Written by Daniel Savarino, DO
Tendinopathy, or painful tendons, is a condition that affects many people, from elite athletes to office workers that are on the computer for 8 hours a day. Any tendon in the body can be effected, from the Achilles tendon in the ankle to the many small tendons in your hands and fingers.
For many years our options in treating these conditions was mostly limited to anti-inflammatory medications, steroid injections, physical therapy and surgery if all else failed. While steroids and anti-inflammatories provide pain relief, many times this is only temporary and these medicines do not aid in healing of the tendon. The ultimate goal of treatment should not be to simply mask the problem with pain medications but to heal the tendon and restore the integrity of the tissue. There is now a much better alternative.
When a tendon is first injured there is an acute inflammatory response which is called tendonitis. In this early stage, conventional treatment with NSAID’s or steroid injections can be very helpful and may even resolve the injury. If the tendon has not healed in the first couple of months the acute inflammatory cells are replaced by chronic cells and there is thickening and microtearing of the tendon. These tears do not heal on their own because our tendons do not have a good blood supply and blood is what brings the cells responsible for healing to our tissues. When the initial acute inflammatory response has dissipated and the tendon remains structurally compromised this condition is chronic and called tendonosis”. Platelet Rich Plasma or PRP may be a much better alternative than conventional treatments of steroids and/or NSAIDS.
PRP is a biologic procedure that takes the platelets from your own blood and concentrates them. The platelets are then injected into the painful tendons, usually using ultrasound for guidance. In your platelets are many healing factors or growth factors that help to heal the microtears and chronic structural damage in the tendon. This is a natural treatment that allows your own body to heal itself.
More and more studies are showing the benefit of PRP for chronic tendinopathy. In addition its use in chronic tendinopathy, PRP has also been effective in treatment of arthritis, ligament damage, muscle strain and multiple other treatments outside of sports medicine like aesthetics and dentistry.
In our practice we have seen very good results with PRP. This is a regenerative treatment that not only provides pain relief but actually fixes the problem by healing the tendon and restoring its structural integrity.