Tennis Elbow Classroom

Learn How To Break Your Vicious Tennis Elbow Cycle!

  • Tennis Elbow Program
  • Golfer’s Elbow Program
  • Thumb Program
  • Success Stories
  • Treatment Strategy
  • Exercise Principles
  • Members Login Here
  • About Me
  • Consults
  • Contact
Home » Treatments » Topical Treatments For Tennis Elbow: Lotions, Potions And Creams, Oh My!

Topical Treatments For Tennis Elbow: Lotions, Potions And Creams, Oh My!

April 29, 2018 By Allen Willette, Neuromuscular Therapist 3 Comments

Can A Cream Or Lotion Actually Help Your Injured Tendons HEAL?

Your Golfer’s or Tennis Elbow is screaming like a banshee, and you desperately need some relief, so you buy some cream, spray or gel and rub it in… Presto! Instant pain relief! Great idea, right?

Maybe, maybe not! At best, you may get some temporary relief from your symptoms from that topical remedy – Possibly with little or no side effects or other downsides…

But, although you CAN reasonably expect a cream or salve to help protect your SKIN while it heals from a cut or abrasion, you can’t realistically expect something you put on your skin…

To help HEAL your Tennis Elbow injury faster!

Podcast Episode

In this podcast episode, (and in the video above) I discuss the pros and cons of the 3 main classes of topicals. Scroll down for the podcast subscribe link.

Okay, so WHY can’t lotions, creams and other topicals help your injury heal faster!?…

Because Tennis and Golfer’s Elbow are injuries that involve changes (varying possible degrees of damage) DEEP in your tendons, below your skin – and that damage needs to be healed and repaired by your body – biologically, from the inside!

Well, perhaps it’s not fair to completely deny all possible healing benefits.

There may be some effect to increasing circulation in the area – circulation being beneficial to healing.

Just don’t imagine (or believe any hype) that some nutrient applied to your skin is going to penetrate all the way down to your tendon and directly aid in the healing and repair of it.

Topical treatments for Tennis Elbow image

And there ARE significant potential downsides, depending on which kind of topical treatment (lotion, cream or spray; medicated – prescription or “over the counter” or herbal/non-medicated) you decide to use. (Especially if you use it long term.)

For simplicity, I’m going group them into three “sub classes” (AND because there are big differences between them – Some are much worse than others!)

The 3 Main Topical Remedy Types / Table Of Contents:

  1. Herbal Creams (Non-Medicated) – Non-drug-containing creams and lotions, like the well-known Penetrex Cream – Herbal, Non-Drug Creams

  2. Over The Counter “Liniment” Type Drugs – Basic, heating and cooling creams found in any drug store or supermarket without a prescription, like BenGay or IcyHot – Over The Counter

  3. And Steroid And Non-Steroidal Anti-inflammatory Creams – Prescription medications, including topical steroids (usually by Iontophoresis) or non-steroidal anti-inflammatory creams – Anti-Inflammatory Medicated Creams

Let’s talk about the pros and cons of each of these three groups, because they are different “creatures” with different properties.

But, first, let’s dispel a myth that makes up one of the biggest reasons these lotions, potions and creams are misguided in their application:

Inflammation!

The whole concept of applying a lotion (or taking a pill or getting a shot) to “reduce inflammation” when one has Golfer’s or Tennis Elbow is wrong at the root.

Firstly, because Tennis Elbow is not generally an inflammatory condition to begin with – It’s a chronic, degenerative process of gradual tendon degradation – (TendinOSIS NOT TendinITIS – Read more about that here)

And, secondly, because even if there is some inflammation that could potentially be “reduced” – that inflammation would be a normal, natural part of the healing process, anyway, and not something you would WANT to “reduce!”

(And it’s probably important to add that the burning pain and other symptoms of Tennis and Golfer’s Elbow are not generally caused by inflammation – Those symptoms seem to be caused mainly by other biochemical factors.)

And I hate to make it seem even more complicated, but all the major anti-inflammatory tactics from ice, to creams, pills and Cortisone Shots all WORK in the sense that they usually RELIEVE pain and other symptoms…

And they usually work (at least in the short term) whether those symptoms have anything to do with inflammation OR NOT!!

See my article Tossing The “Tendonitis” Myth for more on this inflammation fallacy…

And my main treatment page for an overview of the Tennis Elbow Classroom treatment strategy…

Now, I’m going to cover each of the three “classes” of topical treatments, from the “least medicated” and least potentially harmful to the “most medicated” (and potentially damaging.)

Non-Drug Herbal Creams And Lotions: Penetrex, Biofreeze, Etc.

The best thing that can be said about these creams, like Biofreeze and Pentrex, is that they don’t contain any drugs…

Or at least any powerful medications that one would need a prescription for.

They may claim to “reduce inflammation” which we already know is a pointless NON objective…

But there’s no way that have the power to suppress ones natural inflammatory healing response the way the prescription drug-based creams and gels do.

Whatever positive effect to be gained by their ingredients, whether Vitamin or herbal, nothing of that nature has the ability to be absorbed through the skin and completely knock out inflammation the way a Cortisone cream (or shot) can.

At best these creams, lotions and sprays may provide some much-needed temporary symptomatic relief, which is perfectly fine.

And at worst, the only likely side effect would be a rash.

Next, we have the actual medications.

Over The Counter “Liniment” Lotion Drugs

The most well-known examples of these liniment creams, found in almost every grocery or drug store, are probably BenGay and IcyHot, but there are countless others.

Most of these drug-containing creams contain active ingredients like Methyl Salicylate, Lidocaine, menthol, and camphor.

Methyl Salicylate, Lidocaine (and Prilocaine) are topical anesthetics that penetrate the skin and block pain receptors in nerve endings.

So, most of these types of creams and lotions seen to belong more in the category of ‘Analgesics’

Members of the group of drugs used to achieve analgesia, which is relief from pain, AKA, “painkillers.”

(as opposed to Anti-inflammatories, which “target” inflammation – although, as mentioned earlier, seem to relieve symptoms whether those symptoms are related to inflammation or not.)

These creams have potential side effects, locally, including skin rashes, but, unlike the previous non-medicated creams, this group of creams can cause systemic reactions, since they contain drugs that wind up circulating through a users entire system.

And just like taking pills or using ice for pain, if you rely too much on the tactic of “relief by symptom suppression” – without taking the necessary steps to support the healing of the actual injury…

You may lull yourself into a false sense that your Tennis or Golfer’s Elbow is better than it actually is and continue to overwork and overload it.

But the upside is that, like the next class of creams, they do not seem to have the power to block or suppress inflammation.

Now, let’s get into the more “serious stuff!”

Topical Steroid / Cortisone And Non-Steroidal Anti-Inflammatory Medicines

This class of topical anti-inflammatory creams and gels are only available by prescription.

There are two major kinds, the steroid / Cortisone type and the non-steroidal anti-inflammatory medications (NSAIDs)

And the non-steroidal kind is much more commonly used, so lets cover that first.

Nonsteroidal Anti-Inflammatory Medications

It is well established that there are very serious gastrointestinal and other potential side effects from taking the oral (pill) forms of these anti-inflammatory meds.

Including stomach pain, diarrhea and internal bleeding – They can even be lethal.

Especially when taking these pills over a longer period of time.

(And this applies to the common, over-the-counter versions, like Ibuprofen – Not just the prescription varieties.)

The big upside, if you choose to use a topical anti-inflammatory cream or gel medication is that, although some of the medication will end up circulating in your system, it will be at nowhere near the levels you would expose yourself to by taking it in pill form.

So, it’s much safer, in that respect.

Voltaren Gel is one of the newer and, apparently, more effective topical anti-inflammatories.

It’s the topical version of Diclofenac, (which only came in a pill form, originally.)

So, do these drugs work?

According to this review study, seen at PubMed, which included 13 trials involving 664 participants:

“We are uncertain whether topical NSAIDs improve pain because of the low quality of the evidence.”

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0012239/

Of course, we need to ask ourselves:

What does it mean to “work” or to “relieve” pain?

Is a treatment working and relieving pain because it’s helping our body heal or is it merely suppressing our symptoms temporarily?

Let’s talk about the steroid versions of these topical anti-inflammatories first, and then we’ll conclude with the (hopefully) obvious answer…

Steroidal Anti-Inflammatory Medication Creams And Iontophoresis

Now, we come to the real “Bad Boys” of topical medications:

The Steroid creams.

Unlike the injectable versions of these Corticosteroid drugs, (Cortisone Shots) which are unfortunately still widely used, despite their well-known dangers and lack of long term effectiveness…

See my article and video on Cortisone Shots in the Treatment of Tennis Elbow here

The cream varieties are not very commonly prescribed and used for treating Tennis Elbow.

You may be familiar with something called Hydrocortisone Cream, but that is generally used for skin conditions (rashes, psoriasis, eczema etc.) – Not tendon injuries.

When steroids are used topically in a cream form they are usually applied in conjunction with a treatment called ‘Iontophoresis’

Which is often performed by Physical Therapists in a Physical Therapy treatment setting.

“Iontophoresis is a process of transdermal drug delivery by use of a voltage gradient on the skin. Molecules are transported across the stratum corneum by electrophoresis and electroosmosis and the electric field can also increase the permeability of the skin.”

https://en.wikipedia.org/wiki/Iontophoresis

Or, in simpler terms, Iontophoresis is a way of applying an electrical current with pads on the skin in such a way as to help the molecules of a drug get past the skin and into the deeper layers of tissue.

And it seems that the most commonly-used steroid in this treatment is a drug very similar to Cortisone, called Dexamethasone.

The upside is that having a steroid gradually seeping into ones tissues transdermally is safer and less potentially damaging than a sudden, powerful blast of Cortisone injected via a needle directly into ones tissues in a highly concentrated form.

However, these are still synthetic catabolic steroids that suppress natural metabolic functions necessary for the healing process.

And it has been well established by medical research and long-term-outcome studies that these drugs weaken and degrade the collagen protein that tendons are mostly composed of…

Making repair and recovery less likely and recurrences MORE likely.

Either way…

Whether we’re talking about steroid or non-steroidal anti-inflammatory creams, the question remains the same:

Is this treatment working and relieving pain because it’s helping our body heal?

OR is it merely suppressing our symptoms temporarily?

Even if these drug creams do “work” by effectively attacking and “reducing” inflammation…

The problem with Tennis and Golfer’s Elbow is NOT one of inflammation…

Yes, in spite of the deceptive, burning pain that seems to scream:

“I’m on fire with inflammation!”

It’s actually a failure of the healing process, usually with an absence of the normal, expected inflammatory healing response.

It’s the breaking down of the tendon (the degeneration) and the irritating metabolic chemicals that seem to be the source of the pain with Tennis and Golfer’s Elbow.

There SHOULD be some inflammation present as a symptom of the healing process doing its job…

Since there is no healing without it!

But there is often little to no inflammation present in these condition – at least past the very early stages.

And, even if there was significant inflammation present, to suppress it would be to suppress ones own healing process.

What a terrible trade off – Right?

To sacrifice long-term healing and recovery for fleeting, short-term pain relief.

So, if you don’t like the sound of that trade off (and I don’t blame you)…

And you don’t want to potentially sacrifice healing for pain relief…

Then you may want to avoid the topical anti-inflammatory creams.

And choose the less-powerful creams that may provide some pain relief – (if you really need it)…

But, at least not at the risk of attacking and suppressing what little inflammation may be present (and necessary) as your body desperately tries to heal your injured tendons!

That’s it for now on this topic – But be sure to explore all the other free articles and videos I have here for you, as well as my free video course: Tennis Elbow 101

And check out my premium self-help programs if you have a stubborn injury and want to learn how to treat yourself at home with the most effective self-massage techniques, stretches and exercises.

Learn To Treat And Heal Your Own Tennis Elbow Or Golfer’s Elbow At Home With This Video Program

Learn more about the Tennis Elbow program
You’ll get instant access to a complete VIDEO program designed by a professional therapist to help you take charge and break your vicious cycle of pain and frustration!…

I’ll be your personal tutor guiding you through step-by-step video lessons, where you’ll get the therapy techniques, key stretches and essential exercises you need to treat and recover from your injury at home. (Without any special equipment.)

Just watch the videos, follow along and start putting an end to your elbow pain today, whether you have Golfer’s or Tennis Elbow from playing your guitar – or other stringed instrument or ANY instrument, for that matter!)

Tennis Elbow sufferers: Learn more about the Tennis Elbow program here

Golfer’s Elbow sufferers: Learn more about the Golfer’s Elbow program here

More Treatment-Related Articles For You:

The Best Self Massage Techniques For Tennis Elbow

The 3 Best Tennis Elbow Self Massage Techniques For Home Treatment

Learn why Advanced Massage Therapy Techniques are the best way to treat your own Tennis Elbow or Golfer's Elbow, and discover the most powerful self-massage methods to use – Straight from an experienced, professional Neuromuscular Massage Therapist, who treats these injuries every day.

Tennis Elbow Surgery: When Is It Time?

If you have a stubborn, chronic case of Golfer's or Tennis Elbow, when is it 'time' to start thinking about surgery? – Here are five key things to consider, including whether you're a good candidate, the risks, recovery time and whether you've "tried everything!"

Selfie Elbow: Is it a new type of injury?

Selfie Elbow 101: What Is It And How Do You Treat It?

Does your elbow hurt from taking too many selfie pics? (And texting or using your ipad?) You may have a "new" type of Tech Injury, many are starting to call "Selfie Elbow" – But, is this Selfie Elbow really a new medical condition, or is it just the repetitive actions causing it that are new? (Hint: It's actually Tennis Elbow – So, let's treat that!)

Healing Tennis Elbow (Vid. Prev. Img.)

Healing Tennis Elbow: How Muscles And Tendons Heal

Why do muscles – and especially tendons – often take so long to heal?… WHY don’t they fully recover from injury – even when you follow the “official” Tennis Elbow treatment advice to the letter?... And why do those tendons so often get re-injured in spite of your best efforts?
Tennis Elbow season: Watch out for the warning signs of injury

Watch Out: It’s Tennis Elbow Season!

It's that time of year again... T-shirts, tee times and tennis rackets – Most call it spring – but it's also Tennis Elbow Season! Here are the early warning signs of Tennis Elbow to watch for, what to do if you start feeling them – And how seriously to take them.

Filed Under: Treatments Tagged With: Lateral Epicondylitis, podcast, Topical Remedies, video

About Allen Willette, Neuromuscular Therapist

I'm a Neuromuscular Therapist in Marin County, California, and my passion for treating and teaching about Tennis Elbow began in 1990 when I developed a terrible case of wrist/elbow Tendonitis. (Involving the infamous BEE-Sting Story!) You're laughing WITH me - Right? - Here's my full bio

Comments

  1. Naz says

    June 24, 2018 at 11:17 am

    In addition to these mentioned supplements, I wanted to mention Nitroglycerine patches.

    A pain doctor prescribed these to me (as per my request, was trying everything)

    .2 mg/hr patches, 12 hours on, then 12 hours off. I put them on as soon as I woke up.

    They gave me MASSIVE headaches, nearly immediately, and the headache went away when they were removed. There was no way I could sleep with these on.

    No noticeable effect on my tennis/golfers elbow issue either.

    One thing, they were pretty cheap with my insurance, 10$ for a month’s supply.

    Nothing good to say here.

    Reply
  2. Teresa M. Stanley says

    August 13, 2020 at 8:01 am

    My outer elbow bone hurts terribly. I have a forearm compression band but that does not seem to be helping. Can anyone recommend a product that will help with this. Thank you in advance for any recommendations.

    Reply
  3. Lake Mendota says

    July 11, 2022 at 9:26 am

    I would have thought some creams increase blood flow, much like a heat pad, and thus, might promote healing.

    Reply

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

How To END Your Tennis Elbow:

Are you tired of Tennis Elbow?

Sick And Tired Of Tennis Elbow?
If you're fed up with all the resting, hoping and waiting, and want to learn how to break your vicious Tennis Elbow cycle naturally, click HERE or above and watch the video.

Classroom Members-Only Links

  • Members Log-In
  • Tennis Elbow Program
  • Golfer’s Elbow Program
  • Thumb Program
  • Members’ Forum

More Treatment-Related Posts

How Important Is Rest In Treating Tennis Elbow?

Who Are The Real Experts In Treating Tennis Elbow?

Can Acupuncture Help Your Tennis Elbow Heal?

Tennis Elbow Supplements And Vitamins: Help You Heal Or Waste Of Money?

Can You Heal A Tendon Tear Without Surgery – With Tennis Elbow Or Golfer’s Elbow?

Dry Needling For Tennis Elbow: Who Needs It?

What Is Pickleball Elbow And How Do You Treat It?

Healing Tennis Elbow: How Muscles And Tendons Heal

Dog Walker’s Elbow? The Key To Healing Leash-Related Injuries Of The Wrist, Hand And Elbow

Selfie Elbow 101: What Is It And How Do You Treat It?

Tennis Elbow Surgery: When Is It Time?

Don’t Use Ice to Treat Your Tennis Elbow! (Really)

How Long Does Tennis Elbow Take To Heal?

Gardener’s Elbow? How Gardening Causes Elbow Pain And Injury – And How To Treat It

Should You Wear A Tennis Elbow Brace? – (It Depends On Your Goals!)

Search This Site:

Get Your Membership!

Get your Tennis Elbow Classroom membership and start breaking your vicious cycle today - Learn more here.

OR check out the Golfer's Elbow program here.

Most Recent Articles

  • 3 Quick Tests For De Quervain’s Syndrome Tenosynovitis / Mommy Thumb – Diagnose Yourself
  • What Is De Quervain’s Tenosynovitis? AKA, Mommy Thumb Or Gamer’s / Texter’s Thumb
  • Two Surgeons Talk Tennis Elbow – Why Cortisone, MRIs And Surgery Are Rarely Needed

Main Topic Sections

  • Home / Blog / Recent Articles
  • Better Treatment Strategies
  • Key Rehab Exercise Principles
  • What Causes Tennis Elbow?
  • What Is Tennis Elbow?
  • Golfer’s Elbow Treatment
  • News
  • Videos

Members Log In Here

Tennis AND Golfer's Elbow Program members log in to members area here.

Login Button For Gold Members of Tennis Elbow Classroom

Copyright 2023 · Tennis Elbow Classroom, All rights reserved   ·   Home | About | Contact | Terms | Consult Terms | Disclaimers | Testimonial Disclaimer | Privacy