For all tendinopathies , improvements in pain were significant when comparing GTN versus placebo in the short term ( < 8 weeks ; poor evidence ) .
Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following : patient satisfaction ( strong evidence ) ; chances of being asymptomatic with activities of daily living ( strong evidence ) ; range of movement ( moderate evidence ) ; strength ( moderate evidence ) ; pain ( at night and with activity ; poor evidence ) and local tenderness ( poor evidence ) .
Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo ( moderate evidence ) .
Conclusions and relevance Treatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions
Objective To produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate ( GTN ) in the treatment of tendinopathies .
Management of tennis elbow with topical glyceryl trinitrate.
OBJECTIVE The aim of this study was to evaluate the treatment results of the application of nitric oxide ( NO ) in the form of topical glyceryl trinitrate ( GTN ) for the treatment of lateral epicondylitis ( LE ) . METHODS The study included 40 patients with LE r and omized into 2 equal groups . Selection criteria included the presence of pain , tenderness , and positive pain stimulating maneuvers .  Glyceryl trinitrate patches were applied to the area of maximal tenderness once a day in the treatment group and placebo patches in the control group . Outcomes in terms of pain relief was assessed using the visual analog scale ( VAS ) and were evaluated according to the criteria of Verhaar et al. Excellent or good results were considered successful . Differences in VAS scores between the two groups were calculated using the Mann-Whitney U-test and the chi-square test was used to investigate distributions of categorical variables ( sex , affected side ) and good and excellent results among groups . RESULTS There were no significant differences in any of the baseline clinical parameters between groups . At the 3rd week follow-up , there were statistically significant differences in the pain measured using VAS between groups ( mean VAS score of the control and treatment groups were 6.45 and 3.15 , respectively ) ( p=0.001 ) . Patients in the GTN group and control group had lower VAS pain scores and reduced elbow pain at 3 weeks ( 3.15 vs 8.05 in the GTN and 6.45 vs 8.80 in the control group ) . In the control group , no patient had excellent or good results while 18 ( 90 % ) patients in treatment group reported successful treatment . There was statistically significant difference in the VAS measured at 6 months between groups ( mean VAS score of the control and treatment groups were 4.85 and 0.70 , respectively ) ( p=0.001 ) . CONCLUSION The administration of NO directly over an area of tendinopathy through a GTN patch reduces pain and other symptoms in chronic LE
For all tendinopathies , improvements in pain were significant when comparing GTN versus placebo in the short term ( < 8 weeks ; poor evidence ) .
Significant improvements in midterm outcomes for treatment with GTN versus placebo included the following : patient satisfaction ( strong evidence ) ; chances of being asymptomatic with activities of daily living ( strong evidence ) ; range of movement ( moderate evidence ) ; strength ( moderate evidence ) ; pain ( at night and with activity ; poor evidence ) and local tenderness ( poor evidence ) .
Patients treated with topical GTN reported a higher incidence of headaches than those who received placebo ( moderate evidence ) .
Conclusions and relevance Treatment of tendinopathies with topical GTN for up to 6 months appears to be superior to placebo and may therefore be a useful adjunct to the treating healthcare professions
Objective To produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate ( GTN ) in the treatment of tendinopathies .