The tendons are one of the body’s weakest links. While muscle and bone heal well after injury, the fibrous tissue that connects muscle to bone has a relatively poor blood supply, and for that reason, it recovers only slowly.
Inflammation in the tendon or its sheath is called tendonitis. Symptoms include tenderness, redness, swelling, and pain on exertion. These symptoms may last for months or years. Tendonitis occurs most commonly in the following areas: elbow (lateral epicondylitis or medial epicondylitis, also known as tennis elbow and golfer’s elbow), knee (peripatellar tendonitis), hip (iliotibial band tendonitis), shoulder (rotator cuff tendonitis), lower calf (Achilles' tendonitis), forearm, and thumb.
Overuse of a tendon (repetitive strain injury) is the most common cause of tendonitis. This form of injury frequently occurs in computer keyboard users, people who perform manual labor, and athletes (such as tennis elbow and golfer’s elbow). Acute injury to a tendon, such as an excessive stretch, can also cause tendonitis.
Conventional treatment consists primarily of avoiding the movement that caused the injury and allowing the body to heal on its own. Nonsteroidal anti-inflammatory drugs (such as ibuprofen) may help reduce pain, but have not been shown to speed recovery. Steroid injection into the affected tendon is thought to help in certain cases, but the scientific basis for this commonly used method remains weak at best.
Principal Proposed Natural Treatments
Although the evidence remains incomplete and somewhat inconsistent, acupuncture
For example, a
Another study compared superficial insertion of acupuncture needles (sham treatment insertion) with normal deep insertion in 82 people with tennis elbow.
Benefits have also been seen in studies of people with tendonitis in the shoulder. For example, a trial of 52 people with rotator cuff (shoulder) tendonitis found acupuncture more effective than sham acupuncture.
Laser acupuncture is a widely used substitute for needle acupuncture, but it may not be effective. A double-blind study of 49 people with tennis elbow failed to find 10 treatments with laser acupuncture more effective than the same number of treatments using fake laser acupuncture.
Other Proposed Natural Treatments
A form of massage
Other natural treatments sometimes recommended for tendonitis, but which lack scientific substantiation for that purpose, include
6. Kleinhenz J, Streitberger K, Windeler J, et al. Randomized clinical trial comparing the effects of acupuncture and a newly designed placebo needle in rotator cuff tendinitis. Pain. 1999;83:235-241.
7. Ceecherelli F, Bordin M, Gagliardi G, et al. Comparison between superficial and deep acupuncture in the treatment of the shoulder's myofascial pain: a randomized and controlled study. Acupunct Electrother Res. 2001;26:229-238.
10. Bisset L, Paungmali A, Vicenzino B et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med . 2005;39:411-422; discussion 411-422.
11. Bisset L, Paungmali A, Vicenzino B et al. A systematic review and meta-analysis of clinical trials on physical interventions for lateral epicondylalgia. Br J Sports Med . 2005;39:411-422; discussion 411-422.
13. Oken O, Kahraman Y, Ayhan F, et al. The short-term efficacy of laser, brace, and ultrasound treatment in lateral epicondylitis: A prospective, randomized, controlled trial. J Hand Ther. 2008;21:63-68.
Last reviewed April 2009 by EBSCO CAM Medical Review Board
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