Tendinitis develops when a tendon -- a thick cord connecting a muscle to a bone -- becomes inflamed or irritated. While tendinitis can occur in any tendon, it commonly affects the shoulder, elbow, knee, wrist, thumb and ankle. Over-the-counter treatments, like cold and heat therapy, antiinflammatory medications and various forms of tendon support can help reduce pain and swelling at the tendon site so you can get back to your daily routine.
Heat and Cold Therapy
Cold therapy can be helpful in the first day or two after a tendon injury. The cold temperature helps reduce pain and causes constriction of the blood vessels surrounding the tendon to limit swelling. Cold therapy is typically applied to the injured area for 15 to 20 minutes several times a day. Heat therapy is often recommended after a couple of days of cold therapy. The warm temperature increases blood flow to the injured tendon and helps relax nearby muscles. Heat is typically applied to the affected area for 10 to 20 minutes several times daily. Many over-the-counter hot and cold packs are available in a variety of sizes, and several types can be used for both therapies.
Topical analgesics are pain relievers applied to the skin in the form of a patch, cream, spray, gel or rub. Many over-the-counter products promoted for relief of muscle and joint pain contain menthol and/or camphor (Icy Hot, Mentholatum ointment and Tiger Balm Extra). These substances stimulate nerves in the skin, creating a cool or warm sensation that may counteract the pain of an injury. Salicylates (Aspercreme, Sportscreme) -- another common ingredient in topical analgesics -- may also decrease the perception of pain. Some products contain a combination of active ingredients such as menthol, camphor and salicylate (Bengay Ultra Strength, Muscle Rub, Flexall Ultra Plus and Salonpas gel). While there is no evidence that topical analgesics are effective for treating tendinitis, they may provide temporary pain relief.
A short course of a nonsteroidal antiinflammatory drugs, known as NSAIDs, can provide temporary pain relief with tendinitis. NSAIDs relieve pain and reduce inflammation, but it is not clear whether they actually help the tendon heal. Over-the-counter NSAIDs include ibuprofen (Advil, Motrin), naproxen (Aleve, Anaprox) and aspirin. Doctors typically recommend limiting NSAID use to 7 to 10 days. Check with your doctor before taking an over-the-counter NSAID to make sure it is safe for you.
Support devices are used to reinforce and protect injured tendons, although the evidence on their effectiveness in treating tendinitis is limited. They theoretically work by alleviating tension on the tendon during activity. Many support devices -- such as a heel lift for Achilles tendinitis and forearm straps for elbow tendinitis -- are available over the counter. Support devices are typically used until your tendon pain resolves, but your doctor may recommend continued use for certain activities.
When To See Your Doctor
Tendinitis sometimes does not get better with rest and over-the-counter therapies. If you have tendon pain or swelling that persists for a few days or is worsening, see your doctor. Also seek medical attention if everyday activities are still limited, despite using over-the-counter treatments. Physical therapy or a another form of treatment is sometimes needed. Seek immediate medical attention if you have sudden, severe pain or cannot use the affected area. This could indicate a serious injury like a tendon rupture.
Is This an Emergency?
- American Family Physician: Common Overuse Tendon Problems: A Review and Recommendations for Treatment
- Merck Manual Professional Version: Tendinitis and Tenosynovitis
- Family Practice Notebook: Local Heat Therapy
- Sports Health: Evaluation and Management of Elbow Tendinopathy
- U.S. Food and Drug Administration: Medication Guide For Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- Merck Manual Professional Version: Achilles Tendinitis