From the Guidelines
To treat pain from calcific tendinitis, the most effective approach is to start with relative rest and reduced activity, as this prevents further damage and promotes healing and pain relief. This is based on the evidence from the American Family Physician study 1, which recommends relative rest and reduced activity as a key component of treatment.
Key Components of Treatment
- Relative rest and reduced activity to prevent further damage and promote healing and pain relief 1
- Cryotherapy, such as repeated applications of melting ice water through a wet towel for 10-minute periods, for acute relief of tendinopathy pain 1
- Eccentric strengthening to reverse degenerative changes and promote healing 1
- NSAIDs, such as ibuprofen or naproxen, for short-term pain relief, although they have no effect on long-term outcomes 1
Additional Treatment Options
- Topical NSAIDs may be effective and have fewer systemic side effects, although it is unclear whether they are better than other analgesics 1
- Locally injected corticosteroids may be more effective than oral NSAIDs in acute-phase pain relief, but do not alter long-term outcomes 1
- Extracorporeal shock wave therapy appears to be a safe, noninvasive, and effective means of pain relief for chronic tendinopathies, although it is expensive 1
- Surgery is an effective option in carefully selected patients who have failed three to six months of conservative therapy 1
Prioritizing Treatment
The treatment approach should prioritize reducing inflammation, promoting healing, and restoring normal tendon function. Conservative measures, such as relative rest and reduced activity, cryotherapy, and eccentric strengthening, should be tried first. If pain persists, additional treatment options, such as NSAIDs, topical NSAIDs, and locally injected corticosteroids, can be considered. In severe cases, extracorporeal shock wave therapy or surgery may be necessary.
From the FDA Drug Label
Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis Because the sodium salt of naproxen is more rapidly absorbed, naproxen sodium is recommended for the management of acute painful conditions when prompt onset of pain relief is desired. Naproxen may also be used The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required.
The treatment for pain from calcific tendinitis may include naproxen. The recommended starting dose is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required 2.
From the Research
Treatment for Pain from Calcific Tendinitis
There are no research papers directly addressing the treatment for pain from calcific tendinitis. However, we can look at the treatment options for similar conditions, such as musculoskeletal pain, to find possible answers.
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
- NSAIDs are commonly used to treat musculoskeletal pain, including pain from tendinitis 3, 4, 5.
- Topical NSAIDs are recommended for treating acute and chronic musculoskeletal pain, including pain from tendinitis 4.
- The choice of NSAID should be based on the patient's clinical background, including gastrointestinal and cardiovascular risk factors 5.
- NSAIDs with moderate to high selectivity for COX-2 versus COX-1 can be administered at doses that maximize efficacy while minimizing COX-1 inhibition and associated side effects 5.
Other Treatment Options
- There is limited evidence on the effectiveness of other treatment options, such as oral analgesic agents, for treating pain from calcific tendinitis 3.
- More research is needed to determine the best treatment options for pain from calcific tendinitis.
Key Considerations
- The treatment of pain from calcific tendinitis should be individualized based on the patient's clinical background and preferences 4, 5.
- The potential benefits and harms of each treatment option should be carefully considered, including the risk of gastrointestinal and cardiovascular side effects 3, 5.