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Ultrasound-guided injections help ease chronic Achilles tendon pain

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. Pauls 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.


Contact: Necoya Lightsey
American Roentgen Ray Society

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