Tendons--time to revisit inflammation

Br J Sports Med. 2014 Nov;48(21):1553-7. doi: 10.1136/bjsports-2012-091957. Epub 2013 Mar 9.

Abstract

It is currently widely accepted among clinicians that chronic tendinopathy is caused by a degenerative process devoid of inflammation. Current treatment strategies are focused on physical treatments, peritendinous or intratendinous injections of blood or blood products and interruption of painful stimuli. Results have been at best, moderately good and at worst a failure. The evidence for non-infammatory degenerative processes alone as the cause of tendinopathy is surprisingly weak. There is convincing evidence that the inflammatory response is a key component of chronic tendinopathy. Newer anti-inflammatory modalities may provide alternative potential opportunities in treating chronic tendinopathies and should be explored further.

Keywords: Immune Function; Immunology; Tendons.

Publication types

  • Review

MeSH terms

  • Anti-Inflammatory Agents / therapeutic use
  • Chronic Disease
  • Cyclooxygenase 1 / physiology
  • Cyclooxygenase 2 / physiology
  • Humans
  • Matrix Metalloproteinase Inhibitors / therapeutic use
  • Matrix Metalloproteinases / physiology
  • Musculoskeletal Pain / prevention & control
  • Neovascularization, Pathologic / pathology
  • Neovascularization, Pathologic / physiopathology
  • Substance P / physiology
  • Tendinopathy / drug therapy
  • Tendinopathy / etiology*
  • Tendinopathy / pathology
  • Tendons / blood supply
  • Tumor Necrosis Factor-alpha / antagonists & inhibitors

Substances

  • Anti-Inflammatory Agents
  • Matrix Metalloproteinase Inhibitors
  • Tumor Necrosis Factor-alpha
  • Substance P
  • Cyclooxygenase 1
  • Cyclooxygenase 2
  • Matrix Metalloproteinases