PMID: 15216906Jun 26, 2004Paper

Chronic tendon pain--implications for treatment: an update

Current Drug Targets
Håkan Alfredson

Abstract

In previous studies we found high concentrations of the neurotransmitter glutamate in chronic painful tendons. To evaluate the possible importance, the high intra-tendinous glutamate concentrations had for the pain suffered in chronic Achilles tendinosis, microdialysis was performed before and after treatment. The results showed that in patients that were pain-free after treatment there were no significant differences in the glutamate levels before compared to after treatment. With this finding in mind, also other possibly pain-related mechanisms were evaluated. Using ultrasonography and colour doppler technique, we found that in chronic painful tendinosis tendons, but not in normal pain-free tendons, there was a neovascularisation inside and outside the area with structural tendon changes and pain. To test the hypothesis that there was an association between neovascularisation and pain, in a pilot study, under ultrasound and colour doppler guidance the area with neovascularisation was destroyed by injecting the sclerosing agent Polidocanol. The clinical results showed that 8/10 patients were pain-free and had no remaining neovessels. The 2 patients that were not pain-free had remaining neovessels. In a following investigation ...Continue Reading

Citations

May 3, 2005·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Mads KristoffersenHåkan Alfredson
Aug 13, 2009·Knee Surgery, Sports Traumatology, Arthroscopy : Official Journal of the ESSKA·Per David TrobischDavid J Hak
Nov 18, 2011·Sports Medicine and Arthroscopy Review·Yinghua XuGeorge A C Murrell
Jul 28, 2013·The Journal of Orthopaedic and Sports Physical Therapy·Hongying ChenSiu Ngor Fu
Apr 7, 2010·Annals of Physical and Rehabilitation Medicine·J-L ZiltenerP-E Fournier
Oct 29, 2015·Journal of Athletic Training·Justin H RigbyDavid O Draper
Feb 3, 2007·The American Journal of Sports Medicine·Norimasa TakahashiDavid Amiel
Apr 12, 2011·The American Journal on Addictions·Jermaine D JonesSandra D Comer
Dec 27, 2005·Clinical Journal of Sport Medicine : Official Journal of the Canadian Academy of Sport Medicine·Merzesh Magra, Nicola Maffulli
Oct 5, 2011·Pediatrics·Gastón Andrés TopolHung-wen Yeh

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