Hot or Cold? What is Best for Tendonitis

Tendonitis is diagnosed by a medical provider finding tenderness directly over a tendon, pain with movement of muscles and tendon and swelling of the tendon. The pain may be a slow progressive pain that builds with continued use or a sudden and severe pain at the time of injury. Motion can be lost and is most commonly seen in the shoulder area referred to as a frozen shoulder. It can be caused by a multitude of activities from tennis to shoveling a driveway. There is no one particular cause but repetitive, relatively minor impacts to the same location are what cause a majority of the cases.

Tendonitis can occur anywhere there is a tendon. A tendon is the thick cord that attaches a bone to the surrounding muscle. The most common places for tendonitis to occur are in the wrist, elbow, shoulder, hip, knee and Achilles. Wrist tendonitis is seen often with painters, people who use a scrubbing motion and pitchers. Most often in the wrist it is inflammation of the tendon sheath. After icing the area the best treat is resting the wrist and avoiding activities that will only aggravate the wrist.

Achilles tendonitis is occurs in the back of the heel. If not careful and re-aggravate this area it can result in serious complication such as a rupture that would require surgery. This is seen often in professional sports players but can happen to anyone who flexes the ankle frequently.

Tendonitis in the kneecap “Patellar” is referred to as jumper’s knee. This follows the same treatment as the Achilles tendonitis and if not careful can have serious complications if not rested until the tendon has a chance to heal.

These are just a few of the spots that are commonly seen by emergency room doctors; all who agree that icing the area immediately after injury is the best immediate treatment possible. Many orthopedic doctors disagree; however, on the treatment that follows the day of injury.

So the question arises is heat or ice better therapy for tendonitis? In general any new injury to a muscle or joint that results in swelling is best treated immediately with ice. Ice causes blood vessels to narrow thus reducing swelling. Reducing swelling is paramount in any type of injury. Swelling can cause the level of inflammatory substances to increase in the tissue that is injured. Ice can also help to reduce the level of external pain perception by numbing the area.

Heat packs will help open the blood vessels surrounding the injured tendon which can promote freer blood flow to the area. Blood flow is necessary in chronic injured tendons to promote healing at the site. Many doctors believe that the heat combined with over-the-counter anti-inflammatory medications is the all that is needed in the following weeks. It is a matter of preference by the doctor which course of therapy to use.

The sports therapist promotes rest first and foremost as the primary follow up treatment. In addition sports therapist recommend in most cases a course of ice therapy to reduce swelling and immediately followed by heat therapy to re-establish a healthy blood flow back into the area.

The best advice is always to listen to your medical doctor’s opinion as no two cases are identical. All agree that avoiding any activity that will aggravate the tendon injured is a must during the week following the injury. Most cases do not require further treatment; however, if your symptoms do not improve after a week follow up with your medical doctor as another form of treatment may be necessary.