Tendinitis

Health Condition

Tendinitis

  • DMSO

    Dimethyl sulfoxide is anti-inflammatory and may be applied topically to reduce pain and swelling.

    Dose:

    Apply a 10% gel twice per day under medical supervision
    DMSO
    ×

    DMSO, or dimethyl sulfoxide, has a long history as a topical anti-inflammatory agent. One double-blind trial used a 10% DMSO gel topically on patients with tendinitis of the elbow and shoulder and found that it significantly reduced pain and inflammation in each joint.2 Other preliminary3,4 and double-blind5,6 trials found DMSO to be effective in treating tendinitis, but one double-blind trial found no difference between the effects of a 70% DMSO solution and a 5% DMSO placebo solution.7 Certain precautions must be taken when applying DMSO, and it should only be used under the guidance of a qualified healthcare professional.

  • Bromelain

    Bromelain is anti-inflammatory and may help heal minor injuries and relieve pain.

    Dose:

    2,000 to 9,000 mcu per day
    Bromelain
    ×
     

    Bromelain, a proteolytic enzyme, is an anti-inflammatory agent and for this reason is helpful in healing minor injuries, particularly sprains and strains, muscle injuries, and the pain, swelling, and tenderness that accompany sports injuries.8,9,10

  • Digestive Enzymes

    Supplementing with digestive enzymes may reduce the severity of symptoms and speed healing.

    Dose:

    Several tablets per day of proteolytic enzymes
    Digestive Enzymes
    ×
     

    Alternative healthcare practitioners frequently recommend proteolytic enzymes for various minor injuries. Research demonstrates that these enzymes are well absorbed when taken by mouth,11,12 and preliminary13,14,15,16 and double-blind17,18,19,20 trials have shown their effectiveness for reducing pain and swelling associated with various injuries and for speeding up the healing process. Unfortunately, many of these studies did not specifically identify the patients’ injury, so it is unclear whether the positive results included improvements in tendinitis.

What Are Star Ratings
×
Reliable and relatively consistent scientific data showing a substantial health benefit.
Contradictory, insufficient, or preliminary studies suggesting a health benefit or minimal health benefit.
For an herb, supported by traditional use but minimal or no scientific evidence. For a supplement, little scientific support.

Holistic Options

Acupuncture may be helpful for treating tendinitis. A controlled trial compared acupuncture to sham (fake) acupuncture in people with shoulder tendinitis and found that acupuncture treatment produced significantly higher scores on a combined measurement of pain, ability to perform daily activities, ability to move shoulder without pain, and strength.21 This study also reported that the beneficial effects of acupuncture continued for at least three months following treatment. Another controlled study found traditional “deep” acupuncture more effective than superficial acupuncture for tennis elbow immediately after a series of ten treatments, but at 3 to 12 months’ follow up, both treatment groups had improved similarly.22 A third controlled study found no benefit from ten treatments of laser acupuncture for tennis elbow.23

Certain treatments used by physicians and other healthcare practitioners have been shown to be effective for tendinitis. In a controlled trial, patients with tendinitis of the shoulder received 24 treatments over six weeks of either ultrasound or a sham treatment.24 Ultrasound resulted in considerable improvement in pain level and overall quality of life, but many of the patients had their original symptoms return after nine months. The use of ultrasound for tennis elbow has not been validated, according to a systematic review of controlled studies.25 One controlled trial compared the effects of ultrasound alone to ultrasound plus a topical steroid medication (a process known as phonophoresis, where ultrasound is used to drive a substance into the skin).26 Both of these treatments were given three times per week for three weeks and both produced similar reductions in pain and tenderness.

Preliminary studies have suggested that daily use of TENS (transcutaneous electrical nerve stimulation) for one to two weeks reduces or eliminates pain in patients with tendinitis.27,28 Controlled studies are needed to confirm these findings.

References

1. Berkow PK, Fletcher AJ, Beers MH (eds). The Merck Manual of diagnosis and therapy, 16th Ed. Rahway, NJ: Merck Research Laboratories, 1992;1367-8.

2. Kneer W, Kuhnau S, Bias P, et al. Dimethylsulfoxide (DMSO) gel in treatment of acute tendopathies. A multicenter, placebo-controlled, randomized study. Fortschritte Med 1994;112:142-6 [in German].

3. Lockie LM, Norcross BM. A clinical study on the effects of dimethyl sulfoxide in 103 patients with acute and chronic musculoskeletal injuries and inflammations. Ann N Y Acad Sci 1967;141:599-602.

4. Steinberg A. The employment of dimethyl sulfoxide as an antiinflammatory agent and steroid-transporter in diversified clinical diseases. Ann N Y Acad Sci 1967;141:532-50.

5. Brown JH, Wood DC, Jacob SW. Current status of dimethyl sulfoxide (DMSO). A double blind evaluation of its therapeutic value in acute strains, sprains, bursitis and tendonitis. Bull Soc Int Chir 1972;31:561-6.

6. Brown JH. A double blind study-DMSO for acute injuries and inflammations compared to accepted standard therapy. Curr Ther Res Clin Exp 1971;13:536-40.

7. Percy EC, Carson JD. The use of DMSO in tennis elbow and rotator cuff tendonitis: a double-blind study. Med Sci Sports Exerc 1981;13:215-9.

8. Seligman B. Bromelain: an anti-inflammatory agent. Angiology 1962;13:508-10.

9. Cirelli MG. Treatment of inflammation and edema with bromelain. Delaware Med J 1962;34:159-67.

10. Masson M. Bromelain in the treatment of blunt injuries to the musculoskeletal system. A case observation study by an orthopedic surgeon in private practice. Fortschr Med 1995;113:303-6.

11. Miller JM. The absorption of proteolytic enzymes from the gastrointestinal tract. Clin Med 1968;75:35-42 [review].

12. Castell JV, Friedrich G, Kuhn CS, et al. Intestinal absorption of undegraded proteins in men: presence of bromelain in plasma after oral intake. Am J Physiol 1997;273:G139-46.

13. Cirelli MG. Five years experience with bromelains in therapy of edema and inflammation in postoperative tissue reaction, skin infections and trauma. Clin Med 1967;74(6):55-9.

14. Trickett P. Proteolytic enzymes in treatment of athletic injuries. Appl Ther 1964;6:647-52.

15. Sweeny FJ. Treatment of athletic injuries with an oral proteolytic enzyme. Med Times 1963:91:765.

16. Boyne PS, Medhurst H. Oral anti-inflammatory enzyme therapy in injuries in professional footballers. Practitioner 1967;198:543-6.

17. Deitrick RE. Oral proteolytic enzymes in the treatment of athletic injuries: A double-blind study. Pennsylvania Med J 1965;Oct:35-7.

18. Holt HT. Carica papaya as ancillary therapy for athletic injuries. Curr Ther Res 1969;11:621-4.

19. Rathgeber WF. The use of proteolytic enzymes (Chymoral) in sporting injuries. S Afr Med J 1971;45:181-3.

20. Buck JE, Phillips N. Trial of Chymoral in professional footballers. Br J Clin Pract 1970;24:375-7.

21. Kleinhenz J, Streitberger K, Windeler J, et al. Randomised clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis. Pain 1999;83:235-41.

22. Haker E, Lundeberg T. Acupuncture treatment in epicondylalgia: a comparative study of two acupuncture techniques. Clin J Pain 1990;6:221-6.

23. Haker E, Lundeberg T. Laser treatment applied to acupuncture points in lateral humeral epicondylalgia. A double-blind study. Pain 1990;43:243-7.

24. Ebenbichler GR, Erdogmus CB, Resch KL, et al. Ultrasound therapy for calcific tendonitis of the shoulder. N Engl J Med 1999;340:1533-8.

25. van der Windt DA, van der Heijden GJ, van den Berg SG, et al. Ultrasound therapy for musculoskeletal disorders: a systematic review. Pain 1999;81:257-71.

26. Klaiman MD, Shrader JA, Danoff JV, et al. Phonophoresis versus ultrasound in the treatment of common musculoskeletal conditions. Med Sci Sports Exerc 1998;30:1349-55.

27. Kaada B. Treatment of peritendinitis calcarea of the shoulder by transcutaneous nerve stimulation. Acupunct Electrother Res 1984;9:115-25.

28. Saveriano G, Lionetti P, Maiolo F, Battisti E. Our experience in the use of a new objective pain measuring system in rheumarthropatic subjects treated with transcutaneous electroanalgesia and ultrasound. Minerva Med 1986;77:745-52 [in Italian].

29. Latko WA. Armstrong TJ, Franzblau A, et al. Cross-sectional study of the relationship between repetitive work and the prevalence of upper limb musculoskeletal disorders. Am J Ind Med 1999;36:248-59.

30. Piligian G, Herbert R, Hearns M, et al. Evaluation and management of chronic work-related musculoskeletal disorders of the distal upper extremity. Am J Ind Med 2000;37:75-93.

31. Stock SR. Workplace ergonomic factors and the development of musculoskeletal disorders of the neck and upper limbs: a meta-analysis. Am J Ind Med 1991;19:87-107.

32. Tittiranonda P, Rempel D, Armstrong T, Burastero S. Effect of four computer keyboards in computer users with upper extremity musculoskeletal disorders. Am J Ind Med 1999;35:647-61.

Copyright © 2024 TraceGains, Inc. All rights reserved.

Learn more about TraceGains, the company.

The information presented by TraceGains is for informational purposes only. It is based on scientific studies (human, animal, or in vitro), clinical experience, or traditional usage as cited in each article. The results reported may not necessarily occur in all individuals. Self-treatment is not recommended for life-threatening conditions that require medical treatment under a doctor's care. For many of the conditions discussed, treatment with prescription or over the counter medication is also available. Consult your doctor, practitioner, and/or pharmacist for any health problem and before using any supplements or before making any changes in prescribed medications. Information expires December 2024.

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