From the Guidelines
Diclofenac is typically prescribed at a dose of 1% for topical formulations for tendinitis. The treatment duration usually ranges from 7-14 days, though this may vary based on symptom severity and response 1. Diclofenac works by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), reducing prostaglandin production and thereby decreasing inflammation, pain, and swelling in the affected tendon.
Key Points to Consider
- Side effects may include gastrointestinal issues, so taking the medication with food is recommended.
- For those with cardiovascular, renal, or hepatic concerns, lower doses or alternative treatments might be more appropriate.
- Combining diclofenac with rest, ice, compression, and elevation (RICE) therapy often provides better outcomes for tendinitis treatment.
- Eccentric strengthening is an effective treatment of tendinopathy and may reverse degenerative changes 1.
- Topical NSAIDs are effective and may have fewer systemic side effects 1.
Treatment Approach
The approach to treating tendinitis should prioritize a combination of rest, ice, compression, and elevation (RICE) therapy, along with the use of diclofenac for pain relief.
- Relative rest and reduced activity prevent further damage and promote healing and pain relief 1.
- Cryotherapy 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.
Important Considerations
- Most patients with overuse tendinopathies (about 80 percent) fully recover within three to six months 1.
- Surgery is an effective treatment that should be reserved for patients who have failed conservative therapy 1.
From the Research
Diclofenac for Tendinitis
- The provided studies do not specify the exact percentage of diclofenac used for tendinitis treatment.
- However, the studies discuss the efficacy of diclofenac in treating various forms of tendinopathy, including Achilles tendinopathy 2 and rotator cuff tendinopathy 3.
- A study on topical diclofenac for Achilles tendinopathy found no significant difference between diclofenac and placebo groups in terms of symptom improvement 2.
- Another study on oral non-steroidal anti-inflammatory drugs, including diclofenac, found that they provide short-term pain relief for rotator cuff tendinopathy, but not functional improvement 3.
- The dosage of diclofenac used in these studies varies, with one study using 25,50, and 75 mg of diclofenac for acute pain management 4.
Efficacy of Diclofenac
- Diclofenac has been shown to be effective in reducing pain in the short term for various musculoskeletal conditions, including tendinopathy 4, 3.
- However, the long-term efficacy of diclofenac for tendinopathy treatment is unclear, with some studies suggesting that it may not provide significant benefits over placebo 2, 3.
- The use of diclofenac for tendinitis treatment should be considered in the context of individual patient needs and medical history, as well as the potential risks and benefits of treatment 5, 6.