Tendinitis pain: Should I apply ice or heat?

My husband has tendinitis, and his doctor recommended warm compresses for pain. However, your Web site recommends cold compresses for tendinitis pain. Which is better?

- Ruby / Texas

Answer

If tendinitis is recent, ice may be a better choice for reducing pain and inflammation. Ice causes narrowing (vasoconstriction) of blood vessels and is helpful in reducing swelling. Reducing swelling also helps reduce the level of some inflammatory substances that can be produced with tissue injury. If tendinitis is long-standing, either heat or ice can help to improve pain.

In general, a new injury to a muscle or joint that causes swelling and pain is best treated with ice. Heat promotes opening (vasodilation) of the blood vessels. This can increase blood flow to an area of chronic injury to promote healing.

Applying heat to a long-term injury to promote blood flow before exercise and ice to the area to reduce swelling after exercise may also be an effective strategy — although there is no strong scientific evidence to support this pattern of use.

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