Management of tennis elbow with topical glyceryl trinitrate

Özden, Raif; Uruç, Vedat; Doğramacı, Yunus; Kalacı, Aydıner; Yengil, Erhan

doi:10.3944/aott.2014.3123

Cited by 12 publications

(9 citation statements)

References 7 publications

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“…In a recent study by Ozden et al ,34 compared with baseline, both treatment and placebo groups had significant decreases in their pain VAS scores at both follow-up stages. The treatment group had significantly lower pain VAS scores compared with the placebo group at both 3 weeks and 6 months.…”

Section: Resultsmentioning

confidence: 89%

Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

et al. 2018

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ObjectiveTo produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.DesignA systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.Data sourcesMEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.MethodsWe examined RCTs comparing the effects of topical GTN with either placebo or other treatments on tendinopathy. Overall quality of each eligible study was determined based on a combined assessment of internal validity, external validity and precision. The level of evidence for each assessed parameter was rated based on the system by van Tulder et al.ResultsA total of 10 eligible RCTs were identified including patients with tendinopathy of the rotator cuff (n=4), wrist extensors (n=3), Achilles (n=2) and patellar (n=1) tendons. 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 relevanceTreatment 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.

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Section: Resultsmentioning

confidence: 89%

Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

et al. 2018

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“…Often called the “tennis elbow,” lateral epicondylosis is a common painful condition that affects the tendons joining the forearm muscles on the outside of the elbow [ 146 ]. Common non-surgical treatment of lateral epicondylosis includes, but not is limited to, physiotherapy [ 147 ], injections of corticosteroid [ 148 ], extracorporeal shock wave therapy [ 149 ], acupuncture [ 150 ], topical glyceryl trinitrate [ 151 ], botulinum toxin [ 152 ], and platelet-rich plasma [ 153 ]. Regarding the cell therapy for lateral epicondylosis, it was surprising that only a handful of studies had been conducted to date.…”

Section: Type Of Msds Targetedmentioning

confidence: 99%

ADSC-Based Cell Therapies for Musculoskeletal Disorders: A Review of Recent Clinical Trials

Lee

Chae

Song

et al. 2021

IJMS

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Recently published clinical trials involving the use of adipose-derived stem cells (ADSCs) indicated that approximately one-third of the studies were conducted on musculoskeletal disorders (MSD). MSD refers to a wide range of degenerative conditions of joints, bones, and muscles, and these conditions are the most common causes of chronic disability worldwide, being a major burden to the society. Conventional treatment modalities for MSD are not sufficient to correct the underlying structural abnormalities. Hence, ADSC-based cell therapies are being tested as a form of alternative, yet more effective, therapies in the management of MSDs. Therefore, in this review, MSDs subjected to the ADSC-based therapy were further categorized as arthritis, craniomaxillofacial defects, tendon/ligament related disorders, and spine disorders, and their brief characterization as well as the corresponding conventional therapeutic approaches with possible mechanisms with which ADSCs produce regenerative effects in disease-specific microenvironments were discussed to provide an overview of under which circumstances and on what bases the ADSC-based cell therapy was implemented. Providing an overview of the current status of ADSC-based cell therapy on MSDs can help to develop better and optimized strategies of ADSC-based therapeutics for MSDs as well as help to find novel clinical applications of ADSCs in the near future.

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“…One study was high risk of selection bias [12] and one study had unclear selection bias [13]. Performance bias was low in three studies [10,11,14] and high in one study [12].…”

Section: Authorsmentioning

confidence: 96%

“…Using the Cochrane Risk of Bias tool, two studies were found to be at low risk of selection bias [ 10 , 11 ]. One study was high risk of selection bias [ 12 ] and one study had unclear selection bias [ 13 ]. Performance bias was low in three studies [ 10 , 11 , 14 ] and high in one study [ 12 ].…”

Section: Reviewmentioning

confidence: 99%

Management of Lateral Epicondylitis Using Transdermal Nitroglycerin: A Systematic Review

McCulloch¹,

Hunter²,

Lipp³

et al. 2022

Cureus

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Lateral epicondylitis (LE), also known as tennis elbow, is an overuse tendinopathy originating from the forearm extensor tendons of the elbow. An emerging therapy for the treatment of LE is the use of transdermal nitroglycerin (NTG) patches for pain relief and improved function. The aim of this systematic review was to assess the current literature on the effect of a transdermal NTG patch for the treatment of LE. A literature search using MEDLINE, EMBASE, SportDiscus, and the Cochrane Database of Systematic Reviews was conducted. Studies selected for inclusion were those in which patients were clinically diagnosed with LE, RCTs, observational studies, and only articles published in English. Studies were excluded if they involved patients <18 years of age or involved patients with a potential alternative source of elbow pain such as previous surgery to the elbow, a previous history of dislocation, fracture of the elbow or tendon rupture, or a referred pain source such as cervical radiculopathy or peripheral nerve involvement. Studies were also excluded if they involved patients who were already prescribed topical NTG for any other indication (i.e., angina), and if the studies had no measurement of symptom relief or measurement or functional scoring. The initial search strategy yielded 69 articles, out of which four met the eligibility criteria and were included in this systematic review. The studies showed improvement in elbow pain in the shortterm and mid-term (up to six months), while one study that followed participants for a five-year duration post-treatment, showed no benefit. Three studies used an effective NTG dose of 1.25mg/24h and one study used an effective dose of 1.44mg/24h. Topical NTG was more effective when combined with a tendon rehabilitation program. The most commonly reported side effects of topical NTG were headaches and dermatitis. Overall, the current literature demonstrates that the use of NTG patches for LE improves shortand mid-term pain as well as elbow function. However, more studies are required to fully understand the effect of topical NTG on LE, particularly the effective dose range and the long-term benefits.

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Management of tennis elbow with topical glyceryl trinitrate

Abstract: The administration of NO directly over an area of tendinopathy through a GTN patch reduces pain and other symptoms in chronic LE.

Cited by 12 publications

References 7 publications

Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

Topical glyceryl trinitrate for the treatment of tendinopathies: a systematic review

ADSC-Based Cell Therapies for Musculoskeletal Disorders: A Review of Recent Clinical Trials

Management of Lateral Epicondylitis Using Transdermal Nitroglycerin: A Systematic Review

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