Tendonitis, the inflammation of a tendon, can cause significant pain and discomfort that limits movement. While rest, ice, and physical therapy are crucial for recovery, topical creams can play a vital role in managing symptoms by delivering medication directly to the affected area. These treatments target localized pain and inflammation, providing effective, and often faster, relief than oral medications for superficial conditions. The best cream for tendonitis depends on the active ingredients, with nonsteroidal anti-inflammatory drugs (NSAIDs) and counterirritants being the most common and effective choices.
Topical NSAID Gels for Targeted Relief
Topical nonsteroidal anti-inflammatory drugs (NSAIDs) are a top recommendation for addressing the inflammation associated with tendonitis. Unlike pills that travel through the entire body, topical NSAIDs like diclofenac are applied directly to the skin, where they can be absorbed into the underlying tissues to target the source of the pain. This localized action reduces inflammation and pain with fewer systemic side effects, such as stomach upset, commonly associated with oral NSAIDs.
How diclofenac gel works
Diclofenac works by inhibiting enzymes responsible for producing prostaglandins, which are chemicals that cause pain and inflammation. By blocking these enzymes at the site of the injury, the gel reduces swelling and eases pain. Clinically proven to relieve pain from inflammatory conditions, diclofenac gel is an excellent choice for superficial tendonitis affecting areas like the elbow, wrist, ankle, and knee. Brand names often include Voltaren and Voltarol. For maximum effectiveness, it is typically applied 2-4 times daily for up to 14 days, as directed by the product label or a healthcare provider.
Counterirritant Creams for Pain Signal Desensitization
Counterirritant creams create a cooling or warming sensation that distracts the brain from the deeper pain of the inflamed tendon. These creams don't reduce inflammation in the same way as NSAIDs but can provide noticeable and immediate pain relief. They are particularly useful for mild-to-moderate tendonitis pain and can be used in conjunction with other therapies, or for those who cannot use NSAIDs.
Common counterirritant ingredients
- Menthol: Found in products like Icy Hot and Bengay, menthol provides a cooling sensation that helps dull pain.
- Capsaicin: Derived from chili peppers, capsaicin creates a warming sensation. With consistent use, it can deplete the body's pain-signaling chemical, substance P, to reduce nerve-related pain over time.
- Methyl salicylate: Often combined with menthol, this ingredient also acts as a topical analgesic.
Comparison of Creams for Tendonitis Relief
| Feature | Topical NSAIDs (e.g., Diclofenac) | Counterirritant Creams (e.g., Menthol, Capsaicin) | Natural Creams (e.g., Arnica, Frankincense) |
|---|---|---|---|
| Primary Mechanism | Reduces inflammation by inhibiting prostaglandins. | Masks pain by creating distracting sensations. | Contains plant-based ingredients with purported anti-inflammatory properties. |
| Onset of Relief | Builds over time with consistent use (often within 7 days). | Immediate, temporary relief upon application. | Variable; depends on the specific ingredient and formula. |
| Pain Type Addressed | Inflammatory and musculoskeletal pain. | Mild-to-moderate pain by sensory distraction. | Mild pain, bruising, and muscle soreness. |
| Side Effects | Mild skin irritation or rash at the application site. | Skin irritation, burning, or tingling sensation. | Generally well-tolerated, but skin reactions are possible. |
| Best For | Acute, inflammatory tendonitis in superficial joints. | Short-term, localized pain management. | Those seeking complementary therapies for mild pain. |
| Medical Consultation | Recommended for proper usage, especially for long-term use. | Advised if pain persists or worsens. | Recommended to ensure safety and effectiveness. |
How to Choose and Apply the Right Cream
Before selecting a cream for your tendonitis, it's wise to consult with a healthcare provider. They can accurately diagnose the condition and recommend the most suitable treatment plan, which may include a combination of topical medication, rest, and physical therapy. When applying, always follow the package directions or your doctor's instructions for dosage and frequency. Wash your hands thoroughly before and after application to avoid contact with eyes or sensitive skin. Do not apply the cream to broken, irritated, or infected skin.
Complementary Therapies for Tendonitis
Topical creams are most effective when used as part of a comprehensive treatment strategy. Additional steps can accelerate healing and reduce discomfort:
- Rest: Avoid activities that aggravate the tendon to prevent further damage and allow it to heal.
- Ice: Applying a cold pack to the affected area for 10-15 minutes several times a day can help reduce swelling and pain, especially during the initial stages of the injury.
- Compression: Wraps, braces, or sleeves can help reduce swelling and provide support to the injured tendon.
- Physical Therapy: A physical therapist can provide targeted exercises to strengthen the surrounding muscles, improve range of motion, and prevent future injury.
- Oral Medications: For more severe pain, a doctor may recommend oral NSAIDs, but these should be used with caution and under medical guidance due to potential side effects.
Conclusion
For localized pain and inflammation caused by tendonitis, creams and gels with diclofenac are a highly effective, clinically proven option. Counterirritant creams containing ingredients like menthol and capsaicin offer an alternative for masking pain and providing temporary relief. Natural products with ingredients like arnica can be a complementary approach for mild symptoms. The best choice depends on the specific needs of the individual and the severity of the condition. Always consult a healthcare professional to determine the most appropriate treatment and follow application guidelines carefully to ensure safe and effective use. Combining topical therapy with rest and other complementary treatments offers the best chance for a speedy recovery.
The Role of Topical Treatments in Tendinopathy
Topical diclofenac has been studied for its effectiveness in tendinopathy, though results can be mixed. While some studies show benefit, one specific study on chronic Achilles tendinopathy found no significant difference between topical diclofenac and a placebo. The efficacy is most pronounced for superficial tendons, where the medication can penetrate deep enough to reach the inflamed tissue effectively. In contrast, deeper tendons may not receive the full benefit. For persistent or severe cases, combining topical treatment with other interventions remains the recommended approach.
Potential Side Effects and Precautions
Though generally safer than oral alternatives, topical creams still have potential side effects. The most common is localized skin irritation, including rashes or itching. Diclofenac, in rare cases, can cause more serious systemic side effects, particularly with prolonged use or improper application. For this reason, it's crucial to follow dosing instructions and report any adverse reactions to a healthcare provider. Individuals with a history of allergies to aspirin or other NSAIDs, or those with certain heart or kidney conditions, should use topical NSAIDs with caution and medical supervision.
The Importance of Holistic Care
Simply using a cream is not a complete treatment plan for tendonitis. The underlying cause—often repetitive motion or overuse—must be addressed to prevent the condition from returning. This involves not only managing immediate symptoms with creams and rest but also implementing long-term solutions, such as improving ergonomics at work, correcting athletic form, and incorporating regular stretching and strengthening exercises. A holistic approach ensures not only relief from current pain but also lasting recovery and prevention.
Mayo Clinic's guide to Patellar Tendinitis provides further information on treating localized tendon issues.
