Abstract
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 carreer. 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 vasculoneural 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.
Keywords: Chronic tendon pain, neovessels, nerves, ultrasonography, Doppler, polidocanol
Cardiovascular & Hematological Agents in Medicinal Chemistry
Title: Sclerosing Polidocanol Injections of Small Vessels to Treat the Chronic Painful Tendon
Volume: 5 Issue: 2
Author(s): H. Alfredson and R. Lorentzon
Affiliation:
Keywords: Chronic tendon pain, neovessels, nerves, ultrasonography, Doppler, polidocanol
Abstract: 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 carreer. 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 vasculoneural 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.
Export Options
About this article
Cite this article as:
Alfredson H. and Lorentzon R., Sclerosing Polidocanol Injections of Small Vessels to Treat the Chronic Painful Tendon, Cardiovascular & Hematological Agents in Medicinal Chemistry 2007; 5 (2) . https://dx.doi.org/10.2174/187152507780363232
DOI https://dx.doi.org/10.2174/187152507780363232 |
Print ISSN 1871-5257 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6182 |
Call for Papers in Thematic Issues
Medicinal Plants with Beneficial Properties on Diabetes and Hypertension
Diabetes and hypertension are real scourges of the 21st century. It is imperative to act in order to find innovative solutions to this problem. Taking medications such as hypoglycemic and antihypertensive drugs may aggravate certain underlying comorbidities, such as chronic kidney disease and cardiovascular disease. This significant drawback therefore requires ...read more
- Author Guidelines
- Graphical Abstracts
- Fabricating and Stating False Information
- Research Misconduct
- Post Publication Discussions and Corrections
- Publishing Ethics and Rectitude
- Increase Visibility of Your Article
- Archiving Policies
- Peer Review Workflow
- Order Your Article Before Print
- Promote Your Article
- Manuscript Transfer Facility
- Editorial Policies
- Allegations from Whistleblowers
Related Articles
-
Matrix Metalloproteinases in Venous Tissue Remodeling and Varicose Vein Formation
Current Vascular Pharmacology Anatomical Approach to Clinical Problems of Popliteal Fossa
Current Rheumatology Reviews Therapeutic Apheresis in Metabolic Syndrome
Immunology, Endocrine & Metabolic Agents in Medicinal Chemistry (Discontinued) Pharmacology of the Human Saphenous Vein
Current Vascular Pharmacology The Clinical Spectrum of Nephrogenic Systemic Fibrosis
Current Rheumatology Reviews Genetic Variations of the Hemostatic System as Risk Factors for Venous and Arterial Thrombotic Disease
Current Genomics Neuropeptides and Other Chemical Mediators, and the Role of Anti-inflammatory Drugs in Primary Headaches
Anti-Inflammatory & Anti-Allergy Agents in Medicinal Chemistry Identification of Novel Anti-inflammatory Agents from Ayurvedic Medicine for Prevention of Chronic Diseases: “Reverse Pharmacology” and “Bedside to Bench” Approach
Current Drug Targets Inflammation and Thrombophilia in Pregnancy Complications: Implications for Risk Assessment and Clinical Management
Cardiovascular & Hematological Disorders-Drug Targets A Qualitative and Quantitative Study of the Innervation of the Human Non Pregnant Uterus
Current Protein & Peptide Science Beta-Blockers: Current State of Knowledge and Perspectives
Mini-Reviews in Medicinal Chemistry Angiogenic and Vascular Modulation by Extracellular Matrix Cleavage Products
Current Pharmaceutical Design Anti-inflammatory Effects of Mesenchymal Stem Cells and their Secretomes in Pneumonia
Current Pharmaceutical Biotechnology Bacteriophages as Therapeutic Agents: Alternatives to Antibiotics
Recent Patents on Biotechnology Localisation of Endothelin-1 and its Receptors in Vascular Tissue as Seen at the Electron Microscopic Level
Current Vascular Pharmacology Effect of a Peptide Construct on Differentiated Macrophage MMP-2 and MMP-9 Levels of Varicose Patients
Current Pharmaceutical Design Cellular Mechanisms of Bypass Vein Graft Arterialization and Approaches to Attenuate Graft Remodeling
Vascular Disease Prevention (Discontinued) Venous Thromboembolism Risk and Adequacy of Prophylaxis in High Risk Pregnancy in the Arabian Gulf
Current Vascular Pharmacology Semicarbazide-Sensitive Amine Oxidase: Current Status and Perspectives
Current Medicinal Chemistry Ultrasound Diagnosis of Soft Tissue Vascular Malformations and Tumours
Current Medical Imaging