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Sclerosing polidocanol injections of small vessels to treat the chronic painful tendon.
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine.
Umeå University, Faculty of Medicine, Surgical and Perioperative Sciences, Sports Medicine.
2007 (English)In: Cardiovascular & hematological agents in medicinal chemistry, ISSN 1871-5257, Vol. 5, no 2, 97-100 p.Article, review/survey (Refereed) Published
Abstract [en]

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.
Keyword [en]
Chronic tendon pain, neovessels, nerves, ultrasonography, Doppler, polidocanol
National Category
Medical and Health Sciences
URN: urn:nbn:se:umu:diva-32820PubMedID: 17430133OAI: diva2:306183
Available from: 2010-03-29 Created: 2010-03-29 Last updated: 2010-03-29Bibliographically approved

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Alfredson, HåkanLorentzon, Ronny
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