Sclerosing polidocanol injections of small vessels to treat the chronic painful tendon

Cardiovasc Hematol Agents Med Chem. 2007 Apr;5(2):97-100. doi: 10.2174/187152507780363232.


The chronic painful tendon (tendinopathy, tendinosis) is generally considered difficult to treat, not seldom causing long-term disability and sometimes ending the sports or work carreér. Most common sites for tendinopathy are the Achilles-, patellar-, extensor carpi radialis brevis (ERCB)-, and supraspinatus tendons. The origin of pain has for many years been unknown, but recently, by using ultrasound (US) + colour Doppler (CD), immunohistochemical analyses of tendon biopsies, and diagnostic injections of local anaestesia, we found a close relationship between areas with vasculo-neural ingrowth and tendon pain. Sensory nerves (Substance-P-SP and Calcitonin Gene Related Peptide-CGRP) were found inside and outside the vascular wall. In following clinical studies we have demonstrated good short-and mid-term clinical results using treatment with US+CD-guided sclerosing polidocanol injections, targeting the area with neovessels outside the tendon. Two-year follow ups have showed remaining good clinical results, and sonographically signs of remodelling with a significantly thinner tendon with a more normal structure. Whether the effects of polidocanol are mediated through destruction of neovessels, activity on nerves or a combination, is under evaluation.

Publication types

  • Review

MeSH terms

  • Humans
  • Neovascularization, Pathologic / drug therapy*
  • Pain / drug therapy*
  • Polidocanol
  • Polyethylene Glycols / therapeutic use*
  • Sclerosing Solutions / therapeutic use*
  • Tendons / blood supply*
  • Tendons / diagnostic imaging
  • Tendons / drug effects*
  • Ultrasonography, Doppler, Color


  • Sclerosing Solutions
  • Polidocanol
  • Polyethylene Glycols