A tendon injection is a precise, image-guided injection placed in and around an irritated or degenerated tendon to calm inflammation and ease the persistent pain of tendinopathy when rest, bracing, and physical therapy alone have not been enough.
OVERVIEW
What a tendon injection is and how it works
Tendons are the tough, cord-like bands that anchor muscle to bone. When a tendon is repeatedly overloaded it can become inflamed (tendinitis) or, over time, break down at the cellular level (tendinopathy), producing nagging pain, tenderness, and weakness with use. A tendon injection delivers medication — typically a local anesthetic, sometimes combined with a corticosteroid — to the sheath surrounding the affected tendon or to the painful soft tissue where the tendon attaches to bone.
The goal is to reduce local inflammation and quiet pain so you can move more comfortably and make progress in physical therapy, which remains central to long-term tendon recovery. The anesthetic in the injection can also be diagnostic: if your pain temporarily fades after the medication reaches the target, it helps confirm that the tendon is the true source of your symptoms. Steroid is used selectively — never injected into the body of the tendon and not repeated frequently in the same area — because, while it can calm inflammation, it may weaken tendon tissue over time. At Columbia Pain & Spine Institute, our dual board-certified, fellowship-trained Physical Medicine & Rehabilitation physicians in Gresham and Portland will discuss whether a steroid injection, a regenerative option such as platelet-rich plasma (PRP) therapy, or a combined plan is the best fit for your tendon.
Commonly treats
YOUR PROCEDURE
What to expect
Before your tendon injection
Your physician reviews your history, exam, and any imaging to confirm a tendon problem and to rule out a complete tendon tear, which is managed differently. Tell us about blood thinners, diabetes, or allergies. No sedation is needed for a routine tendon injection, so most patients can drive themselves to and from the visit.
During the procedure
The skin over the tendon is cleaned and numbed. Using ultrasound guidance — and in some cases fluoroscopy — your physician watches in real time as a thin needle is guided alongside the tendon, avoiding the tendon’s core, and the medication is delivered exactly where it is needed. Image guidance improves accuracy and helps protect healthy tendon fibers. The injection itself usually takes only a few minutes, and the whole visit is typically brief and performed in the office.
After your injection
- You rest briefly and are usually discharged the same day to resume light activity.
- Mild soreness or a temporary ache at the site is common for a day or two; ice and acetaminophen can help.
- If a steroid was used, its full anti-inflammatory effect often develops over several days to a couple of weeks.
- We generally recommend protecting the tendon by easing off the aggravating activity for a short period rather than returning immediately to heavy or repetitive loading.
Recovery and follow-up
How long relief lasts varies from person to person and by which tendon is involved. Because a steroid injection does not repair the underlying tendon, the most durable results usually come from pairing the injection with targeted physical therapy, activity modification, and bracing. We track your response and adjust the plan from there — whether that means continuing rehabilitation, considering a regenerative approach, or coordinating other care through our services.
FAQS
Frequently asked questions
Is a tendon injection painful?
Most patients feel only a brief sting from the numbing medication and mild pressure during the injection. Because the skin is numbed first and the needle is guided with ultrasound, discomfort is usually short-lived.
How is this different from a joint injection?
A joint injection places medication inside a joint space, while a tendon injection targets the inflamed soft tissue and sheath around a tendon. If your pain comes from a nearby joint instead, your physician may recommend a major joint injection or a small joint injection.
How many injections will I need?
Many tendons settle after one injection combined with therapy. Steroid injections are deliberately limited and not repeated frequently in the same tendon to protect the tissue. If pain persists, we may discuss other options, including platelet-rich plasma (PRP) therapy.