CBD Oil For Tendonitis

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Are you looking for tendonitis relief? Thanks to its many health benefits, CBD for tendonitis may be a great option. Here are some of the best CBD products for Tendonitis, a common sports injury caused by either overusing or overloading the tendons during physical activities. Tendonitis is a common condition among athletes and physical workers as it is caused by overuse or overload of tendons, as well as by repetitive movement

CBD for Tendonitis – Does It Work?

You may be wondering if CBD for tendonitis is a good treatment option. You’ve likely heard of the many benefits of CBD (cannabidiol) over the past couple of years as more and more research has been done on its effects. CBD has shown to help manage anxiety, promote better sleep, and even reduce pain. But can its pain-relieving benefits also apply to tendonitis?

If you’ve ever suffered from tendonitis, you know that the pain can be unbearable. While certain prescription medications and topical treatments can provide relief, you may be interested in trying out a more natural remedy in order to deal with the pain.

That’s where CBD comes in.

Thanks to its plethora of health benefits, and its ability to reduce inflammation in the body, CBD oil for tendonitis may be a great option. Keep reading to learn more about CBD, tendonitis, and what we consider the best CBD cream for tendonitis.

What is tendonitis?

Simply put, tendonitis is the irritation or inflammation of a tendon due to overuse or strain.

The tendons in your body are pieces of tissue that connect your muscles and bones. Tendons are found throughout your body. There are small tendons located in places like your hand, and larger rope-like ones in your legs. Your tendons react when your muscles contract, which then allows your bones to move. Healthy tendons are essential for easy and pain-free movement.

Tendons can easily suffer from tears or inflammation if too much stress is put on your joints. Although the tissue can heal itself quickly after slight or infrequent damage, if your tendons experience consistent or extreme strain, tendonitis can develop.

You’ve probably heard of at least a few of the following conditions: tennis elbow, golfer’s elbow, jumper’s knee, or pitcher’s shoulder. All of those are just clever names for the same thing – tendonitis. But you don’t need to be an athlete to suffer from the condition, even activities like gardening, cleaning, or painting can cause injury to the tendons.

Common Locations of Tendonitis

You can get tendonitis in basically any area of the body where a tendon is present. However, the most common places to experience this condition include:

  • Elbow
  • Shoulder
  • Hip
  • Knee
  • Thumb
  • Achilles tendon (where your calf muscles connect to your heel bone)

How serious is tendonitis?

Tendonitis can vary greatly in severity. It can start with mild pain but can easily transition into severe injury. In some cases, if the injury is not treated properly, tendon rupture can occur. This is when the tendon becomes so damaged and overused that it breaks. Surgical repair is often required in these extreme situations.

Because tendonitis can cause severe damage if it is left untreated and you continue to strain those tendons, it’s imperative that you seek medical treatment if your pain worsens. Make sure that you speak with your health care provider and get your injuries evaluated in order to see how severe the damage is, and to discuss potential treatment options.

While CBD will not cure your tendonitis, using CBD for tendonitis can help reduce the inflammation and can reduce the pain you experience caused by tendonitis.

What treatment is available for tendonitis?

Although rare, sometimes it requires surgery to treat tendonitis. Often, this is only when severe damage has been done to the tendon and only when all other treatment options are not effective. In order to avoid getting to that point, it’s crucial that you allow your body time to rest and recover, and that you utilize other forms of treatment.

Ultimately, taking a break from whatever activity is causing the damage is your priority. It is very important that you allow your tendons the time to heal so that the injury does not get worse.

A few options for treating tendonitis include using a splint or brace, taking certain medications, participating in physical therapy or massage, and more. Physical therapy for those with tendonitis focuses on stretching and strengthening the affected muscles and tendons. Some of the methods and treatments in physical therapy have been proven to be very effective.

If your case is more extreme, then surgical procedures are possible. Ultrasonic treatment is a procedure where the doctor will use ultrasonic sound waves to remove tendon scar tissue that is affected. Another option is dry needling, which has a goal of stimulating the factors involved in tendon healing by making small holes in the tendon with a thin needle. Lastly, if your situation is extreme and the tendon has torn away from the bone, then a surgical repair may be necessary.

If your case isn’t as extreme, then it’s even more important to address symptoms so that things don’t get worse. Anti-inflammatory drugs like ibuprofen or aspirin may be used to reduce swelling and minimize pain. However, those are not your only options.

CBD for tendonitis may be an effective option as well. Using CBD as an exercise recovery tool isn’t new. Quite a few athletes have been singing its praises, so much so that many have developed their own CBD brands or have become sponsors for already-established brands. Our blog on CBD For Exercise highlights the benefits of using CBD for muscle recovery.

Whether you want to avoid using medications altogether or you want to supplement your treatment with a more natural anti-inflammatory option, CBD is certainly something to consider.

Before we jump into how effective a CBD cream for tendonitis can be, let us briefly discuss what CBD is and how it works.

What is CBD?

CBD, short for cannabidiol, is a natural compound called a cannabinoid found in cannabis plants. It is extracted from hemp plants.

Unlike its cousin THC (tetrahydrocannabinol), CBD is completely non-psychoactive. It does not cause you to experience a “head high” and it is completely safe for almost everyone to use. Although both CBD and THC come from cannabis plants, they vary greatly in how they affect your body. CBD generally provides you with a relaxed and calm feeling and provides many health benefits, while certain forms of marijuana containing THC can induce psychoactive effects.

CBD works by interacting with your body’s natural endocannabinoid system (ECS). This system is responsible for a lot of important tasks including regulating mood, managing appetite, promoting sleep, and more. When CBD enters the body, it links up with the ECS in a way that helps your body to naturally become more balanced. This may be through making you feel calmer and more relaxed, helping you to sleep better, and potentially improving your mood as well. You can read more on CBD and your endocannabinoid system here.

REGULATIONS OF CBD

Thanks to the 2018 Farm Bill, CBD is completely federally legal in the United States. The bill legalizes the regulated production of industrial hemp plants and the extraction and sale of CBD. However, only CBD products containing less than 0.3 percent of THC can legally be sold throughout the U.S. As long as the product contains less than 0.3 percent THC (and is from a reputable company that uses safe ingredients) it is non-psychoactive and completely safe for consumption and use.

The World Health Organization regards CBD as a safe compound without many side effects. In addition, the FDA has even approved CBD as a treatment option for epilepsy, as it is currently the main ingredient in the epilepsy medication Epidiolex.

While frequent use is in an oil form, CBD is also effective in capsules, creams, gummies, and more. When it comes to treating the pain caused by conditions like tendonitis, using a topical CBD cream for tendonitis is a great option, although CBD oil for tennis elbow and CBD capsules are great choices as well.

Can CBD for tendonitis help alleviate the pain?

In addition to helping your body achieve more balance overall, CBD is also known for its anti-inflammatory benefits. Inflammation is the primary cause of pain in conditions like tendonitis. This means that you can use CBD for tendonitis pain relief so you can rest your body while it works to recover naturally.

While more research must be done on the subject before anything can be proven, the studies that have been done on CBD’s effects on inflammation are very promising. This leads us to believe that CBD for tendonitis is effective in reducing the inflammation.

A study from the European Journal of Pain shows that when CBD applies directly to the skin it can help lower inflammation and therefore reduce the pain caused by arthritis. The study found that CBD may be a safe treatment for osteoarthritis (OA).

Another study completed in 2016 found that the topical use of CBD can help relieve the inflammation associated with arthritis as well.

CBD AND INFLAMMATION

To better understand how CBD helps with pain relief, you must first understand how inflammation affects the body.

Inflammation is your body’s natural response to protect itself from damage. The cause of this is from your immune system releasing white blood cells to protect the affected area. Although inflammation is essential in that it helps in the healing process, too much inflammation can cause a lot of pain. This is why many recommend anti-inflammatory drugs such as aspirin or ibuprofen when you have an injury or experience pain due to inflammation.

However, as mentioned above, those drugs are not your only option for dealing with inflammatory pain. CBD is also an effective agent in reducing inflammation and ultimately providing natural pain relief.

How do I use CBD for tendonitis pain relief?

You can use a CBD cream for tendonitis in order to reduce the pain you experience in that area. A tennis elbow cream that contains CBD may be a good option for managing your discomfort. Creams containing CBD are great options because they provide targeted relief. Apply the cream to your elbow or knee, wherever you’re experiencing the pain and receive direct relief.

One of the most powerful options for the best CBD cream for tendonitis is this Medterra Pain Cream. It has 1000mg of CBD in just a 1.7 ounce container and also contains other natural ingredients. Examples of natural ingredients include menthol, arnica, and aloe to provide a cooling sensation and ultimate pain relief. Simply pump the product onto your hand, and apply directly to the affected area. Fun Fact: this product won 2021 Product of the Year in the “CBD Personal Care” section.

Two other great choices are the Green Roads Muscle and Joint Roll-Ons, one with Cooling Relief and one with Heat Relief. Both of these have 750mg in a 3 ounce roll-on, so it’s a strong 250mg of CBD per ounce. This roll-on provides instant warmth or cooling to provide relief to your muscles and joints. To use, simply apply the product to your injury and rub it in. It is effective in not only relieving pain from tendonitis but general joint pain and sciatica pain as well.

Read our blog here for more CBD pain cream relief product comparisons. You can also do your own research to find out what works best for you. This article can help you find which CBD product, what dosage, and what strength can help reduce your tendonitis pain.

Here at The Green Dragon CBD, we want to support those suffering from tendonitis. Please use Coupon Code: TENDON20 for 20% off your entire order!

CBD is federally legal according to the 2018 Farm Bill.

You can use CBD products for tendonitis pain and inflammation, but consult a doctor for tendonitis treatment.

There are quite a few types of CBD products. The best for tendonitis will be topicals to control your pain and inflammation. Capsules and oils are also good options. To find the best product for you, consult with our team and we will be happy to help find what product you should try.

Best CBD for Tendonitis – August 2022

Tendonitis (also called tendinitis) is a common sports injury caused by either overusing or overloading the tendons during physical activities. Its symptoms include pain and inflammation of tendons.

In a recent study, CBD oil has shown anti-inflammatory, immunomodulating, and pain reduction properties for rheumatic diseases (1) .

CBD is the only cannabinoid that is allowed to be used by athletes, according to the updated World Anti-Doping Code of the World Anti-Doping Agency (WADA) (2) .

Some traces of CBD or THC may show up on drug tests (3) , especially if products are improperly labeled (4) .

Further clinical trials and medical research are needed for CBD to be considered useful in treating tendonitis.

Why People Are Using CBD for Tendonitis

Tendonitis is often treated with over-the-counter (OTC) and prescribed oral painkillers called NSAIDs, like aspirin, ibuprofen, and naproxen.

Although the said drugs are used to treat minor pains, taking them together may cause one drug to be ineffective (5) . Taking two similar medications may increase the risk of severe side effects , such as gastrointestinal bleeding and heart attack (6) .

People who have tendonitis also resort to corticosteroid injections for pain management (7) . Athletes use this method for immediate pain and inflammation relief (8) .

Based on a study, corticosteroid injections provided more improvement in patients’ shoulder pain than oral NSAIDs (9) . However, repeated corticosteroid injections may cause the tendons to weaken and eventually rapture (10) .

The side effects caused by these pain and anti-inflammatory drugs may cause people to look for other alternative treatments for tendonitis.

According to studies, cannabidiol ( CBD ) has anti-inflammatory properties that may help relieve inflammation in certain medical conditions (11) .

One medical condition included in the study is arthritis. This condition can affect the connective tissues, such as tendons and ligaments (12) .

In a recent study, CBD oil has shown anti-inflammatory, immunomodulating, and pain reduction properties for rheumatic diseases (13) .

The study also stated that traditional prescription drugs showed inefficacious results, leading to uncontrolled rheumatic pain. Thus, some people are inclined to seek new and safe treatments for pain.

Rheumatic diseases are inflammation of the body’s connecting structures, such as joints, tendons, ligaments, muscles, and bones.

However, according to the study previously mentioned, there is still a need for further research on the effective dosage and formulation of CBD products (14) .

In another study, CBD and tetrahydrocannabinol ( THC) showed great potential in combating chronic pain caused by rheumatic diseases.

The compounds are comparab le to other drugs, like opioids and antidepressants. Unfortunately, opioids and antidepressants can have adverse side effects (15) .

Meanwhile, CBD is generally safe to use (16) , as opposed to THC, its counterpart that elicits psychoactive effects.

In the 2020 updated World Anti-Doping Code of the World Anti-Doping Agency (WADA), CBD is the only cannabinoid that is allowed to be used by athletes (17) .

The code is a comprehensive list of prohibited substances and methods for competing and non-competing athletes. WADA is a foundation that monitors drug use and abuse in sports worldwide.

How CBD Oil Works to Help Alleviate Symptoms of Tendonitis

Tendonitis is characterized by swelling and pain in the area where tendons are located. Symptoms may last from days to weeks, depending on the severity of the injury. Recovery time for this condition varies from two days to six weeks.

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Chronic pain, joint stiffness, and movement restriction are symptoms of a more serious case of tendon degeneration called tendinosis.

The condition happens when the tendon’s collagen starts to break down due to overuse while the tendons are not fully healed (18) .

Collagen is the most abundant protein in the human body. This protein is responsible for elasticity, strength, and structure of the skin and bones.

Tendonitis takes longer to heal, around three to six months. Treatments for this condition include stretching, massaging, surgery, and shockwave therapy (19) .

People with severe tendinitis conditions may wear temporary splints, braces, or slings on affected areas . In some severe cases where the tendons rapture, surgery is done to realign and repair them.

CBD for Pain Relief

CBD works in the body through the endocannabinoid system (ECS), the system involved in pain modulation (20) .

The ECS has two primary receptors , called CB1 and CB2 , that are found throughout the body. These cannabinoid receptors work closely with the molecules called endocannabinoids.

The molecules regulate the body’s physiological functions, such as inhibiting pain and maintaining homeostasis (21) .

When administered, CBD works as a cannabinoid that activates the receptors that help treat various pain felt throughout the body (22) . CBD is a non-psychoactive phytocannabinoid found in cannabis plants .

In a study about pain management, patients with chronic pain reduced their opioid intake upon taking CBD. They also improved their quality of life within eight weeks of constant CBD use (23) . Based on the study, CBD may be an alternative for people taking opioids.

On the other hand, an animal study conducted on rats has found that the transdermal application of CBD may provide pain relief for arthritis (24) . Although the study was conducted on animals, the results may be useful in further studies to be conducted on humans.

CBD for Inflammation

Another physiological function of the cannabinoids present in the ECS is to regulate the immune system’s response to inflammation (25) .

Inflammation is the body’s natural response when injuries or harmful substances enter the body.

CBD is also known for its inflammatory response of macrophages (26) . When CBD activates the cannabinoid receptors, the macrophages inhibit the release of cytokines.

Cytokines are proteins that signal inflammation (27) , while macrophages are white blood cells that respond to infections.

In a study conducted on rats, an increase in CBD’s daily oral dosage further reduced edema or inflammation on the test subjects’ paws (28) .

There was also a significant decrease in the swelling a few hours after the first CBD administration.

The results suggested that further clinical trials on CBD should be conducted on humans to test if similar results would occur.

The Pros and Cons of CBD Oil for Tendonitis

Pros
  • According to the World Health Organization (WHO), CBD has a good safety profile (29) .
  • CBD may have the potential to alleviate symptoms of tendonitis. It may be safer than prescription drugs mentioned because it has no severe side effects.
  • Studies presented showed the effects of CBD on other rheumatic diseases. The results of the studies may spark further interest in conducting studies on CBD’s effect on tendonitis.
Cons
  • People who take CBD may experience side effects, like diarrhea and constipation, that may affect their lifestyle (30) .
  • Traces of THC in full-spectrum CBD oils may show up on drug tests (31) , especially if products are improperly labelled (32) .
  • CBD may interact with other medications and may cause potential adverse side effects (33) .

How CBD Oil Compares to Alternative Treatments for Tendonitis

Tendonitis is a condition that usually requires rest. RICE ( rest, ice, compression, and elevation) treatment is a common home remedy for tendonitis.

Other than that, some physicians may require the patient to undergo occupational and physical therapy.

The goal of the former is to improve the person’s motor and cognitive skills for daily living. Some examples of the tasks and skills an occupational therapist might focus on are getting dressed, writing, or cooking.

The latter helps people recover from injuries by either aligning the bones and joints or increasing mobility by easing pain. This therapy involves handling conditions from diagnosis to full recovery.

Some topical creams may also work as temporary pain relievers for swollen muscles that come with tendinitis. These ointments may contain essential oils that may quickly relieve pain and soreness .

Essential oils can be used in diffusers or by massaging directly on the target area. In rare cases, gargling helps if the inflammation is inside the mouth.

Conventional essential oils used to lessen inflammation and pain are the following (34) :

  • Peppermint oil contains menthol and is practical for soothing sore, achy muscles and joints.
  • Marjoram oil is typically used for coughs and headaches but can also be used to ease pain and inflammation.
  • Lavender oil is known for its fragrant smell. This oil can calm and relax tense muscles.
  • Eucalyptus oil has the same cooling effect as peppermint oil. This oil can reduce pain and inflammation in target areas.
  • Chamomile oil can be used in various conditions other than inflammation and pain. It can be used in wound healing, digestion, and sleep problems (35) .

All the treatments mentioned may be used as supplementary treatments for oral medications.

CBD also comes in products that may help relieve pain caused by tendonitis. Topical products, such as CBD creams , salves, and lotions, may contain essential oils combined with CBD’s pain-relieving benefits.

Other CBD products, like tinctures and oils, may be taken orally in small doses. CBD oils may act as topical pain relievers . These may be applied to swollen areas, such as the Achilles tendon and knees.

However, taking oral CBD alongside other drugs may elicit adverse side effects (36) . It is better to consult a doctor before taking any CBD product for the first time.

How to Choose the Right CBD Oil for Tendonitis

CBD oil is classified into three types: CBD isolates, broad-spectrum, and full-spectrum CBD.

CBD isolates are pure CBD. All other cannabinoids and plant impurities are eliminated through a series of extraction processes. CBD isolates are non-intoxicating and contain 99% CBD.

Broad-spectrum CBD oil contains all the cannabinoids, flavonoids, fatty acids, and terpenes, except THC.

Flavonoids are plant chemicals that are widely found in fruits and vegetables. They are responsible for giving vivid colors to plants. They also provide health benefits because of their antioxidant, anti-inflammatory, and anti-carcinogenic effects (37) .

Terpenes are the compounds that produce the natural odor and flavor of the plants. CBD is derived from the hemp plant, which contains the essential fatty acids omega-3 and omega-6.

Full-spectrum CBD oil is the most complete among the three types since it contains the full profile of compounds, including the psychoactive cannabinoid THC.

As a legal requirement, full-spectrum CBD products should adhere to the Farm Bill, which states that hemp-derived products are allowed to contain 0.3% THC or less (38) .

Using broad- and full-spectrum CBD oil may evoke the entourage effect. This effect is described as the synergy of all the compounds, providing benefits to a person’s well-being.

Although a full-spectrum CBD oil may have maximum benefits attached to it, athletes may opt for a broad-spectrum CBD oil. Even if the full-spectrum has relatively low THC levels, traces of it may still be detected in drug tests.

There are other factors to consider when choosing the right CBD oil, and some of those are the following:

  • Choose a reputable supplier that manufactures high-quality CBD products that are safe for human consumption.
  • Look for the certificate of analysis from a third-party lab . This document ensures that the products are lab-tested and do not contain any harmful substances. The lab results should match the information indicated on the product label.
  • Research about the extraction methods used by CBD companies . The methods used have a vital impact on the quality of the end product.
  • Research on other practices that the company may have been employing, such as organic farming and purification processes. These may be crucial to the consumer’s decision-making process.
  • Read online reviews before purchasing any CBD products online or in-store.
  • Get the opinion of a trusted physician on the best CBD products and formulas for tendonitis.

CBD Dosage for Tendonitis

There are no standard dosages for CBD products. The US Food and Drug Administration ( FDA) has no approved CBD dosage for any medical condition (39) .

Several factors , such as body weight, the severity of the condition, existing medical conditions, body sensitivity, allergic reaction to substances, and body chemistry may influence the CBD dosage.

Initial doses may start on low amounts and may gradually increase if there are no significant changes in the condition.

According to research, dosages may range from 1 to 50 mg of CBD per day, with lower doses for anxiety relief and higher doses for more severe conditions, such as epilepsy and seizures (40) .

The best way to determine the right dosage is to consult a medical professional that can give sound advice on the amount of CBD needed to treat tendonitis symptoms.

How to Take CBD Oil for Tendonitis

CBD comes in various products and forms suitable for every person’s lifestyle and condition.

For swollen muscles, CBD topicals , like salves , lotions , and creams, may alleviate the pain and inflammation.

These topical products differ in texture and consistency. CBD salves are oil-based, lotions are water-based, and creams are typically equal mixtures of oil and water.

Topical CBD products may be applied to target areas for a quick but short-term effect. Product reapplication may be needed after a few hours.

CBD oil and tinctures are taken orally or sublingually using a dropper . The difference between the two is their base carriers.

CBD oil may be infused with oils like olive oil, coconut oil , and grapeseed oil. CBD tinctures are alcohol-based concentrates that are often added to food or beverages.

CBD oil may also be applied directly to the skin. It may feel more greasy than lotions or creams.

Another edible form of CBD is gummies . It is suitable for first-time CBD users who want an easy and discreet way to take CBD for their condition.

CBD vape pens are for those who want a fast-acting agent with prolonged effectiveness. Vaping CBD maximizes the bioavailability of the cannabinoid as it instantly circulates throughout the bloodstream.

Bioavailability refers to the rate of activation of a drug as it enters through the body circulation. Based on studies, CBD’s oral bioavailability is around 13-19%, which is relatively low compared to smoking or inhaling CBD, which provides 31% bioavailability (41) .

What is Tendonitis

Tendonitis or tendinitis is the inflammation of the tendons, the tissue that connects the muscle to the bone. This condition is a common sports injury, where a part of the body that contains tendons is either overused or overloaded.

Overuse is the frequent repetition of movement. Weight lifting is an exercise where tendons are overused because of the repeated movements of the arms or legs for strength training.

Overload is movement with a sudden increase in speed. An example of tendon overload is running at high speed immediately after running at a moderate pace. This action may cause the Achilles tendon, the tissue located at the back of the lower leg, to swell.

Tendonitis can also occur as a result of infections, deformities, or other medical conditions, like gonorrhea, Haglund’s deformity, and diabetes.

Types of Tendonitis

Tendonitis may happen in any part of the body where tendons are located. The most common types of tendonitis can happen in the shoulder, elbow, knee, wrist, and heel.

Rotator Cuff Tendonitis

Rotator cuff tendonitis or bicep tendonitis is a type of shoulder pain caused by an inflammation of the biceps tendon. Pain may be felt from the shoulder blades to the upper arm.

This condition may be caused by heavy lifting or frequent stretching of the arms overhead, like throwing and swimming.

A person with rotator cuff tendonitis may have difficulty sleeping and reaching any object or surface above the head or behind the back.

Tennis Elbow

Tennis elbow is an inflammation caused by irritation of the tendons on the outside of the elbow. Pain may crawl from the forearm to the wrist and fingers.

This condition is common among tennis players, plumbers, construction workers, and painters whose jobs and lifestyles involve constant arm movements.

Golfer’s Elbow

Golfer’s elbow is the condition where the tendons of the forearm swell, affecting the inside of the elbow and forearm.

Activities with repetitive hand movements, such as gripping, flexing, throwing, and swinging, can cause inflammation of the tendons. Bowling, baseball, and wall climbing may also cause golfer’s elbow.

Jumper’s Knee

Jumper’s knee or patellar tendonitis is the swelling of the tendons on the knee. The tissue connects the kneecap to the tibia, the large bone in front of the leg.

This condition usually affects athletes and people who do exercises or sports that require frequent jumping or knee movements, such as volleyball, gymnastics, running, and soccer.

Achilles Tendonitis

Achilles tendonitis is the inflammation of the largest tendon in the body called Achilles tendon. This tissue connects the heel to the calf muscles.

It is a sports injury for runners who suddenly increase in speed or duration of their runs. It may also happen to a person who has an abrupt intensity increase during any physical activity.

Differences and Similarities Between Tendonitis and Arthritis

Tendonitis is sometimes mistaken as arthritis because of the tendon’s proximity to the joints. While both conditions involve inflammation, the difference between the two is the source of inflammation.

Arthritis is the inflammation of the bony aspect of joints and is characterized by joint pain . Meanwhile, tendonitis is the inflammation of the tendons characterized by difficulty in tendon movement.

Tendonitis can be easily identified if a person has engaged in any physical activity that might cause injuries. Meanwhile, arthritis may be caused by old age, cartilage deterioration, or a misdirected immune system .

The best way to determine what condition a person is experiencing is by consulting a doctor. The correct diagnosis of a condition can help identify what treatments may be done for rapid rehabilitation.

The Legality of CBD

Medical CBD is allowed in 18 states in the United States (42) . Most states have legalized CBD use for neurological conditions, like epilepsy and seizures.

Three states, namely Florida, Iowa, and Georgia, allow CBD use for muscle spasms, chronic pain, and intractable pain, respectively. Intractable pain is a more severe condition than chronic pain, which cannot be relieved or treated easily.

Three other states have authorized the use of CBD for any clinically-diagnosed condition as prescribed by a doctor. These states are Virginia, Wisconsin, and Kansas.

Specific state laws in Virginia and Wisconsin permit patients to use any product formulation of CBD. Other states have only legalized the use of CBD in oil form.

A patient can obtain CBD oil for medicinal purposes that contain 5 to 15% of CBD and no more than 0.3 to 0.5% of THC.

Florida is the only state that allows a patient to acquire a higher THC dose as long as a physician prescribes it. The product must be obtained from a state-licensed dispensary.

Patients that are part of any state-supported clinical research are authorized to use CBD. They are also protected by the laws to obtain CBD outside of the research facility.

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Conclusion

Tendonitis is the inflammation of tendons, which are tissues that connects the muscles to the bones. It is a common condition among athletes, physically active individuals, and professionals that engage in repetitive movements.

Although home remedies can cure tendonitis, not giving the tendons enough time to heal may lead to a more severe condition called tendinosis. It may require constant therapy and surgery.

No direct studies have stated that CBD is a cure for tendonitis. However, CBD can help alleviate the symptoms of the condition, such as inflammation and pain.

Various CBD products may be used to address the symptoms of tendonitis. The products’ effectiveness may depend on a person’s body weight, and body chemistry.

Consulting a physician with a background in CBD studies may give a person more insight and guidance. A trusted medical practitioner may help a person decide if CBD is the best treatment for the condition.

Move without limits. How to use CBD for tendonitis?

Tendonitis is a common condition among athletes and physical workers as it is caused by overuse or overload of tendons, as well as by repetitive movement. In the case of this condition, tendons become inflamed that lead to inflammation and pain. Without treatment, tendonitis can cause additional, more serious injury, such as a tendon rupture. Although this condition can be treated and doesn’t belong to diseases with serious consequences, it can still significantly affect the patient’s quality of life, carrying both psychological and financial burden. Over-the-counter drugs and physical therapy can cope with tendonitis symptoms in the early stages, while in the case when the condition is more severe, opioid drugs, corticosteroid injections or surgical intervention can be needed. These treatment methods are effective enough, although they can entail severe adverse effects on health, including even addiction and death in the case of opioids use. CBD is considered an effective and safe method to cope with the symptoms of this condition as it can significantly reduce inflammation and pain in tendons by interacting with the endocannabinoid system in our body. Global research has confirmed its anti-inflammatory and painkilling properties, while health experts suggest it may become a worthy alternative to opioids and other prescription drugs.

Introduction

Tendonitis is an inflammation or irritation of tendons – pieces of connective tissue between our muscles and bones. This condition usually causes acute pain and tenderness and makes it difficult to move the affected joint. Tendonitis can also be called a tennis elbow, golfer’s elbow, jumper’s knee, pitcher’s shoulder, or swimmer’s shoulder. Besides this, the tendinopathy term is often used as well. Tendinopathy is an umbrella term for “tendonitis”, “tendinosis”, and “tenosynovitis”. What is the difference between all these conditions? “Tendonitis” is the original term to define pain and inflammation that occur within the tendon, while “tendinosis” is the preferential term to describe the degenerative changes observed. As for “tenosynovitis”, it refers to inflammation of the synovial sheath surrounding the tendon, and many health experts don’t consider this condition tendinopathy, in which degenerative changes are mainly observed in the tendon.

Anyone can get tendonitis, although this condition occurs more commonly in people who do repetitive activities. For example, the “risk group” for this condition includes people who are engaged in gardening or landscaping, shovelling, painting, scrubbing, woodworking, as well as those who often play tennis, golf, and baseball. Those whose job requires physical exertion or overhead lifting are also more likely to develop this condition. The risk of tendonitis also increases if people perform repetitive motions while working or playing sports incorrectly. In addition to this, tendonitis can also result from permanent poor posture at work or home and the presence of certain diseases that can weaken the muscles, such as, for example, rheumatoid arthritis, gout or pseudogout, and blood or kidney diseases. Age also belongs to factors that can increase the risk of developing this condition. Adults forty years of age and older belong to the risk group for tendonitis as their tendons are less elastic, tolerate less stress, and can tear more easily. Certain medications (antibiotics and statins, in particular) can also cause tendons to tear.

The disease burden of tendonitis and tendinopathy, in general, is primarily reflected by the number of patients with this condition, the effect on their quality of life, the cost-effectiveness of treatments, and the economic implications of work disability. As for the prevalence of this condition, it differs significantly depending on the population groups. Thus, in athletes, due to the high intensity and frequency of physical activities, permanent stress is exerted on the tendons. As a result of this, tendinopathy is within the top three most treated conditions in this population group. Among athletes, age can increase the risk of this condition as well. For example, in one of the studies investigating the rotator cuff tendinopathy risk in athletes, it was demonstrated that in elderly athletes, the prevalence of this condition was seen to be as high as 48.2%. However, health experts state sports-related tendinopathy is quite challenging to estimate and generalise due to the difference in anatomical sites affected and the degree of exposure. For example, dancers have a higher risk of developing Achilles’ tendinopathy, while rowers more frequently develop rotator cuff tendinopathy or epicondylitis. In addition to this, the degree of sport participation usually differs significantly between recreational athletes and professional athletes that make it difficult to fully evaluate the risk of tendinopathy development.

As for the category of workers, an increased risk of tendinopathy is usually associated with repetitive movements that are commonly observed in daily work tasks and with poor workplace ergonomics, which can significantly affect posture. Tendinopathy in workers is almost always present in the upper extremities, with lateral epicondylitis being the most common form. The prevalence of this condition in workers is 2-3%, although, in coal miners and spine surgeons, it can vary from 18% to 41%. Similarly to athletic exposures, the type of work can also significantly influence the prevalence of tendinopathy in workers. The risk of this condition often depends on the frequency of repetitive motion, ergonomic factors, and the length of exposure.

For the general population, the prevalence of rotator cuff tendinopathy in adults is reported to range from 2% to 3.8% , although in the elderly population, it may increase to 5-7%. However, currently, there is a gap in the available evidence on tendinopathy incidents rates, as most studies held for today were carried out on tendinopathic ruptures only. Thus, it is assumed that in the general population, the actual prevalence of this condition may be higher.

Types of tendonitis. Who is in the risk group?

In our body, tendons are tough strips of fibrous, stretchy tissue that connect muscles to bones and can withstand tension. Tendons are involved almost in every movement of our body, including even blinking eyelids. Tendonitis is a debilitating physical condition, which occurs when the tendons become painfully inflamed. There are over a thousand tendons in our body, but this condition more commonly develops in the larger tendons that are prone to overuse. Most often, it develops over a period of time due to a repeated motion that puts stress on the tendon. This condition is considered a common sports injury as it typically develops when a part of the body, which contains tendons, is overloaded or overworked. The word “overload” usually implies a sudden increase in speed. For example, when a person starts running at high speed immediately after walking steadily for a while, a significant overload on his tendons occurs. When being repeated, such overloads of tendons can result in the Achilles tendon – condition, when the tissue at the back of the lower leg gets swollen. At the same time, “overwork” means that the frequent repetition of certain movements can have a negative impact on the tendons in arms and legs in general. For example, frequently repeated weight lifting is highly likely to lead to tendonitis one day.

Besides these factors, causes of tendonitis may also include infections and certain medical conditions, such as gonorrhoea, diabetes, and Haglund’s deformity.

There are several different types of tendonitis, and all of them differ depending on the parts of the body this condition affects. For example, it may develop in the shoulder, knee, wrist, elbow or heel or occur in smaller tendons like the temporal tendon (but this is less common). Let’s take a look at what tendonitis types are most common to date.

Tennis elbow is the type of tendonitis, which appears when the tendons located on the outer side of the elbow become inflamed. In the case of the tennis elbow, the pain usually begins in the forearm and then surges to the wrist and fingers. As the name suggests, this type of tendonitis is the most common among tennis players due to the permanent overwork of the elbow tendons. However, besides them, tennis elbow can also affect painters, construction workers, plumbers, and artists.

Another common type of tendonitis is known as Achilles tendonitis . It occurs in the largest tendon in our body, which is known as the Achilles tendon. It occurs in the largest tendon in our body, which connects the heel with the calf muscle and is known as the Achilles tendon. When this tendon is overworked, Achilles tendonitis occurs, causing swelling and pain. Due to significant permanent overload on the Achilles tendon, runners are the most exposed group to this type of tendonitis, although it may also occur in people who have a sudden rapid increase in pace during running activities.

Golfer’s elbow also belongs to the most common tendonitis types. This condition is usually caused by the inflammation of the forearm. In this case, the swelling appears on the inside of the forearm and elbow. Golfer’s elbow can be triggered by a wide range of different activities that involve repetitive hand movements, such as, for example, flexing, swinging, throwing or gripping.

Rotator cuff tendonitis or, as it’s also often called, bicep tendonitis is also a common type of this condition. It involves shoulder pain, which is caused by inflammation of the biceps tendon and is usually triggered by heavy lifting or frequent stretching of the arms. In the case of rotator cuff tendonitis, people most often experience pain running from the shoulder blades to the upper arm. This condition may cause problems with reaching objects and surfaces located above the head and behind the back, as well as with falling asleep.

As for the effect of tendinopathy on patients’ quality of life, its socio-economic impact is lower if compared with other common musculoskeletal conditions, such as rheumatoid arthritis, osteoarthritis, and lower back pain. However, tendinopathy can still affect the patient’s life . For example, shoulder tendinopathy takes approximately ten months to heal , and, besides this, workers often take additional amounts of sick leave to recover as they are less productive at work. In fact, patients may return to work within six weeks following operative repair, although their recovery may take a few months . In addition to the negative impact of tendonitis on work productivity, this condition also affects the daily activities of people. Thus, according to one of the studies investigating pain, functional disability, and psychologic status in tennis elbow, about 25% of patients with this type of tendonitis reported difficulty in their daily activities, such as dressing, carrying objects, driving, and sleeping. In addition to this, 55% of patients with tennis elbow reported increased levels of anxiety, while 36% reported significantly elevated levels of depression. These results point out that tendonitis has not only a physical impact on health but psychological importance as well and requires a psychological assessment as well.

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What symptoms to watch for? Tendonitis diagnosing and treatment

Most often, tendonitis is caused by minor but repetitive impact on the affected area, but it can also develop from a sudden serious injury as well. Pain is the most common symptom of this condition. Typically, the pain from tendonitis is a dull ache, which is concentrated around the affected joint. This area is usually tender, and the pain often increases when you move the injured area, or someone touches it. Some people may also experience tightness, which makes it difficult to move the joint or swelling. Tendonitis-induced pain may be a gradual buildup or sudden and severe, especially in the case when calcium deposits are present.

In case if you develop tendonitis symptoms, specialists usually recommend trying to cope with the condition by applying ice and resting the affected area. If the pain increases or swelling doesn’t go away after a few days of rest, you should consult with the doctor to diagnose the condition and choose the most appropriate treatment for your case.

In order to diagnose tendonitis, a doctor always first asks about the patient’s medical history and performs a physical exam of the affected area. Besides this, tenderness and range of motion are examined as well. The most common questions for patients with tendonitis symptoms include the information about recent or past injuries to the area, where the pain is concentrated, any previously diagnosed medical conditions, all past and present sports and physical activities, and all the drugs a patient is currently taking, including prescription drugs, over-the-counter medications, and herbal supplements. In cases when a physical examination is not enough to make a definitive diagnosis, a doctor may order several additional tests, such as X-rays, magnetic resonance imaging (MRI), and ultrasounds.

Clinical diagnosis remains the main diagnostic technique for tendonitis, although MRI and ultrasound are still actively being used to support the final diagnosis. In addition to this, it was demonstrated in several studies that using radiological imaging revealed a higher incidence rate compared with the clinical evaluation only. It is believed that such a discrepancy can be caused by the inclusion of patients who had no tendonitis symptoms at the time of examination and who could be left unnoticed in tendinopathy diagnosis.

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As for tendonitis treatment, its main goals include pain reduction, recurrence prevention, and the ability of patients to return to sports or preinjury functionality. Treatment options that are currently available for tendonitis patients help to reduce pain and inflammation on the affected tendon. The most common treatment approaches include:

  • Oral non-steroidal anti-inflammatory drugs. Over-the-counter (OTC) medications are considered the first-line tendinopathy treatment and usually include such drugs as acetaminophen, aspirin, ibuprofen, and naproxen. These medications can help to reduce both inflammation and pain in the affected tendon in the case of early treatment.
  • Corticosteroid injections. Corticosteroids, which are also often called simply “steroids”, are commonly used for tendinopathy treatment as they provide quick inflammation and pain relief. In some cases, a single corticosteroid injection can be enough to reduce pain and inflammation. Repeated injections are not recommended as they can cause the tendon to weaken and increase the chances of injury.
  • Physical therapy. This method of tendinopathy treatment includes a range of stretches and motion exercises and the use of special orthopaedic devices, such as casts and splints, that are used to protect and support injured bones and joints. Casts and splints are made from fibreglass or plaster and are most often used for thumbs, forearms, and hands.

Besides this, some tendonitis therapies may also include injections of autologous blood or platelet-rich plasma.

Also, in some severe cases, failure of conservative treatments may lead to surgical intervention when a surgeon will excise the tendinopathic tissue and repair the ruptured tendon. This treatment approach is needed for tendinopathy cases that don’t respond well to other treatments and are often necessary for a tendon rupture.

When diagnosed and treated early, tendonitis usually resolves quickly. However, in some cases, this condition can recur and become long-term or even chronic. Also, if the inflammation in the tendon continues without treatment, it can cause additional, more serious injury, such as a tendon rupture. Although tendonitis can be treated and doesn’t belong to diseases with serious consequences, this condition can still significantly affect the patient’s quality of life, and its indirect costs can reach great amounts in terms of productivity loss and worker’s compensation. In addition to this, direct outpatient medical costs, along with repeated medical visits, are also a concern.

The risk of developing tendonitis can be reduced. Health experts recommend avoiding overuse and repetitive motions, don’t remain in the same position for too long, use proper posture when working or doing other tasks, warm-up before exercising and use proper equipment during athletic activities, as well as keep fit and build your muscle tone. For athletes, it is also recommended to cross-train. In case you feel sudden pain of tendonitis, you should immediately stop the activity, apply ice, and rest.

CBD for tendonitis treatment. How effective is the natural approach?

Most people with tendonitis cope with this condition by using OTC painkillers, such as ibuprofen, aspirin, and naproxen. However, despite being effective at treating minor pain, combining different non-steroidal anti-inflammatory drugs (NSAIDs) can entail a range of side effects for our health. It is estimated that these drugs are responsible for 30% of hospital admissions for adverse drug reactions , such as bleeding, stroke, heart attack, and renal damage. From the first day of use, all NSAID drugs increase the risk of gastrointestinal bleeding, stroke, and myocardial infarction . They also reduce prostaglandin synthesis. The risk of adverse effects from NSAIDs use is considerably higher in older people as many of them take medicines that can interact with NSAIDs in a negative way. In addition to this, these medications lose their effectiveness over time.

As for severe cases of tendonitis, here is when corticosteroid drugs come into play. These potent painkillers are used for immediate relief from pain and inflammation. Corticosteroids are stronger than NSAIDs and can also negatively affect the patient’s health. Chronic use of these drugs can weaken the tendons, impairing their functioning and causing even more significant damage. The primary concern regarding corticosteroids use is an increased risk of tendons rupture , which is associated with the direct injection of the drug into the tendon.

While being effective, both NSAIDs and corticosteroids are dangerous for our health as their adverse effects are very serious. This is probably, the main reason why people have started to seek out not only effective but also safe treatment for tendonitis symptoms. CBD or cannabidiol is considered a worthy natural alternative to prescription drugs for patients with tendonitis diagnosis. Let’s take a look at how CBD oil can help to alleviate tendonitis symptoms and whether it is really safe for our health.

One of the reasons CBD has become so popular in the world of medicine is its remarkable anti-inflammatory and painkilling properties. Numerous scientific studies, along with constantly rising anecdotal evidence from CBD oil users, have confirmed these health benefits. Moreover, CBD has demonstrated its effectiveness without the dangerous adverse effects for patients’ health in contrast to most prescription and OTC painkillers. Cannabidiol, together with numerous other cannabinoids, belong to the active components of the Cannabis Sativa plant and mediate its beneficial effects on health through activation of cannabinoid receptors of our endocannabinoid system known as CB1 and CB2 receptors.

Numerous studies have demonstrated the potent anti-inflammatory properties of cannabidiol , while some of them have found this cannabinoid can be effective for people with arthritis as it can help to alleviate pain, which affects the connective tissues like tendons and ligaments. Another study investigating the anti-inflammatory properties of CBD has found that cannabinoids could suppress inflammatory response and subsequently alleviate symptoms of numerous diseases. The anti-inflammatory effects of cannabinoids are mediated through multiple pathways , such as induction of apoptosis in activated immune cells, suppression of cytokines and chemokines at inflammatory sites, and upregulation of FoxP3+ regulatory T cells. The beneficial effects of cannabinoids and CBD, in particular, have been tested in different models of autoimmune disorders, such as rheumatoid arthritis, multiple sclerosis, colitis, and hepatitis and demonstrated the ability to reduce the symptoms of these conditions through induction of multiple anti-inflammatory pathways. It was also mentioned in the study that traditional prescription painkillers had comparably low effectiveness, while drugs like opioids can even worsen the inflammation and lead to uncontrolled rheumatic pain, which is one of the underlying causes of rheumatoid arthritis.

It was also discovered in a range of studies that CBD can provide more potent effects on inflammation and pain when taken in combination with another popular cannabis compound known as THC.

THC or tetrahydrocannabinol is the second major cannabinoid in the cannabis plant and is also being actively studied for its health benefits. In contrast to CBD, THC has psychoactive properties that significantly complicates its use from the legality point of view in many countries. Both CBD and THC can be compared to opioids in terms of their effectiveness in reducing inflammation and pain. Even while taking into account the intoxicating effects of THC, neither THC nor CBD has such serious adverse effects as opioid drugs. Moreover, they can’t lead to a fatal overdose as they don’t target the brainstem area, which is responsible for respiratory function.

In 2020, the World Anti-Doping Agency (WADA) approved CBD for athletes and applied those changes in its updated World anti-Doping Code. What are the main CBD benefits for tendonitis, and are there any restrictions for its use?

As it was already said in this review, tendonitis involves swelling and pain in the tendons. People usually recover from this condition within two days to six weeks, although it always depends on each particular case. Tendonitis symptoms can also vary depending on the severity of the injury and may last from several days to a few weeks. If this condition is left untreated and ignored, it can transform into tendinosis, which, in its turn, involves severe tendon degeneration, leading to joint stiffness, chronic pain, and movement restrictions.

The most promising benefit of CBD for tendonitis is its ability to regulate the reaction of the immune system to inflammation. Inflammation is a natural process, which always occurs when the body gets injured as a defensive reaction. A remarkable anti-inflammatory effect of CBD is due to its interaction with the receptors of our endocannabinoid system. When interacting with the ECS, cannabidiol causes the macrophages (white blood cells that react to infections) to inhibit the release of cytokines – proinflammatory proteins that play an important role in cell signalling.

One of the studies investigating the anti-inflammatory activity of cannabidiol on rats has revealed that cannabidiol administered orally with the dosage of 5-40 mg/kg once a day for 3 days after the onset of induced acute inflammation in rats helped to reduce inflammation on the rats’ paws. It was also demonstrated that cannabidiol had a time- and dose-dependent anti-hyperalgesic effect after a single injection. Thus, subsequent daily doses caused further time- and dose-related reductions. The authors of the study concluded that the oral form of CBD might have a beneficial action on two symptoms of established inflammation – oedema and hyperalgesia in rats. It was also stated human trials are necessary to investigate whether CBD can provide the same results on inflammation.

The endocannabinoid system of our body is the major regulatory network, which is involved in numerous processes, including pain modulation. The primary task of this system is to maintain homeostasis – a balance, which allows our body to function properly. In the case of any diseases and malfunctions in the body, homeostasis is disrupted. Due to interaction with CB1 and CB2 receptors of ECS, cannabidiol indirectly increases the concentrations of cannabinoids to help retrieve the balance lost and thus, is able to treat different conditions, including tendonitis.

One of the studies evaluated the effects of CBD extract on opioid use and quality of life in chronic pain patients. The study found that cannabidiol effectively reduces pain and can be an effective alternative to opioid drugs. Over half of the study participants (53%) reduced their opioid use within 8 weeks after including CBD-rich hemp extract in their treatment. In addition to this, almost all CBD users (94%) who participated in the study reported improvements in their quality of life. While based on the results of this and other studies investigating the possibility of CBD use for pain management, researchers concluded that cannabidiol could significantly reduce the use of opioid drugs, as well as relieve chronic pain and improve sleep quality in patients who take opioids as a part of their treatment programs. It is suggested that CBD oil may become an effective replacement for analgesic treatment.

To date, CBD comes in various forms and thus, can be chosen to suit different consumers needs. In the case of tendonitis, CBD oil can be taken orally or topically. People with symptoms of this condition can take CBD sublingual drops that are infused into olive oil, coconut oil or hemp seed oil to get the desired effect. Those users who don’t like the specific earthy taste of natural CBD oil can choose between CBD-infused capsules or edibles, such as, for example, CBD-infused honey sticks. Besides this, CBD can also provide relief for tendonitis symptoms through vaporisation. Usually, vaporised CBD takes 5-10 minutes to provide the effect and has the highest availability among all possible forms that can be used for tendonitis treatment. Bioavailability is one of the major terms for CBD users. It describes the amount of CBD oil, which enters the bloodstream after ingestion. The higher the bioavailability index, the better the effect of the drug.

In addition to these methods, CBD can also be used topically to reduce inflammation and pain in inflamed tendons and swollen muscles. CBD – infused creams and gels are also popular among people with tendonitis symptoms as they provide comparably quick relief by interacting with the cannabinoid receptors into the epidermis layer of the skin. CBD-infused topical products come in different textures and consistencies. For example, CBD salves always use oils, CBD lotions use water as a base, while creams usually combine these two ingredients. In the case of tendonitis symptoms treatment, topical CBD products should be applied to the affected area.

As for the most effective and at the same time safe CBD dosage, it usually differs from one particular case to another. Finding the right dosage for all patients with tendonitis symptoms is a challenging task as they all differ in gender, age, weight, metabolism rate, health conditions, and a wide variety of other factors that can affect CBD’s effectiveness. Currently, there is no one-size-fits-all dosage, which could be recommended for everyone. The best way to define the best dosage for your condition is to start with a low dose of CBD and then gradually increase it if there is no desired relief of tendonitis symptoms. According to researchers, an effective dose of CBD for pain relief range from 1 to 50 mg per day, while lower doses are always used for mild discomfort and higher doses for severe, chronic pain. Anyway, it is highly recommended to visit a doctor before starting taking CBD products in order to determine the optimal dose and avoid negative interactions with other medications.

Bottom line

Tendonitis is a curable but debilitating condition, which can significantly affect the quality of patients’ life and entail great amounts of both direct and indirect costs. This condition usually occurs in tendons when they become inflamed due to overload or repetitive motions. Tendonitis is a common disease among sportspeople, and physical workers as their activities often involve overuse or overload of tendons and repetitive movements. Prescription painkillers can reduce inflammation and pain – the most common symptoms of this condition, although these drugs may have serious side effects on health, while drugs like opioids are addictive and can lead to opioid-related death. Physical therapy and OTC drugs can be effective but only in the early stages of tendonitis. If the condition is more severe, corticosteroid injections or surgery may be needed. CBD oil is considered the most effective and safe natural option that can be used for alleviation of tendonitis symptoms as it can significantly reduce inflammation and pain without causing serious adverse effects on patients’ health. CBD can be applied topically on the affected area if localised relief is needed, as well as can also be used orally in the oil form or through vaporisation. Numerous studies have already demonstrated the anti-inflammatory and painkilling properties of cannabidiol, although research is still ongoing to find out the most effective way of CBD oil use for tendonitis symptoms.

Verified by a health professional

Anastasiia Myronenko

Anastasiia Myronenko is a Medical Physicist actively practicing in one of the leading cancer centers in Kyiv, Ukraine. She received her master’s degree in Medical Physics at Karazin Kharkiv National University and completed Biological Physics internship at GSI Helmholtz Centre for Heavy Ion Research, Germany. Anastasiia Myronenko specializes in radiation therapy and is a fellow of Ukrainian Association of Medical Physicists.

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