The Pain & Therapy Bibliography, Record ID 4293 {show all records}
Treatment of tendinopathy: what works, what does not, and what is on the horizon
most detailed summaries by Paul Ingraham
abstract
Tendinopathy is a broad term encompassing painful conditions occurring in and around tendons in response to overuse. Recent basic science research suggests little or no inflammation is present in these conditions. Thus, traditional treatment modalities aimed at controlling inflammation such as corticosteroid injections and nonsteroidal antiinflammatory medications (NSAIDS) may not be the most effective options. We performed a systematic review of the literature to determine the best treatment options for tendinopathy. We evaluated the effectiveness of NSAIDS, corticosteroid injections, exercise-based physical therapy, physical therapy modalities, shock wave therapy, sclerotherapy, nitric oxide patches, surgery, growth factors, and stem cell treatment. NSAIDS and corticosteroids appear to provide pain relief in the short term, but their effectiveness in the long term has not been demonstrated. We identified inconsistent results with shock wave therapy and physical therapy modalities such as ultrasound, iontophoresis and low-level laser therapy. Current data support the use of eccentric strengthening protocols, sclerotherapy, and nitric oxide patches, but larger, multicenter trials are needed to confirm the early results with these treatments. Preliminary work with growth factors and stem cells is promising, but further study is required in these fields. Surgery remains the last option due to the morbidity and inconsistent outcomes. The ideal treatment for tendinopathy remains unclear.
related content
- “Overuse tendinosis, not tendinitis, part 1: a new paradigm for a difficult clinical problem (part 1),” an article in Phys Sportsmed, 2000.
- “Overuse tendinosis, not tendinitis, part 2: applying the new approach to patellar tendinopathy,” an article in Phys Sportsmed, 2000.
- “Histopathology of common tendinopathies. Update and implications for clinical management,” an article in Sports Med, 1999.
- “Plantar fasciitis: a degenerative process (fasciosis) without inflammation,” an article in Journal of the American Podiatric Medical Association, 2003.
- “Treatment of tendinopathy: what works, what does not, and what is on the horizon,” an article in Clinical Orthopaedics & Related Research, 2008.
These four articles on SaveYourself.ca cite this paper as a source: