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 .
Topical Nitric Oxide Application in the Treatment of Chronic Extensor Tendinosis at the Elbow
Background : Extensor tendinosis ( “ tennis elbow ” ) is a degenerative overuse tendinopathy of the wrist extensors at their attachment to the lateral humeral epicondyle . No treatment has been universally successful . Topical application of nitric oxide has been used effectively to treat fractures and cutaneous wounds in animal models , presumably by stimulation of collagen synthesis in fibroblasts . Purpose : To determine whether topical nitric oxide can improve outcome of patients with extensor tendinosis . Study Design : Prospect i ve , r and omized , double-blinded clinical trial . Methods : Eighty-six patients with extensor tendinosis were r and omized into two equal groups ; both were instructed to perform a st and ard tendon rehabilitation program . One group received an active glyceryl trinitrate transdermal patch , and the other group received a placebo patch . Results : Patients in the glyceryl trinitrate group had significantly reduced elbow pain with activity at 2 weeks , reduced epicondylar tenderness at 6 and 12 weeks , and an increase in wrist extensor mean peak force and total work at 24 weeks . At 6 months , 81 % of treated patients were asymptomatic during activities of daily living , compared with 60 % of patients who had tendon rehabilitation alone . Conclusions : Application of topical nitric oxide improved early pain with activity , late functional measures , and outcomes of patients with extensor tendinosis
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 .