Why cortisone injections work in tendinopathy
Two scientific articles which have just been released have shed some light on one of sports medicine recent mysteries - just why does cortisone help in tendinopathy when there are no inflammatory cells? An article recently published in CJSM has shown that repeated exposure to Prostoglandin E2, which is produced by tendons during exercise, leads to tendon breakdown. Cortisone would inhibit the production of PGE2, as would NSAIDS, by cyclo-oxygenase inhibition. ref: Clinical Journal of Sport Medicine: Vol 15(1) Jan 2005 pp 27-33. Click here to read the CJSM abstract Another article in the JSMS has suggested that stress-shielding is responsible for failure to heal in insertional tendinopathy. Superficial cortisone injection may help relieve stress-shielding by weakening the superficial tendon and allowing the deep stress-shielded tendon to heal, in a similar fashion to adductor tenotomy. ref: Journal of Science and Medicine in Sport Volume Dec 2004 Vol 7(4) pp 424-428. |
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