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Diagnosed with tendinitis in knees. Having pain in wrist and elbow. Proper diagnosis?

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I have been diagnosed with tendinitis in both knees. I now have the same pain in both wrists and my left elbow. I am right hand dominant, so I don't think the elbow is from overuse. I'm concerned that there might be an underlying issue/syndrome. My joints do not become red, nor is there any noticeable swelling. Pain is worse at night.
My R shoulder is also sore after working out, and there is a noticeable grinding with rotation. The grinding is not painful.
Posted Fri, 3 May 2013 in Bones, Muscles and Joints
Answered by Dr. Sunil 8 hours later
Thanks for posting your query.

There are many causes of tendinitis and multiple joint pains, so detailed history and proper investigation is necessary.
Overuse tendinopathy can be suspected in workers and recreational athletes, so your activities and type of work should be described.
These symptoms also suggest arthritis (Rheumatoid arthritis) and Lupus which typically present with joint tenderness and swelling.
If you have history of Gut problems then Biliary cirrhosis (due to gall stones) and Crohn's disease should be ruled out.
Physical examinations, chest Xray,MRI, CT scan, joint fluid and blood tests should be performed to reach a diagnosis.
Let me know if you experience morning stiffness? how long pain lasts? what factors aggravate or relieve your symptoms? Is there any limitation in movements if yes then what degree? have you experienced long lasting bowel changes? have you experienced jaundice?

I will be writing back after your answers.

Dr Sunil
Above answer was peer-reviewed by
Follow-up: Diagnosed with tendinitis in knees. Having pain in wrist and elbow. Proper diagnosis? 54 minutes later

I have had no morning stiffness. I actually feel best in the morning. Zero jaundice also. I had my my gallbladder removed in 2006 due stones.

I am annActive Duty military paramedic. For the past three years, i have been working in an ER as well as covering base EMS response. It's not too taxing, although I would be on my feet for 12 hr shifts. I have enjoyed weight lifting and cardio, particularly cycling since 2005. I practice good form; I'm also a certified personal trainer.

The pain in my knees is almost constant, exacerbated with movement. I would rate activities such as ascending steps to be a 6/10. My wrist pain is intermittent; I have been unable to recognize a pattern that instigates discomfort. I would rate that pain a 4/10. My shoulder is rare, it's the only joint that "grinds", and would rate that pain a 2/10. The elbow pain is the newest, and the most aggravating. It emulates tennis elbow and starts medially and shoots down to my pinky. It's intermittent, worse at night, presents as a constant cramping, and I would rate it a 7/10.

I can't report any real gut related problems. I have fought constipation for years, with it becoming extreme during recent pregnancy. My one and only child, my son, is now 7 months old. Since his birth my stool has been remarkably loose.

No physical limitation in movement, however with even the slightest movement discomfort sets in.
Answered by Dr. Sunil 5 hours later

Thanks for writing back.

According to your description you are having tendinitis and tendinopathy which may be due to overuse or poor techniques. Stop or reduce activities and find substitute activities.

One of the best way to diagnose it is, change your activities and see if you get any improvement. The success of conservative treatment frequently depends upon a coordinated program of relative rest, correction of any underlying biomechanical faults, active rehabilitation, and a gradual return to tendon-loading activities.

Perform stretching exercises following activity. Historically, friction massage applied directly to the painful tendon was considered an important treatment for tendinopathy. NSAIDs, Corticosteroids and Topical glyceryl trinitrate help to relieve pain and accelerate healing.

You may need to visit your doctor and get colonoscopy or barium enema done to rule out crohn's disease. In sever cases, when all conservative treatments fail then you will need to visit orthopaedic surgeon for further management.

Hope I have answered your query. If you have any further question, feel free to ask.

Wish you good health.
Dr Sunil
Above answer was peer-reviewed by
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