Polidocanol (aethoxysclerol 0.5%) is a medication typically used for the treatment of varicose veins, as it scleroses (scars) the veins and thus rid the patient of their pain and cosmetic issue of enlarged veins. It has also been used in the treatment of tendinosis (commonly referred to as “tendinitis"), as well as surrounding tendon inflammation, known as tenosynovitis. Though not well understood, in an attempt to heal the body of the tendinosis, new blood vessels and nerves grow into a diseased tendon, producing pain. Targeting these new blood vessels and nerves with polidocanol often results in relief of symptoms.
Ultrasound follow up of patients following a polidocanol tendon injection usually demonstrates decreased blood flow and an overall normal appearance of the tendon, which is associated with an improvement of symptoms.
Polidocanol injections are routinely used as a second line method of treating tendon pain at Melbourne Radiology Clinic. As for an autologous blood or platelet rich plasma injection, polidocanol may be used to treat any painful tendon and is performed under ultrasound guidance to accurately and safely deliver the medication into the area of abnormality. Patients will first require a test to confirm that the tendon is the source of their pain, usually with either an MRI and/or ultrasound scan.
References:
- Rabago D, Best TM, Zgierska A, Zeisig E, Ryan M, Crane D. A systematic review of four injection therapies for lateral epicondylosis: prolotherapy, polidocanol, whole blood and platelet rich plasma. Br J Sports Med Jan 21, 2009 [Epub ahead of print]
- Knobloch K. Sclerosing polidocanol injections in Achilles tendinopathy in high level athletes. Knee Surg Sports Traumatol Arthrosc 16(11):1061-2, 2008
- Alfredson H, Harstad H, Haugen S, Ohberg L. Sclerosing polidocanol injections to treat chronic painful shoulder impingement syndrome-results of a two-centre collaborative pilot study. Knee Surg Sports Traumatol Arthrosc 14(12):1321-6, 2006
- Hoksrud A, Ohberg L, Alfredson H, Bahr R. Ultrasound-guided sclerosis of neovessels in painful chronic patellar tendinopathy: a randomized controlled trial. Am J Sports Med 34(11):1738-46, 2006
For more information read:
Melbourne Radiology Clinic - Patient Fact Sheet: Polidocanol Injection
