In multiple sclerosis (MS), lesions on the brain and spinal cord can trigger musculoskeletal pain. Over time, nerve damage can also affect your posture and how you walk. Abnormal posture or walking patterns may lead to joint issues like tendonitis or joint pain. In rare cases, certain medications may also damage tendons.

Many MyMSTeam members have discussed their MS and tendonitis. Tendonitis is inflammation of a tendon. Tendons are strong tissues that connect muscle to bone.

“I had tendonitis in my right Achilles tendon behind my ankle. I struggled with it for a long time,” wrote one member. Another mentioned their tendon issues affecting walking. “I’m getting pain in the strangest places, but I’ve been working with a physical therapist to get better,” they wrote.

🗳️ Have you experienced problems with your tendons since being diagnosed with MS?

Yes, I’ve had problems with one or more tendons.

No, I haven’t had any problems with tendons.

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Tendon injuries are manageable, but treatment depends on factors like where the injury is, what’s causing it, and how long you’ve had symptoms.

Keep reading to learn how tendonitis can be related to MS and what may help ease your pain.

What Is Tendonitis?

Tendonitis happens when a tendon becomes irritated or inflamed, often after repeated stress or overuse. This overload can happen from moving too quickly, lifting too much weight, or repeating the same movement.

But tendonitis is just one type of tendon injury, or tendinopathy. Tendinopathy is an umbrella term for conditions that affect a tendon. These can also include:

• Tenosynovitis — Inflammation of the sheath that surrounds a tendon
• Tendinosis — Tendon injury due to repetitive use or chronic overuse, usually without significant inflammation

“I have "tennis elbow." It's really annoying as I can barely hold a coffee cup. Anyone else just get random tendonitis?”

— A MyMSTeam member

If an injured tendon is left untreated, or if the tendon is stressed too much, it can tear. Ruptures, or full tears, may need surgery to repair.

Symptoms of Tendinopathy

Common symptoms of tendinopathy occur near joints, where muscles connect to bones. Symptoms can vary but may include:

• Pain with movement
• Tenderness
• Redness
• Swelling
• Warmth
• Weakness
• Stiffness
• Muscle cramping

Tendon pain may be constant or come and go. Sitting, standing, walking, gripping, or bending can be difficult depending on which tendons and muscles are involved.

Tendinopathies can develop almost anywhere in the body but tend to affect areas around joints, including the wrists, elbows, shoulders, knees, and ankles. They also commonly affect the hands and feet. Neck and back pain aren’t usually related to tendon-specific injuries, especially in people with MS.

“I had my tendons repaired due to trigger finger, but in my thumb. Now they say I have a partially torn tendon behind my left knee.”

— A MyMSTeam member

How Can MS Cause Tendinopathy and Joint Pain?

MS can cause joint pain and lead to tendinopathy in different ways.

However, having tendinopathy or joint pain with MS doesn’t necessarily mean the symptoms are caused by MS. These injuries can have many other causes, so ask your doctor for an evaluation. Your healthcare team can recommend treatment based on the diagnosis.

Abnormal Gait and Posture

Common MS symptoms from lesions, such as muscle weakness, muscle spasms, fatigue, poor balance, and sensation changes, can affect walking and posture.

For instance, people with MS-related leg weakness may have to hike their hip to prevent a fall when walking. Some MyMSTeam members report drop foot, which is when they have trouble lifting their foot to clear the ground. “I need to use a brace to keep my foot up so I don’t trip,” wrote one member.

“I just found out today that the pain my foot is from a tight Achilles tendon.”

— A MyMSTeam member

Your body tries to make up for chronic pain or weakness by moving differently and using additional muscles to stabilize joints. Over time, your new posture and walking pattern increase the risk of falls and lead to musculoskeletal issues, including tendon and joint pain.

Tips for Tendonitis Relief

Most tendinopathies improve without surgery, but symptoms can be stubborn. Below are a few tips to help find relief.

Get a Diagnosis

Tendinopathies are not all treated the same way. The first goal in tendinitis is to control inflammation, but managing tendinosis needs a different approach. Ask your doctor which type of tendinopathy you have. Knowing the type can help determine the right treatment.

Avoid Painful Activities

Depending on the type of tendinopathy, you may need to rest the affected area or avoid activities that make symptoms worse. If you have Achilles tendonitis in MS, for example, you may need to take a break from your daily long walk for a short time. Or, you might need to ask your healthcare team about a brace for temporary tendon support while at work.

See a Physical Therapist Early

Go to a physical therapist and learn massage techniques, exercises, or stretches you can do to calm and repair the tendon. They’ll build a treatment plan based on your type of tendinopathy, which may involve targeted exercises to help rebuild the tendon’s fibers in a healthy way. They can also help you understand symptoms of MS versus other pains, like differentiating tendonitis from spasticity.

Ask About Medication

Not all tendinopathies respond well to anti-inflammatory medications. Steroid injections and nonsteroidal anti-inflammatory drugs (NSAIDs) can help in the short term, but they don’t address the underlying issue long term. Ask your doctor which medications may help and when to use them.

How Can You Prevent Tendinopathy and Joint Pain?

Here are a few ways people with MS can help prevent tendon, muscle, and joint injuries.

Exercising

Exercise has many benefits for MS, including strengthening muscles and joints. Warm up before exercise by doing light exercise for five minutes to help lower the chance of injury.

If you’re not sure where to start, consider yoga and tai chi. These are gentle activities that teach movement basics, mobility, and balance. Ask your physical therapist about adaptive yoga and tai chi, which can be adjusted to fit your physical ability.

Stretching

Stretching can help you feel less stiff, prevent aches, and improve tendon health. You can stretch alone or with someone to help you.

Regardless of how advanced your MS may be, there are stretches that you can safely perform to improve your flexibility. Because everyone’s MS is different, talk to a physical therapist for stretching activities most helpful for you.

Taking Breaks

If you feel yourself getting tired, take breaks. Challenging your body through exercise, like a long walk, can be beneficial. But if leg weakness causes your body to compensate, your walking pattern may change and contribute to tendon or joint pain.

If you want to keep your body challenged, change up your exercises. If you walk one day, lift weights the next. Or, instead of walking one mile, walk half a mile and stretch.

Taking breaks or changing up activities can allow your joints to work in a different way, which may help prevent tendon overuse and injury.

Splinting

Talk to a physical or occupational therapist about wearing a splint or brace to help you move with less risk for injury.

Ask your doctor about what type of splint would be most effective and when you should wear it. Splints for various joints are usually sold at pharmacies, but you may benefit from a specific type based on your weakness or pain patterns.

Join the Conversation

On MyMSTeam, people share their experiences with multiple sclerosis, get advice, and find support from others who understand.

Does MS cause you joint pain or tendinopathy? Let others know in the comments below.