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 .
[Transdermal nitroglycerin versus corticosteroid infiltration for rotator cuff tendinitis].
AIMS To compare transdermal nitroglycerin ( NTG ) and corticosteroid infiltration in patients with rotator cuff tendinitis ( RCT ) . DESIGN Experimental , r and omized controlled study . SETTING Semirural basic health area in the Garraf region of Barcelona province , Spain , with a population of public health service users of 12000 . PATIENTS AND METHODS Patients diagnosed as having RCT of less than 6 weeks ' evolution who had not responded to treatment with oral nonsteroid antiinflammatory drugs . The patients were distributed r and omly into two groups : a ) group A , local infiltration via a posterior approach with a depot corticosteroid and local anesthesia , and b ) group B , treated for 3 days with a 5-mg NTC patch . MAIN MEASURES Age , sex , pain ( measured with an analog visual scale ) and adverse events . In patients who showed a partial response , treatment was repeated up to 3 times at 15-day intervals . Pain was tested after 7 - 10 days of treatment . Complete improvement was considered a reduction in pain of more than 5 points on the analog visual scale ; partial improvement was considered a reduction of 3 - 5 points , and treatment failure was recorded when there was no improvement in pain or when there was a decrease of less than 3 points . RESULTS A total of 48 patients were included ; 33 ( 69 % ) were women and 15 ( 31 % ) were men . Mean age was 61 years . In group A , complete improvement was seen in 19 patients and partial improvement in 3 ; treatment failed in 2 patients . In group B complete improvement was seen in 5 patients , partial improvement in 5 , and failure of treatment in 14 . The difference between groups was statistically significant . Adverse events were mild pain at the injection site in 4 patients from group A , and headache in 15 patients from group B , 8 of whom ab and oned treatment for this reason . CONCLUSION Treatment with NTG is not a clear alternative to infiltration of corticosteroids in patients with RCT , because of its lack of effectiveness and because of the greater number of patients who had adverse events that lead them to ab and on treatment
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 .