Shining a light on tendinopathy: expensive treatments vs established therapies

By Dr. Bert Fields


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As a busy sports medicine physician I see an increasing number of patients pursuing unproven and often expensive treatments before they have tried established therapies with stronger evidence.  One example of this is a recent patient who saw advertising for a cold laser that they purchased from an internet site. The patient showed no progress with his tennis elbow until we saw him in the office and gave him a series of eccentric exercises and other standard treatment which quickly started a reversal of his problem.

In my opinion marketing and news stories which exaggerate the benefits of unproven therapies are leading patients to make bad choices.  Particularly for tendon injuries, patients are purchasing unproven devices or seeking injections with substances like platelet rich plasma or stem cells before they have done any established treatment.


Related BJSM Articles

Lotta Willberg, Kerstin Sunding, Magnus Forssblad, Martin Fahlström, Håkan Alfredson. 2011. Sclerosing polidocanol injections or arthroscopic shaving to treat patellartendinopathy/jumper’s knee? A randomised controlled studyBr J Sports Med 2011;45:411-415.


A van der Plas, S de Jonge,  R J de Vos, H J L van der Heide, J A N Verhaar, A Weir,  J L Tol. 2011. A 5-year follow-up study of Alfredson’s heel-drop exercise programme in chronic midportion Achilles tendinopathy. Br J Sports Med 2012;46:214-218 Published Online First: 10 November 2011. (FREE ONLINE!)


Mathijs van Ark, Johannes Zwerver,  Inge van den Akker-Scheek. 2011. Injection treatments for patellar tendinopathy. Br J Sports Med 2011;45:1068-1076 Published Online First: 3 May 2011. 


R J de Vos, A Weir, J L Tol, J A N Verhaar, H Weinans, H T M van Schie. 2011. No effects of PRP on ultrasonographic tendon structure and neovascularisation in chronic midportion Achilles tendinopathy. Br J Sports Med 2011;45:387-392 Published Online First: 3 November 2010



Bert Fields, MD is a professor for the UNC School of Medicine and directs the sports medicine fellowship at Cone Health system in Greensboro, NC.  He is a past president of AMSSM.

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