Tendonitis and neck pain are frequently connected, particularly amongst computer users and checkout clerks. Rest and recuperation is the usual advice, but a common cooking spice, turmeric, and the active ingredient, curcumin might be able to give sufferers of tendonitis a helping hand. Typing, scanning barcodes, and many other aspects of people’s work use the tough, rope-like structures, tendons, which connect the muscles and bones to carry out the same movements over and over again. Tendons, whilst strong, are susceptible to injury and often become inflamed and tender through acute trauma, or from friction resulting from repetitive motion of the tendon over the muscles. Common sites of tendonitis include the shoulders, elbows, wrists, knees, hips, and heels and tennis elbow, golfer’s elbow, and Achilles tendon injuries will be familiar to many. In an ageing population where many are experiencing inflammatory illnesses, tendonitis is often connected to other arthritic conditions, rheumatoid arthritis, and even diabetes and other metabolic diseases. Certain antibiotics and other drugs are also connected to an increased risk of tendonopathy.
Causes of Tendonitis in the Neck
Those who engage in heavy lifting frequently put their tendons under excessive strain which can cause microtears and inflammation. Without adequate rest between these episodes of exertion, the tendons are not given the opportunity to recuperate and the injuries begin to build, leading to other problems in the cervical spine which could have even longer-lasting and more serious effects. Tendonitis rarely occurs without associated pain and tension in the connected muscle, which can result in weakness of the muscle. Where inflammation of the spinal muscles occurs as a result of tendonitis and tension it may produce nerve compression and tingling and numbness but these are not typical of tendonitis in other areas of the body.
NSAIDs and Curcumin for TendonitisAnti-inflammatory drugs, such as NSAIDs, are often not ideal as treatment for tendonitis as they can simply mask the condition and create the opportunity for exacerbating it as the patient carries on doing the same damaging movements over and again without feeling the pain. NSAIDs are also capable of producing nasty side-effects, such as stomach ulcers, nausea, vomiting, bleeding, and even headaches, fatigue, and drowsiness in some. Steroid injections to relieve pain and inflammation can be given in some cases of tendonitis, but such injections are usually avoided in the more delicate areas of the cervical spine where there are numerous complex nerve structures and the potential for needle damage. The hope from a recent study (Buhrmann, et al, 2011) into curcumin’s effects on tendonitis is that the curry spice can actually lower inflammation and help kickstart the healing process for the tendons and muscles, thus relieving the pain but also giving a patient the chance to recover.
How Curcumin Affects Cells
Curcumin is the ingredient in turmeric that gives it its bright yellow color and it has been highly prized in many cultures as an anti-inflammatory, analgesic, and even an antibacterial agent. Researchers in the UK and Germany published a study in recent weeks showing that curcumin can be used to suppress inflammation in tendon diseases, such as tendonitis and arthritis although they are careful to say that they are not suggesting it is a cure for such conditions.
The focus of the research, which was published in the Journal of Biological Chemistry as the Nottingham-Munich Study, used human tendon inflammatory models to observe the effects of curcumin on tendon cells. The results showed that the curry spice extract (diferuloylmethane) prevented substances called interleukins, responsible for inducing inflammation and degeneration in the tendon cells, from causing the damaging inflammation. It is unlikely that simply eating a spicy curry once or twice a week will help cure your tendonitis, but this research may lead to the development of a natural, standardized extract of curcumin that can be used to target the tendon cells and act as an anti-inflammatory. Many turmeric products are already available and some have been taking these for years in the hope of preventing or managing conditions as varied as Irritable Bowel Disease and Alzheimer’s Disease. This is the first time however that researchers have looked at the mechanism behind curcumin’s anti-inflammatory effect as it relates to tenocytes, which should help facilitate a move towards development of a targeted product for conditions with an inflammatory origin.
Curcumin Products for Neck Pain
Currently available commercial preparations of curcumin contain three major components: curcumin itself, demethoxycurcumin, and bisdemethoxycurcumin. These three are known as the curcuminoids and appear to exert their effects on cells by affecting transcription factors, enzymes, pro-inflammatory cytokines, and cell surface adhesion molecules. The wide variety of activities that curcumin appears to affect means that a number of conditions are a target of therapeutic research using the spice. Curcumin may have anti-cancer properties, anti-inflammatory effects, and is being looked at for use in cardiovascular diseases, osteoporosis, and psoriasis. Phase I clinical trials into the safety of curcumin for humans have shown that subjects could tolerate 8-12grams of the substance a day without adverse side-effects (Vanhaesebroeck, 2000, Cheng, et al, 2001, Sharma, et al, 2001, Shehzad, 2010). Taking such a dose outside of a monitored treatment plan for any condition is not advised however as there are likely to be other factors contributing to tendonitis in the neck, as well as other health problems, that require alternative treatment strategies.
Tendonitis in the neck can cause severe sharp pain on movement, with the pain felt from the head right down into the shoulders and back. Pain from tendonitis can range from mild irritation to complete disability. The area over the tendon is usually painful under pressure, and a dull ache or pain is often present even at rest, turning to sharp pain upon movement. The relative mobility of the cervical spine in comparison to the lower regions of the spinal column means that tendonitis in the neck is often difficult to treat as tiny movements and adjustments of the neck muscles, tendons, and ligaments are occurring almost continually to keep the head stable.
Treating and Preventing Tendonitis
Preventing tendonitis is preferable to having to treat it, especially given the limited capacity for regeneration in tendons and ligaments. The best ways of reducing the likely incidence of this painful condition include staying hydrated, ensuring a good ergonomic set-up for the workspace, and having adequate breaks from repetitive activities to ensure that the body is able to rest and recuperate. Specific software is available for office workers to detect likely repetitive strain injury and give prompts for rest periods as well as tendonitis exercises, neck and shoulder stretches, and general advice on posture. Spotting the signs of tendonitis early gives a better opportunity to intervene and change bad habits before the pain becomes severe and the damage to the tendons becomes disabling.
Neck Tendonits Exercises
It is essential to stop any aggravating activity when having received a diagnosis of tendonitis, otherwise any other treatments implemented will likely fail to resolve the condition and it will simply progress into more extreme debilitation. The inflammation needs to be relieved for the tendon to begin healing properly and this cannot happen if the tendon is still being put under repeated stress. Massage, stretching, and physical therapy are part of the recuperative program for tendonitis and these should be used only when satisfied that the inflammation has dissipated. Massage helps to increase blood flow to the area in order to deliver nutrients needed for repair of microtears, as well as keeping the area hydrated and oxygenated. Massage also has the effect of breaking up adhesions that can cause pain and tension between the muscles and tendons. Where tight muscles are thought to be contributing to tendonitis in the neck the patient will usually be given neck exercises to stretch out the neck muscles, thereby lengthening them and reducing the resting stress on the tendons. Specific imbalances and weaknesses in the neck muscles need to be identified and resolved in order to prevent recurrent tendonitis.
Passive measures such as ergonomic work products can help in part but are usually not sufficient to treat or prevent tendonitis where muscle imbalances persist. Patients must usually actively engage in physical therapy to promote endurance, strength, and balance in the neck and back muscles and a targeted exercise plan will be of more benefit than general neck exercises for tendonitis in the neck.
Buhrmann, C., Mobasheri, A., Busch, F., Aldinger, C., Stahlmann, R., Montaseri, A., Shakibaei, M., Curcumin Modulates Nuclear Factor κB (NF-κB)-mediated Inflammation in Human Tenocytes in Vitro: Role of the Phosphatidylinositol 3-Kinase/Akt Pathway, The Journal of Biological Chemistry, 2011; vol 286: pp 28556-28566.
Cheng AL, Hsu CH, Lin JK, Hsu MM, Ho YF, Shen TS, Ko JY, Lin JT, Lin BR, Ming-Shiang W, Yu HS, Jee SH, Chen GS, Chen TM, Chen CA, Lai MK, Pu YS, Pan MH, Wang YJ, Tsai CC, Hsieh CY., Phase I clinical trial of curcumin, a chemopreventive agent, in patients with high-risk or pre-malignant lesions. Anticancer Res. 2001 Jul-Aug;21(4B):2895-900.
Sharma RA, McLelland HR, Hill KA, Ireson CR, Euden SA, Manson MM, Pirmohamed M, Marnett LJ, Gescher AJ, Steward WP., Pharmacodynamic and pharmacokinetic study of oral Curcuma extract in patients with colorectal cancer. Clin Cancer Res. 2001 Jul;7(7):1894-900.
Shehzad, A., Wahid, F. and Lee, Y. S. (2010), Curcumin in Cancer Chemoprevention: Molecular Targets, Pharmacokinetics, Bioavailability, and Clinical Trials. Archiv der Pharmazie, 343: 489–499.
Vanhaesebroeck B, Alessi DR., The PI3K-PDK1 connection: more than just a road to PKB. Biochem J. 2000 Mar 15;346 Pt 3:561-76.