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Painful, overuse tendon conditions have a non-inflammatory pathology

  1. K M Khan, assistant professor,
  2. J L Cook, associate professor,
  3. P Kannus, professor,
  4. N Maffulli, professor and head,
  5. S F Bonar, senior musculoskeletal pathologist
  1. Department of Family Practice, University of British Columbia, Vancouver, Canada V6T 1Z3
  2. School of Physiotherapy, LaTrobe University, Bundoora, Australia 3083
  3. Department of Surgery, Tampere University Medical School and University and UKK Institute, Tampere, Finland 33501
  4. Department of Trauma and Orthopaedic Surgery, Keele University School of Medicine, North Staffordshire Hospital, Stoke on Trent, ST4 7QB
  5. Douglass Hanly Moir Pathology, Sydney, Australia 2113

    Tendinitis such as that of the Achilles, lateral elbow, and rotator cuff tendons is a common presentation to family practitioners and various medical specialists.1 Most currently practising general practitioners were taught, and many still believe, that patients who present with overuse tendinitis have a largely inflammatory condition and will benefit from anti-inflammatory medication. Unfortunately this dogma is deeply entrenched. Ten of 11 readily available sports medicine texts specifically recommend non-steroidal anti-inflammatory drugs for treating painful conditions like Achilles and patellar tendinitis despite the lack of a biological rationale or 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-inflammatory pathology. Light …

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