The use of therapeutic medications for soft-tissue injuries in sports medicine

Med J Aust. 2005 Oct 3;183(7):384-8.

Abstract

The use of non-steroidal anti-inflammatory drugs (NSAIDs) to treat most muscle, ligament and tendon injuries should be reassessed. They have, at best, a mild effect on relieving symptoms and are potentially deleterious to tissue healing. Soft-tissue injury associated with definite inflammatory conditions such as bursitis or synovitis or involving nerve impingement does warrant short-term treatment with NSAIDs. Paracetamol has similar efficacy to NSAIDs in soft-tissue injury, is cheaper, and has a lower side-effect profile. It is the analgesic of choice for most soft-tissue injury. Cyclo-oxygenase-2 (COX-2) inhibitors should not be used to treat soft-tissue injuries unless impingement is a major feature and non-selective NSAIDs are contraindicated (eg, coexisting gastric disorder), and the patient is not at cardiovascular risk. Corticosteroid injections for tendon injuries may achieve a mild to moderate reduction in pain for up to 6 weeks. However, they do not promote tendon healing, so should generally be used only when healing is not a critical goal. Promising new therapeutic treatments for soft-tissue injuries include topical glyceryl trinitrate, aprotinin injections, and prolotherapy.

Publication types

  • Review

MeSH terms

  • Acetaminophen / therapeutic use
  • Adrenal Cortex Hormones / therapeutic use
  • Analgesics, Non-Narcotic / therapeutic use
  • Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
  • Aprotinin / therapeutic use
  • Athletic Injuries / drug therapy*
  • Botulinum Toxins / therapeutic use
  • Cyclooxygenase 2 Inhibitors / therapeutic use
  • Glucosamine / therapeutic use
  • Humans
  • Ligaments / injuries
  • Muscle, Skeletal / injuries
  • Nitroglycerin / therapeutic use
  • Sclerosing Solutions / therapeutic use
  • Serine Proteinase Inhibitors / therapeutic use
  • Soft Tissue Injuries / drug therapy*
  • Sports Medicine / instrumentation*
  • Sports Medicine / methods*
  • Tendon Injuries / drug therapy
  • Treatment Outcome
  • Vasodilator Agents / therapeutic use

Substances

  • Adrenal Cortex Hormones
  • Analgesics, Non-Narcotic
  • Anti-Inflammatory Agents, Non-Steroidal
  • Cyclooxygenase 2 Inhibitors
  • Sclerosing Solutions
  • Serine Proteinase Inhibitors
  • Vasodilator Agents
  • Acetaminophen
  • Aprotinin
  • Botulinum Toxins
  • Nitroglycerin
  • Glucosamine