Multiple Tendonitis: Why Are You Getting Tendonitis Everywhere

Which diseases can cause multiple tendonitis?

First, it is important to note that it is entirely possible to develop multiple tendonitis without it being due to a specific disease.

Imagine, for example, that you meet the following conditions:

• You are over 40 years old (a factor that increases the chances of developing tendonitis);
• You engage in sports activities regularly and intensely;
• You have a genetic tendency above average to develop tendonitis.

So, under these conditions, you can easily end up with at least two simultaneous tendonitis cases. There’s no need to reference any specific disease here.

That said, there are indeed diseases that can cause tendonitis (among other issues). We can distinguish five main groups:

• Inflammatory diseases that affect the joints and surrounding areas (including tendons). These are also known as rheumatic diseases.
• Diseases that affect cellular function. These are known as metabolic diseases.
• Drug intoxications.
• Genetic diseases.
• Other diseases.

Let’s now examine each of these groups in detail.

Rheumatic Diseases

There are three categories of rheumatic diseases that can lead to tendonitis:

1️⃣ Rheumatoid arthritis;

2️⃣ Seronegative spondyloarthropathies, including:

• Axial spondyloarthritis;
• Reactive arthritis;
• Psoriatic arthritis.

3️⃣ Microcrystalline rheumatisms, including:

• Gout;
• Apatite rheumatism.

Sources: COFER; Gerster, 2007; Sarkbi, 2010.

Metabolic Diseases

Different forms of diabetes affect tendons and make them more susceptible to tendonitis.

This is also the case for certain congenital metabolic diseases (present at birth) such as:

• Alkaptonuria;
• Glucose-6-phosphate dehydrogenase deficiency;
• Galactosemia.

It is also the case for biological conditions that are not quite diseases, although they are often associated with them:

• Excess cholesterol in the blood (hypercholesterolemia);
• Excess uric acid in the blood (hyperuricemia).

Finally, obesity is also a condition known to weaken tendons.

Sources: Abate, 2013.

Drug Intoxications

Certain medications are known to have a tendency to weaken tendons, sometimes leading to ruptures. These include:

• Quinolones (or fluoroquinolones), a group of synthetic antibiotics;
• Corticosteroids;
• Statins (used to lower cholesterol);
• Aromatase inhibitors (used primarily to treat breast cancer in postmenopausal women);

Other medications are also suspected but without certainty to date:

• Anabolic steroids;
• Isotretinoin;
• Antiretrovirals, particularly protease inhibitors;
• Local anesthetics when injected near a tendon;
• Metalloproteinase inhibitors.

Sources: Bolon, 2017

Genetic Diseases

Ehlers-Danlos syndromes constitute a group of rare genetic connective tissue disorders. Connective tissue is a major component of tendons.

This is why individuals with these conditions are at higher risk of developing tendonitis.

Sources: Gazit, 2016

Other Diseases

There are at least two other diseases that can lead to tendonitis (among other issues):

• Systemic lupus erythematosus;
• Sarcoidosis.

Sources: Dörner, 2022; Rao, 2013

Do Not Confuse Diseases That Cause Multiple Tendonitis With…

Many diseases can cause multiple pains (polyalgias).

While multiple tendonitis can be associated with multiple pains, you can have multiple pains without tendonitis.

In other words, do not confuse diseases that cause multiple tendonitis with diseases that cause multiple pains!

In these circumstances, only consulting a well-trained professional can provide the best chances of making the correct diagnosis.

Sources: Gayraud, 2012

How to Stay Calm in the Face of So Much Information?

If you think you have multiple tendonitis and have read the rest of this article, you might be wondering:

“Oh no! But there can be so many different diseases! How can my doctor be sure it’s not this one or that one?”

First of all, keep in mind that a professional will probably never tell you why they ruled out a particular disease to explain your situation.

For example, they will likely never say:

“I think you don’t have psoriatic arthritis because blah blah blah… And I don’t think you have sarcoidosis because blah blah blah… etc.”

Most often, the professional will simply state the pure diagnosis without detailing their reasoning.

For example:

“I think your pain in your right knee and left shoulder are simple overuse tendonitis.”

Good News: If your professional thinks you have only “simple” tendonitis, it means they have ruled out everything else!

How can you be sure they are not wrong?

I would say:

• You can never be 100% sure; mistakes happen. Additionally, making a diagnosis can be very difficult and sometimes requires time and trial and error.
• Nothing prevents you from calmly asking your professional to detail their reasoning.
• It’s a matter of trust. And trust cannot be commanded. If you don’t have enough trust in your practitioner, you can change or seek a second opinion.