Chronic Achilles Tendon Pain Eased By Ultrasound-Guided Injections

October 30, 2007

Patients with chronic tendinosis of the Achilles tendon can

experience a reduction in pain when injected with a small amount of

a dextrose solution, according to a recent study conducted by

researchers at St. 's Hospital in Vancouver, BC.

" Chronic tendinosis is a common overuse injury which can be very

painful and debilitating and can affect many tendons throughout the

body, " said Norman J. Maxwell, MD, lead author of the

study. " Research has shown that this condition results from impaired

healing of recurrent injury to the tendon. Research has also shown

that chronic tendinosis is not an inflammatory but a degenerative

process, " he said.

" We decided to treat the areas of degeneration and small tears in

the tendon by injecting a 25% dextrose solution which would induce

an inflammatory process in that area of the tendon and initiate

normal wound healing, " said Dr. Maxwell. " We performed this

treatment using a small needle under ultrasound guidance so that the

abnormal areas could be accurately targeted, " he said.

According to the study, 32 out of 36 patients who had long standing

chronic tendinosis of the Achilles tendon with a mean duration of

symptoms of 28.6 months were treated successfully. There was marked

reduction in tendon pain at rest and during tendon loading activity

following completion of the injection therapy. A telephone interview

with 30 patients in the study group a mean of 12 months after their

last injection found that 20 of the 30 patients still were

asymptomatic and nine patients had only mild symptoms with one

patient having moderate symptoms.

" Despite these very encouraging results, further studies are

required to validate the effectiveness of this treatment for chronic

tendinosis, " said Dr. Maxwell. " Some patients respond to the

treatment better than others, largely due to the presence or absence

of calcifications. We have observed that patients with

calcifications in their tendons appear to respond less well to the

treatment than patients who have no calcifications, " he said.

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