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Abstract
Background: Based on the assumption that neovascularization is a cause of tendon pain, sclerosing injections have increasingly been used to treat chronic tendon conditions. A number of clinical studies have investigated the efficacy of this intervention.
Objective: The aim of this study was to review the literature relating to the use of sclerosing injections for the management of painful tendinopathy.
Method: Medline, CINAHL, PEDro, Cochrane Database, PubMed, EMBASE, AMED, Scopus, and Web of Science were searched. Of 4632 abstracts identified, 24 were retained for further analysis. Each abstract was assessed by three reviewers; nine studies (four randomized controlled trials, four pilot studies, and one comparative study) met our inclusion criteria. Quality was assessed using the Downs and Black Scale.
Results: Two outcome measures were utilized: visual analogue score (VAS) for pain and estimated assessment of neovascularization. Seven trials reported some improvement in pain. Results from the three highest quality trials were inconclusive. Five trials reported a change in neovascularization pre- and post-intervention. One trial additionally used the Victoria Institute of Sports Assessment (VISA) to record pain outcomes.
Conclusions: The clinical significance of neovascularization as a cause of pain is contentious. Currently, there is insufficient robust evidence to support the use of sclerosing injections in the treatment of painful tendinopathy with concomitant neovascularity. Further clinical, imaging and laboratory studies investigating the relationship between neovascularity, tendon pain and its management are required.