What is the initial treatment for mild tendonitis in the extensor compartment?

From the Guidelines

The initial treatment for mild tendonitis in the extensor compartment should involve relative rest and reduced activity to prevent further damage and promote healing and pain relief, as recommended by the American Family Physician 1.

Key Recommendations

• Relative rest and reduced activity are essential to prevent further damage and promote healing and pain relief 1.
• Cryotherapy, such as icing, provides acute relief of tendinopathy pain and its use is widely accepted 1.
• Eccentric strengthening is an effective treatment of tendinopathy and may reverse degenerative changes 1.
• Non-steroidal anti-inflammatory drugs (NSAIDs) are recommended for short-term pain relief but have no effect on long-term outcomes 1.

Treatment Approach

The treatment approach should focus on reducing inflammation and pain, while allowing the tendon to heal naturally. This can be achieved through:

• Relative rest and reduced activity to prevent further damage and promote healing and pain relief 1.
• Cryotherapy, such as icing, to provide acute relief of tendinopathy pain 1.
• Eccentric strengthening exercises to promote healing and reverse degenerative changes 1.
• NSAIDs, such as ibuprofen or naproxen, for short-term pain relief 1.

Important Considerations

• Activity modification is essential to avoid movements that aggravate the condition while maintaining gentle range of motion exercises to prevent stiffness.
• Applying ice for 15-20 minutes several times daily can help reduce inflammation, and using a compression wrap or brace can provide support during daily activities.
• Once acute pain subsides, gentle stretching and strengthening exercises should be introduced gradually to promote healing and prevent further injury.
• If symptoms persist beyond 2-3 weeks despite these measures, or if pain is severe, medical evaluation is recommended as more intensive interventions like physical therapy, corticosteroid injections, or specialized bracing might be necessary.

From the FDA Drug Label

DOSAGE AND ADMINISTRATION Carefully consider the potential benefits and risks of ibuprofen tablets and other treatment options before deciding to use ibuprofen tablets. Mild to moderate pain: 400 mg every 4 to 6 hours as necessary for relief of pain.

The initial treatment for mild tendonitis in the extensor compartment may include the use of ibuprofen at a dose of 400 mg every 4 to 6 hours as necessary for relief of pain 2.

From the Research

Initial Treatment for Mild Tendonitis in the Extensor Compartment

The initial treatment for mild tendonitis in the extensor compartment typically involves conservative measures.

• Rest and avoidance of activities that aggravate the condition are often recommended 3, 4.
• The use of anti-inflammatory medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may also be suggested to help manage pain and inflammation 4, 5.
• Physical therapy, including exercises and modalities like ultrasound and low-level laser therapy, can be beneficial in promoting healing and improving function 3, 5.
• In some cases, injections, such as corticosteroid injections, may be considered to reduce inflammation and relieve pain 4, 5.

Rehabilitation and Management

Rehabilitation for mild tendonitis in the extensor compartment typically involves a combination of therapeutic exercises, activity modification, and manual therapy.

• Eccentric strengthening protocols have been shown to be effective in promoting healing and improving function 5.
• Sclerotherapy and nitric oxide patches may also be considered as part of a comprehensive treatment plan 5.
• Occupational or physical therapy can help patients modify their activities to avoid exacerbating the condition and promote recovery 3.
• A gradual return to normal activities, including work and sports, is often recommended to prevent recurrence and promote long-term recovery 6, 7.