OXSPORT@NOC

Patient information leaflet

Treatment of tendinopathy using sclerotherapy

What is tendonopathy?

Tendonopathy is a degenerative process. As a part of this process the tendons become thickened and their structure becomes disorganised. There is often growth of tiny new blood vessels within the tendon-a process called neovascularisation. With these blood vessels are nerve fibres which contribute to the pain of tendonopathy.

What is sclerotherapy?

Sclerotherapy works by obliterating the new blood vessels within the tendon. By doing this we can often eradicate the pain generating nerve fibres associated with the new blood vessels.It involves injecting a sclerosing agent (normally polidocanol) directly into the damaged tendon under ultrasound control.

When do we use sclerotherapy?

We use sclerotherapy in severe tendinopathy which is resistant to traditional exercise treatment alone. The aim of sclerotherapy is to reduce the pain.

It is important to remember that sclerotherapy is only part of your treatment. The most important part of your treatment will still involve the exercises you will be given. It is hoped that sclerotherapy with relieve the pain to make it possible to do the exercises more effectively.

What is the evidence?

There is now evidence from several small studies to support the use of polidonanol in several types of tendinopathy. It is important to remember that the data is fairly new and many of the published studies are small. For this reason, polidocanol treatment is currently unlicensed for use in tendinopathy.

What are the side-effects?

On current evidence, sclerotherapy is a safe procedure. There is some evidence that there may be a tiny risk of tendon rupture. This is a risk in any injection into a tendon.

Other potential side effects are:

Minor skin discolouration at the injection site

Small risk of local infection.

Small risk of a local skin rash.

Small risk of a more generalised allergic reaction.

Oxsport Dr Natasha Jones 1st December 2008