Tendonitis Treatment with Serum Injections

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What is Tendonitis?

Tendons are thick fibrous cords that attach muscles to the bones, often near a joint. People who do repetitive movements in their job or during sports may develop pain and inflammation over time around the muscle and joint. This condition, called tendonitis or tendinitis, often occurs on the shoulders (Pitcher’s shoulder), elbows (tennis elbow), knees (Jumper’s knee), wrists and heels.

Tendonitis can be a source of acute or chronic pain. This condition often responds to medical treatment and physical therapy. However, therapy may go on for a long time because tissue healing takes time. If severe, tendonitis can even lead to a ruptured tendon or calcification for which surgical repair may be indicated.

How Do Serum Injections Work?

Serum injections refer to blood extracts, specifically platelet-rich plasma (PRP), that are taken from a patient’s own blood and injected directly into his tissues as a form of treatment.

A patient who does not respond to conventional therapy and has had chronic pain is a good candidate for this therapy, unless he is taking blood thinners for other diseases. He should also be willing to submit to blood withdrawal and injection of his own serum into the affected tendon.

Platelet-rich plasma (serum) is produced by taking 30 to 50 ml of the patient’s blood (from the arm vein) and subjecting it to a process called centrifugation. After ensuring sterilization and anesthetizing the affected area, 3 to 5 ml of the serum is injected directly to the tendon.

This is an office procedure, and the patient is advised to rest and immobilize the joint after the injection. Anti-inflammatory medications are not to be taken for the next two weeks because these interfere with the action of the serum. Prescribed pain medications such as narcotics or opiates may be taken instead.

The mechanism by which PRP works is that human serum factors are known to enhance tissue and bone healing. Growth factors abound in the platelet concentrate and these have been found to increase the rate of healing, help individuals regain function faster, and avoid the need for surgery.

Risks and Disadvantages of Platelet Rich Plasma Injections

Tendonitis treatment with serum injections has been practiced for a few years now, and many famous athletes, including Tiger Woods and former NFL quarterback Steve Bono have benefited from the procedure.

Although approved by the FDA since it does not involve the injection of any artificial or manufactured product, controlled research studies still have to be done to prove the efficacy of PRP injection for the treatment of tendonitis.

Furthermore, the treatment is unsuitable for people who:

  • Are taking aspirin or blood thinners
  • Cannot avoid using the affected joint and muscle for the time of treatment
  • Are allergic to anesthesia for the procedure
  • Cannot give consent to blood extraction

Since the serum is the patient’s own, no reactions are expected. However, pain is a common side effect for which anti-inflammatory drugs cannot be taken. Narcotics are preferred but can cause side effects like nausea and drowsiness.

The injection of serum or PRP to treat tendonitis is a promising form of therapy not only in tendonitis but also for other conditions like arthritis, fractures and other injuries to the cartilage. Its application in dentistry, certain heart surgeries and wound healing are also being explored.

References

Performance Orthopedics, “Therapeutic Injection of PRP” accessed 2/2/11

https://www.performanceorthopedics.com/files/Education/PRP.pdf

Mayo Clinic, “Tendinitis” accessed 2/2/11

https://www.mayoclinic.com/health/tendinitis/DS00153

Scientific American, “Is Platelet-Rich Plasma an Effective Healing Therapy?” accessed 2/2/11

https://www.scientificamerican.com/article.cfm?id=platelet-rich-plasma-therapy-dennis-cardone-sports-medicine-injury