Time to abandon the "tendinitis" myth

doi:10.1136/bmj.324.7338.626

BMJ 2002;324:626-627 ( 16 March )

Editorials

Time to abandon the "tendinitis" myth

Painful, overuse tendon conditions have a non-inflammatory pathology

The first 150 words of the full text of this article appear below.

Tendinitis such as that of the Achilles, lateral elbow, and rotator cuff tendons is a common presentation to family practitionersand various medical specialists.¹ Most currently practisinggeneral practitioners were taught, and many still believe, thatpatients who present with overuse tendinitis have a largely inflammatorycondition and will benefit from anti-inflammatory medication.Unfortunately this dogma is deeply entrenched. Ten of 11 readilyavailable sports medicine texts specifically recommend non-steroidalanti-inflammatory drugs for treating painful conditions like Achillesand patellar tendinitis despite the lack of a biological rationaleor clinical evidence for this approach. ² ³

Instead of adhering to the myths above, physicians should acknowledge that painful overuse tendon conditions have a non-inflammatorypathology. Light microscopy of patients operated on for tendonpain reveals collagen separation^4-6 $---$ thin, frayed, and fragiletendon fibrils, separated from each other lengthwise and disruptedin cross section. There is an apparent increase in tenocytes withmyofibroblastic differentiation . . . [Full text of this article]

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Rapid Responses:

Read all Rapid Responses

Treatment for tendinopathy?: Anthony Glaser
bmj.com, 16 Mar 2002 [Full text]
Tendinosis/Tendonitis/Tendinopathy?: Gabor Lantos
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