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Tendinitis and Tendinosis

When tendinitis has been present for several months or more, it progresses to become chronic tendinitis or tendinosis. Tendinosis includes degenerative changes in the collagenous matrix of a tendon that weakens and increases its likelihood of a tendon rupture. Regenerative medicine treatments using ultrasound guidance for targeted biologic agent injection aims to resolve chronic tendinitis by promoting natural healing and decreasing the likelihood of a catastrophic tendon rupture.

Tendinitis and Tendinosis Overview

Tendinitis elbow graphicTendinitis refers to inflammation of a tendon, usually of less than several months duration. Symptoms of tendinitis can vary from a burning sensation around the inflamed tendon to aching pains and joint stiffness. Sometimes swelling along the tendon occurs with associated warmth and redness. If tendinitis symptoms become chronic and persist for several months or more, then the tendinitis condition progresses to chronic tendinitis or tendinosis.

tendinosis bodyChronic tendinitis (tendinosis) of the Achilles tendon, rotator cuff of the shoulder, lateral epicondyle of the elbow (Tennis Elbow), medial epicondyle of the elbow (Golfer’s Elbow), and patellar tendon of the knee are common causes of “tendon inflammatory pain” in adults. Regenerative medicine treatments using biologic agents promote natural healing of an injured, partially torn, or degenerative tendon. The choice of which biologic agents to use depends on the extent of tendon and surrounding tissue injury contributing to the patient’s symptoms, combined with physician and patient preference. Usually, a series of PRP treatments are performed as the initial treatment for chronic tendinitis. For severe tendinosis or partial tendon tears, a more complex treatment approach using a combination of biologic agents will likely be considered.

Platelet-rich plasma (PRP) therapy is a recommended biologic agent to promote tendon healing and to prevent progression of tendon degeneration that could lead to tendon rupture. In the case of a partial tendon tear or tendon rupture, a combination of biologic agents may be considered to promote repair and regeneneration.

Regenerative medicine specialists at HOGUE CLINICS advise their patients with chronic tendinitis (tendinosis) to avoid corticosteroid injections for at least three months prior to having a regenerative medicine treatment with biologic agents. This is done to optimize treatment success. Local wound healing is significantly impaired in the presence of injected corticosteroids. Similarly, NSAIDs, aspirin and blood thinners should be avoided for at least 10 days prior to a regenerative medicine treatment at HOGUE CLINICS. Both NSAIDs and aspirin impair platelet function as well as suppress elements of local wound healing.

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Our regenerative medicine specialist, Dr. Roger Hogue, consults with each patient to customize a regenerative medicine treatment plan specific to their degenerative, painful chronic tendinitis (tendinosis) condition.

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