Format

Send to

Choose Destination
Br J Sports Med. 2019 Feb;53(4):251-262. doi: 10.1136/bjsports-2018-099552. Epub 2018 Oct 9.

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

Author information

1
Institute of Infection, Immunity and Inflammation, College of Medicine, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
2
School of Physiotherapy, Royal College of Surgeons in Ireland, Dublin, Ireland.
3
Physiotherapy Department, Connolly Hospital, Dublin, Ireland.
4
Physiotherapy Department, West Glasgow Acute Care Hospital, Glasgow, UK.

Abstract

OBJECTIVE:

To produce a best evidence synthesis of the clinical effects of topical glyceryl trinitrate (GTN) in the treatment of tendinopathies.

DESIGN:

A systematic review of published randomised controlled trials (RCTs) of the use of GTN in patients with tendinopathy.

DATA SOURCES:

MEDLINE, Embase, Scopus and CINAHL from database inception to January 2018.

METHODS:

We 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.

RESULTS:

A 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 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.

KEYWORDS:

overuse injury; tendinopathy; tendinosis; tendon; treatment

PMID:
30301735
PMCID:
PMC6362607
DOI:
10.1136/bjsports-2018-099552
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for HighWire Icon for PubMed Central
Loading ...
Support Center