Oral Treatment Options for Tendinosis

First-Line Oral Treatments

Nonsteroidal anti-inflammatory drugs (NSAIDs) are effective for short-term pain relief in tendinosis but have no effect on long-term outcomes, according to the American Academy of Family Physicians 1, 2
NSAIDs (such as ibuprofen) effectively relieve tendinopathy pain and may offer additional benefit in acute inflammatory tendonitis due to their anti-inflammatory properties, as recommended by the American Academy of Family Physicians 1, 3
Topical NSAIDs also reduce tendon pain and eliminate the increased risk of gastrointestinal hemorrhage associated with systemic NSAIDs, as suggested by the American Academy of Family Physicians 1

Eccentric strengthening exercises have proven beneficial in Achilles tendinosis and patellar tendinosis and may help other tendinopathies, according to the American Academy of Family Physicians 1, 3
Cryotherapy (ice application) is effective for short-term pain relief; applications through a wet towel for 10-minute periods are most effective, as recommended by the American Academy of Family Physicians 1, 4
Relative rest to prevent ongoing damage while allowing activities that don't worsen pain is suggested by the American Academy of Family Physicians 1
Complete immobilization should be avoided to prevent muscular atrophy and deconditioning, as advised by the American Academy of Family Physicians 1

Orthotics and braces may be helpful for specific tendinopathies, though evidence is limited, according to the American Academy of Family Physicians 5
Extracorporeal shock wave therapy appears to be a safe, noninvasive option for chronic tendinopathies, though it can be expensive, as suggested by the American Academy of Family Physicians 4

If oral medications and conservative measures fail after 3-6 months, surgical options may be considered, as recommended by the American Academy of Family Physicians 4
The presence of multiple symptomatic tendons should prompt evaluation for possible rheumatic disease, according to the American Academy of Family Physicians 1

Locally injected corticosteroids may provide short-term relief but do not improve long-term outcomes and may have deleterious effects on tendon healing, as warned by the American Academy of Family Physicians 2