Ethics in Medicine

Tendon Pain, what works?

Kristen Sparrow • March 04, 2011

This article from the New York Times looks at the interesting phenomenon that sometimes occurs with tendonitis: using the injured area, even intensely, can sometimes help. I’ve had at least two interesting experiences with this pattern. One was in a patient who had tennis elbow. I had been treating him and after 3 visits he was much better with less swelling, but he was still aware of it. He was a pro, so needed to play and he had a particularly grueling match and his elbow was all better the next day! I also had the embarrassing situation of turning on an electrotherapeutic device without turning down the intensity first and it gave a massive shock to a patient with tennis elbow. His whole arm leapt from the table and he started yelling. I quickly turned it off. By the next day, all the bruising swelling and pain was gone. I’ve never had the nerve to repeat that mistake, and thank goodness that patient was my husband, but after reading this article, I wonder if more stimulation might be better than less… The theory is that you increase the blood flow and that is what is curative. I addressed the cortisone issue in this post.

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For Tendon Pain, Think Beyond the Needle

Two time-honored remedies for injured tendons seem to be falling on their faces in well-designed clinical trials.

The first, corticosteroid injections into the injured tendon, has been shown to provide only short-term relief, sometimes with poorer long-term results than doing nothing at all.

The second, resting the injured joint, is supposed to prevent matters from getting worse. But it may also fail to make them any better.

Rather, working the joint in a way that doesn’t aggravate the injury but strengthens supporting tissues and stimulates blood flow to the painful area may promote healing faster than “a tincture of time.”