Tendinopathy vs Tendinitis vs Tendinosis – what’s the difference?
It’s time to clear up some of the different terminology around tendon problems.
Originally we had ‘tendinitis’ – the ‘itis’ denotes inflammation
This all changed in 2002 with a great editorial in the BMJ by Karim Khan, Jill Cook, Kannus, Maffuli and Bonar. I still remember when this editorial was handed around the lecture theatre in my second year of undergraduate physiotherapy.
‘Tendinosis’ had a brief run as the preferred teminology – the ‘osis’ basically denotes ‘degenerative change’
However most academics and clinicians have settled on ‘tendinopathy’ – the ‘opathy’ basically means ‘change in’. This reflects the continuum model by Cook and Purdham that showed tendon problems exist on a continuum of reversible, but degenerative change.
Separately to that, we have ‘enthesopathy’ which describes a tendinopathy where the tendon attaches to the bone.
Also we have a partial thickness tear in the tendon, which is typically actually a progression of tendinopathy.
And finally, we have conditions involving inflammation (yes it happens here) in the tendon sheath – the words ‘paratendinitis’, and ‘tenosynovitis’ are used interchangeably here.
Hopefully that all makes sense! Even though it seems unimportant, the difference between 'tendinopathy', ‘tendinitis’ and ‘tendinosis’ is not just in the name and has implications for treatment of tendon problems - particularly that we (generally) don't use rest, ice or anti-inflammatory medications to 'fix' this 'inflammation'. Other implications of this we have covered in other blog posts and will continue to revisit.