Should inflammation be supported or suppressed to heal an epicondylitis?
Should inflammation be supported or suppressed to heal a lateral epicondylitis?
I have read and heard contradictory statements, see examples below.
TheHuffingtonPost:
Once these burdens are identified and lifted, provoking primary inflammation is often the best way to facilitate healing in these chronic problems. This means we get to support the body's natural pathway of healing. In my experience, supporting, rather than suppressing primary inflammation, will foster healing of tissues, even when they have been chronically inflamed and painful for years.
WebMD:
Apply ice or cold packs as soon as you notice pain and tenderness in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as
often as twice an hour, for 72 hours. Continue applying ice (15 to 20
minutes at a time, 3 times a day) as long as it relieves pain.
Although heating pads may feel good, ice will relieve pain and
inflammation.
Take pain relievers if needed. Use acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, as
directed for pain relief. NSAIDs also reduce any inflammation you
might have in or around the tendon (tendinitis). NSAIDs come in pills
and in a cream that you rub over the sore area. Do not rely on
medicine to relieve pain in order to continue overusing a joint.
LiveStrong:
Suppressing inflammation relieves pain and encourages a tendon strain to heal.
MedicalNewsToday:
It should be remembered that inflammation is part of the healing process. Sometimes reducing inflammation is necessary, but not always.
physical-therapy.advanceweb.com/Features/Articles/Tendinitis-or-Tendinosis.aspx indicates that icing should only be used for tendonitis (i.e., when an inflammation is present) but not for tendinosis (i.e., when no inflammation is present, only micro-tears/degeneration):
Treatments for tendonitis are vastly different from those of tendinosis, and there is no room for overlap. In fact, tendonitis treatments can worsen the condition of a patient who actually has tendinosis.
"It could worsen the condition if you're talking using anti-inflammatories, icing and resting with no physical activity," said Bishop. "The most important thing is to understand the mechanism of tendonitis and tendinosis, and the pathomechanics happening in the tendon. Rest and modification of activity and increasing inflammation is the opposite of what you want to do in a tendinosis condition
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