Which parts of the body get tendonitis?
Tendonitis favours a handful of sites: the Achilles at the heel, the patellar tendon below the kneecap, the elbow (tennis and golfer’s elbow), the rotator cuff at the shoulder, the thumb side of the wrist (De Quervain’s), the gluteal tendons at the side of the hip, and the forearm in heavy computer users.
- Achilles tendonitis: pain and morning stiffness above the heel, classic in runners after a training spike and in people returning to sport after years away.[1]
- Patellar tendonitis (jumper’s knee): pain just below the kneecap, loaded hardest by jumping and stairs; overlaps with the patterns on the knee pain page.
- Tennis elbow and golfer’s elbow: outer or inner elbow pain on gripping and lifting, usually from repeated hand work rather than any racquet.[2]
- Rotator cuff (shoulder): outer-arm pain reaching overhead or lying on that side.
- De Quervain’s tenosynovitis: thumb-side wrist pain on gripping and lifting, common with repetitive hand work and in new parents lifting a baby.
- Gluteal tendinopathy: pain over the bony point at the side of the hip, sore lying on that side and climbing stairs, most common in women in mid-life.
How is tendonitis treated?
With load management: reduce the provoking load enough to calm symptoms, keep the tendon working at a tolerable level, then rebuild its capacity with progressively heavier, slow exercise over roughly 12 weeks.[1] Complete rest deconditions the tendon and postpones the problem. Pain relief and other treatments support that process; they do not replace it.
Phase one: calm it down
Trim the aggravating load rather than eliminating all activity: shorter runs on flat ground, lighter grip work, fewer stairs, whatever maps to your tendon. Isometric holds (pushing or holding against resistance without movement, for example a sustained heel raise hold) often ease tendon pain directly and keep the tissue loaded while it settles. Use the 24-hour rule as your meter: if pain during activity stays mild and is no worse by the next morning, the load was acceptable.
Phase two: build it back up
Once daily tasks are comfortable, capacity is rebuilt with slow, heavy, progressive resistance: loaded heel raises for the Achilles, slow squats for the patellar tendon, weighted wrist and grip work for the elbow. Progress by small steps weekly, expect meaningful change over 6–12 weeks and full robustness over months, and keep one honest truth in view: some discomfort during rehabilitation is acceptable and even expected, provided it obeys the 24-hour rule. The programme is straightforward, and it is the treatment with the best evidence for lasting recovery.[1][2]
Do steroid injections help tendonitis?
Honestly, only sometimes, and briefly. Corticosteroid injections reliably ease tendon pain for weeks, but trials in tennis elbow show worse outcomes at a year than letting the tendon recover through loading, and injecting into the Achilles risks rupture.[2] They are an in-person procedure, reserved for selected cases after that trade-off is explained.
The same honesty applies down the menu. Shockwave therapy has reasonable evidence for some stubborn tendinopathies and is a referral option. Platelet-rich plasma (PRP) injections remain unproven enough that guidelines do not recommend them routinely. Braces and straps (a tennis-elbow clasp, a heel wedge for the Achilles) can ease symptoms while loading does the real work. Anything sold as a fast fix for a slow tissue deserves suspicion: tendon remodelling runs on weeks and months, whatever the clinic brochure says.
When should I worry about tendon pain?
Worry about a sudden snap or pop followed by weakness or inability to push off, which suggests rupture and needs in-person care that day; a hot, swollen joint with fever, which can be septic arthritis; new tendon pain while taking a fluoroquinolone antibiotic; and multiple painful, swollen tendons or joints, which raises inflammatory arthritis.[3]
- Sudden snap at the back of the ankle, then unable to push off: same-day in-person care (possible Achilles rupture, classically in men 30–50 returning to sport)
- Any joint hot, swollen and feverish: same-day in-person care; call 112 if you are severely unwell
- Tendon pain or swelling on a fluoroquinolone antibiotic: stop loading the limb and seek prompt advice; rupture risk is a recognised, EMA-restricted side effect[3]
- Several tendons or joints painful and swollen together, or tendon pain with psoriasis or inflammatory bowel disease: assessment for inflammatory arthritis
- Tendon pain not improving after a properly completed 12-week programme: review and referral, not repetition
Which tendonitis treatment might the doctor recommend?
Treatment follows the site and the stage. This is the decision framework the doctors use, aligned with cited European and UK guidance:[1][2]
Swipe sideways to compare →
| Presentation | Likely first step | Suitable for online care? | When referral or in-person care is needed |
|---|---|---|---|
| Recent-onset tendon pain after a clear load spike | Load trim, isometrics, then progressive loading over 6–12 weeks | Usually yes | No clear improvement by 4–6 weeks despite following the plan |
| Persistent tendon pain lasting over three months | Structured heavy-slow loading programme, physiotherapy referral where available | Usually yes | Failed completed programme: shockwave or specialist opinion by referral |
| Severe pain blocking rehabilitation | Pain-relief review; selected cases discussed for injection with the trade-offs explained | Plan online; procedure in person | Injections are an in-person procedure; avoided around the Achilles |
| Sudden snap with loss of function | Same-day in-person assessment | No | Possible rupture; some need surgery, all need proper examination |
| Hot, swollen joint with fever | Same-day in-person care | No | Possible septic arthritis; call 112 if severely unwell |
Not sure which row is your tendon? A doctor can tell you in one consultation.
See available times →Treatment options for tendonitis
What you can do yourself
Start the load-management sequence above: it is self-care and the core treatment in one. Warm the tendon before demanding tasks, keep overall activity going through other movements that do not provoke it, and audit the obvious contributors: footwear past its life for the Achilles, grip size and technique for the elbow, sudden programme jumps for everything. For sport-related flare-ups, the first-days approach on the sports injuries page applies. Track progress weekly by function (how many heel raises, how heavy a grip) rather than by how it felt today; tendons improve on trend lines, not straight lines.
Prescription treatment
A prescription is never issued without a consultation. Where suitable, the doctor may prescribe a short anti-inflammatory course or gel to make sleep and early rehabilitation manageable, after checking your stomach, kidney and heart history, with an honest caveat: because persistent tendinopathy is not primarily inflammatory, NSAIDs ease symptoms rather than repair the tendon.[2][5] Opioids (such as codeine or tramadol), benzodiazepines and other controlled medicines are not prescribed through online consultations. Where a fluoroquinolone antibiotic is the suspected trigger, the doctor reviews that medicine promptly in line with EMA restrictions.[3] Splints and straps have a supporting role by site, physiotherapy referral anchors the loading programme where available, and injection or specialist options go through referral with the trade-offs stated plainly.
When tendonitis is treated online, and when you need in-person care
Treated online: Achilles, patellar, elbow, wrist, shoulder and gluteal tendinopathy, from first flare to structured 12-week programme; recurrent tendon problems that need a better-built plan; medication review alongside your other medicines; and return-to-activity planning for work and sport.
In-person care: sudden snaps with loss of function go the same day for examination, because a ruptured Achilles or other major tendon has a time-sensitive treatment window; a hot, swollen, feverish joint goes to same-day in-person care, with 112 if you are severely unwell; suspected inflammatory arthritis gets blood tests and a rheumatology pathway; and tendons that have genuinely failed a completed programme are referred for shockwave, injection or a specialist opinion rather than recycled through the same exercises. Tendonitis is one of many problems within joint and muscle pain the doctors assess online.
When to get in-person care
Get same-day in-person care for a sudden snap or pop with loss of function (for the Achilles: a blow to the back of the ankle followed by inability to push off), or for any joint that is hot, swollen and feverish, which can signal septic arthritis; call 112 if you are severely unwell with it. Seek prompt medical advice for tendon pain or swelling while taking a fluoroquinolone antibiotic, and urgent review for a limb that is cold, pale or numb, or redness spreading rapidly along a tendon with fever.
How Mobi Doctor works
- Book a time that suits you: open daily 7am–11pm CET. You can see a doctor over video, usually within 15 minutes. No subscription, exact price up front.
- Speak to a licensed doctor about tendonitis: a private video call: you describe what you feel, the doctor asks what matters, and you agree the right plan together.
- Leave with your plan: everything agreed before you hang up: your plan, and a prescription to use at a pharmacy near you where medication is clinically right for you. If your doctor decides you need to be seen in person, you get a full refund.
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Not sure it’s tendonitis? Tick every symptom you have to see each condition page that mentions it. It finds the right page, not a diagnosis: a doctor gives you that on a video call.
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Similar symptoms, different condition? Sports Injury can start the same way. Compare them, or look up any other symptom in the full symptom checker.
Frequently asked questions about tendonitis
What is tendonitis, and what causes it?
Tendonitis is pain and tenderness in a tendon, the cord joining muscle to bone, caused by loading it faster or harder than it can adapt to: a sudden increase in running, jumping, lifting or a repetitive work task, a return to sport after a break, poor technique, worn shoes, or hours of one movement. Age, diabetes, high cholesterol, menopause, obesity and fluoroquinolone antibiotics make tendons more vulnerable.
What are the symptoms of tendonitis?
Tendonitis causes pain and stiffness in the tendon that is worst first thing in the morning and at the start of activity, eases as the tendon warms up, then returns worse afterwards; the tendon is tender to pinch, may feel thickened or creak, and the movement it powers, such as pushing off, gripping or reaching, hurts. Swelling is mild; a hot, red, swollen joint is something else.
Can an online doctor prescribe treatment for tendonitis in Europe?
Yes, once you have had a consultation. For tendonitis the doctor can prescribe anti-inflammatory tablets or a gel where they suit you, build the staged loading programme with you and refer you to physiotherapy, with any prescription used at a pharmacy near you. Opioids and other controlled medicines are never prescribed online, and injections for tendonitis that has not responded to rehabilitation are arranged in person with a frank discussion of their limits.
What is the difference between tendonitis and tendinopathy?
Tendonitis implies inflammation; tendinopathy is the broader, more accurate label for persistent tendon pain, where the main problem is tendon structure reacting to overload rather than ongoing inflammation. The practical consequence: anti-inflammatory approaches alone rarely fix it, while progressively loading the tendon over about 12 weeks rebuilds its capacity and is the treatment with the best evidence.
How long does tendonitis take to heal?
A recently irritated tendon can settle in two to six weeks with sensible load changes. Established tendinopathy typically needs a 12-week progressive loading programme, with full robustness taking longer, and the Achilles and patellar tendons are slowest. Flare-ups along the way are normal and managed by stepping back one stage, not by stopping; tendonitis not improving by 12 weeks is reviewed.
Should I completely rest a painful tendon?
No. Complete rest lowers the tendon's capacity, so the same activity hurts more when you restart. The evidence supports the middle path for tendonitis: trim the provoking load to a tolerable level, use isometric holds (static contractions held for 30 to 45 seconds) to settle pain, and then rebuild with slow, heavy, progressive loading two or three times a week, accepting mild pain that settles within a day.
Do cortisone injections cure tendonitis?
No. Cortisone injections can switch tendon pain off for weeks, which is occasionally exactly what is needed to start rehabilitation, but tennis elbow trials show worse results at a year compared with rehabilitation alone, and repeated injections can weaken tendon tissue; they are never injected into the Achilles or patellar tendon because of the rupture risk. Loading remains the treatment for tendonitis.
Can antibiotics really cause tendon problems?
One family can: fluoroquinolones (ciprofloxacin, levofloxacin and related medicines, often ending in -floxacin) carry a recognised risk of tendon pain and even rupture, especially of the Achilles, sometimes weeks after the course and more so in older people and those on steroids. European regulators restricted their use partly for this reason. New tendon pain during or after such a course needs prompt medical advice.
When is tendon pain an emergency?
Treat tendonitis-type pain as urgent if a snap or pop is followed by weakness or inability to push off, walk on tiptoe, grip or lift, which can mean a tendon rupture that does best with early repair, or if any joint is hot, swollen and feverish, which can signal septic arthritis; call 112 if you cannot bear weight or travel safely. Gradual tendon pain without those features can be assessed online.
What can I do at home for tendonitis?
At home, reduce the provoking activity to a level that causes only mild tendonitis pain, use a cold pack for 20 minutes after activity in the first days and heat before exercise later, take paracetamol or an anti-inflammatory as advised for a week or two, do isometric holds daily and then the loading exercises a physiotherapist gives you, and wear supportive shoes or a heel raise for the Achilles.
How can I prevent tendonitis coming back?
Prevent tendonitis by increasing training or work load gradually, no more than about 10% a week, warming up, strength training the muscles around vulnerable tendons twice a week, keeping some loading going after recovery rather than stopping, replacing worn shoes, varying tasks and techniques, managing weight, cholesterol and diabetes, and avoiding fluoroquinolone antibiotics where an alternative exists.
Is tendonitis different in older people, in pregnancy or at the menopause?
Tendons stiffen and heal more slowly with age, so tendonitis after 50 takes longer and ruptures are commoner, especially with steroids or fluoroquinolones. Around the menopause, falling oestrogen makes tendon pain, particularly gluteal and Achilles, much more frequent, and strength training matters most. In pregnancy, wrist tendonitis from fluid retention and lifting is common and is managed with a splint and activity changes.
- Achilles tendinopathy (Clinical Knowledge Summary), NICE, National Institute for Health and Care Excellence, 2024.
- Tennis elbow (Clinical Knowledge Summary), NICE, National Institute for Health and Care Excellence, 2022.
- Quinolone and fluoroquinolone medicines: restrictions following tendon and other side effects, EMA, European Medicines Agency, 2019.
- Musculoskeletal health fact sheet, WHO, World Health Organization, 2022.
- Topical non-steroidal anti-inflammatory drugs for acute musculoskeletal pain in adults, Cochrane Database of Systematic Reviews, 2015.
- Tendonitis, NHS, National Health Service (UK), reviewed June 2023.
This page is for information only and is not a substitute for a medical consultation. Guideline links are provided for transparency; treatment decisions are made with your doctor.
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