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 Glyceryl Trinitrate Application in the Treatment of Chronic Supraspinatus Tendinopathy
Background Topical glyceryl trinitrate therapy has previously demonstrated short-term pain reduction in patients with supraspinatus tendinopathy . Hypothesis Topical glyceryl trinitrate improves outcome measures in patients with supraspinatus tendinopathy . Study Design R and omized controlled clinical trial ; Level of evidence , 1 . Methods Fifty-three patients ( 57 shoulders ) were recruited , and the authors completed a prospect i ve , r and omized , double-blinded , placebo-controlled clinical trial of continuous topical glyceryl trinitrate treatment ( 1.25 mg/24-h glyceryl trinitrate ) . Results The glyceryl trinitrate group had significantly reduced shoulder pain with activity , at night , and at rest at week 24 ( P = . 03 ) ; reduced internal rotation impingement at week 24 ( P = . 02 ) ; increased range of motion in abduction and internal rotation at week 24 ( P = . 04 ) ; and increased force at weeks 12 and 24 with supraspinatus muscle testing ( P = . 001 ) , external rotation ( P = . 04 ) , internal rotation ( P = . 01 ) , adduction ( P = . 04 ) , and subscapularis pushoff ( P = . 01 ) . Forty-six percent of patients on glyceryl trinitrate patches were asymptomatic with activities of daily living at 6 months compared with 24 % of patients with tendon rehabilitation alone ( P = . 007 , χ2 analysis ) . Mean effect size for all outcome measures was 0.26 . Discussion Topical glyceryl trinitrate treatment significantly improved pain scores , range of motion , internal rotation impingement , muscular force , and patient outcomes in patients with supraspinatus tendinopathy . Topical glyceryl trinitrate should be included as part of nonsurgical management of chronic tendinopathies
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 .