Sclerosing polidocanol injections of small vessels to treat the chronic painful tendon.
2007 (English)In: Cardiovascular & hematological agents in medicinal chemistry, ISSN 1871-5257, Vol. 5, no 2, 97-100 p.Article, review/survey (Refereed) Published
The chronic painful tendon (tendinopathy, tendinosis) is generally considered difficult to treat, not seldom causing long-term disability and sometimes ending the sports or work carreér. Most common sites for tendinopathy are the Achilles-, patellar-, extensor carpi radialis brevis (ERCB)-, and supraspinatus tendons. The origin of pain has for many years been unknown, but recently, by using ultrasound (US) + colour Doppler (CD), immunohistochemical analyses of tendon biopsies, and diagnostic injections of local anaestesia, we found a close relationship between areas with vasculo-neural ingrowth and tendon pain. Sensory nerves (Substance-P-SP and Calcitonin Gene Related Peptide-CGRP) were found inside and outside the vascular wall. In following clinical studies we have demonstrated good short-and mid-term clinical results using treatment with US+CD-guided sclerosing polidocanol injections, targeting the area with neovessels outside the tendon. Two-year follow ups have showed remaining good clinical results, and sonographically signs of remodelling with a significantly thinner tendon with a more normal structure. Whether the effects of polidocanol are mediated through destruction of neovessels, activity on nerves or a combination, is under evaluation.
Place, publisher, year, edition, pages
2007. Vol. 5, no 2, 97-100 p.
Chronic tendon pain, neovessels, nerves, ultrasonography, Doppler, polidocanol
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:umu:diva-32820PubMedID: 17430133OAI: oai:DiVA.org:umu-32820DiVA: diva2:306183