There are lots of common misconceptions about how to treat damaged tendons. Unfortunately, many of them are being sold by places that should know better. See if you’ve come across any of the following:
Number one: Menthol
Menthol comes from mint plants. It produces a cooling effect by stimulating the cold receptors that people have on their skin, sort of a mirror image of how capsaicin stimulates the heat receptors. Capsaicin doesn’t actually raise the temperature of anything, but if you have a mouthful of hot peppers it sure can feel like it. In the same way, menthol doesn’t actually lower the temperature, it just makes your skin feel like it’s gotten cold.
What does this have to do with tendon pain? Well, there are a lot of tendonitis treatment products out there, generally sprays or creams, that contain menthol. These products often claim to provide “instant relief” from tendon pain with just a quick application. Of course, it feels a little like putting ice on your problem area. There is a pleasant cooling sensation, and after a while the area will become somewhat numb. So you feel better – at least for a while. (The critical difference here is that ice, by actually producing a lower temperature, has a beneficial effect on inflammation, whereas menthol has no such effect.)
But these sprays and creams actually do more harm than good. For one thing, menthol has never been shown to have any real effect on the structure of tendons themselves. In other words, there is no healing action. None. If you get “relief” from the pain but still have the underlying problem, it becomes that much easier to ignore your body’s warning signs (which is what pain really is) and do something that’s really going to injure you. If that happens, you can easily go from having a painful – but healable – tendon to a ruptured tendon. And if that happens the only option is surgery.
Menthol can be great for providing temporary relief for temporary conditions like sunburn, and it makes chewing gum, toothpaste and so on taste better. But if you’re looking for tendon pain therapy, any product that has menthol in it should be avoided.
Number Two: Capsaicin
Recently, there’s been some talk around the internet about using capsaicin to relieve or cure tendon pain. The idea is that, applied topically, capsaicin will create heat on a painful area and thus produce relief. The theory sounds good; after all, people use hot-packs for various aches and pains all the time. But the problem (as I mentioned above in the menthol section) is that capsaicin doesn’t produce any real heat. Sure, you’ll feel like something’s on fire, but no actual increase in temperature occurs. The capsaicin just causes your body’s heat sensors to react as though there were real heat.
To put it bluntly, capsaicin for tendon pain is a bad idea. Icing a tendon can be a good therapy for tendon pain that’s not too severe and hasn’t been around for long, but even that won’t be effective for persistent tendon pain. Heat…well, heat just isn’t on the scientifically-verified menu — not even real heat. Also, there is absolutely no research showing that topical capsaicin creams and so on are effective, and anecdotal reports of people trying to rub chili powder and so on directly onto the skin usually end badly.
If you have persistent, long-term tendon pain, it’s a good bet that you don’t have tendonitis at all, but tendonosis, and neither heating nor cooling is going to help much. Long-term pain usually means tendon degeneration, not inflammation, and for that you’re going to need some targeted exercises and a good nutritional strategy to rebuild the affected area.
Number Three: Herbal supplements
These are a favorite among the alternative medicine crowd. While it is true that some herbal supplements can lessen tendonitis pain – if you take a sufficient dosage – none of them actually provide a cure. Most of the recommended supplements, like Devil’s Claw or boswellia, function by inhibiting COX-2 production. COX-2 is an enzyme that is responsible for certain types of inflammation and pain. But long-term tendon pain is usually not inflammation. If you experience any relief from taking these supplements, it’s most likely from their effect on pain reduction itself, not the underlying tendon condition.
Also, most over-the-counter supplements simply don’t have enough of whatever it is that they’re selling in the pills to do any good. A minimum dosage to have any effect whatsoever is going to be 100mg, so if you buy these types of supplements check to make sure that you’re actually getting enough to help. A better choice would be an enzymatic repair formula, or else taking a good look at your diet to see where all this excess inflammation is coming from. But even these measures are more for prevention than cure. If you are already suffering from long-term tendon pain, damage has likely been done, and you’re going to need a more aggressive approach to heal.
The final word
I’m all for non-traditional treatments for many different conditions, but, when it comes to fixing damaged tendons, science is king. There has been loads of research done on tendon pain, and while scientists still disagree on what works best, there is at least broad agreement about what doesn’t work. If you run into any of the above being sold on a website, in a health food store, or anywhere else, do yourself a favor and resist buying. Not only will you save yourself some money, your tendons will thank you for it.