Here at my clinic that provides acupuncture in Mesa, AZ people often ask are cortisone injections bad for you?  And then the next question people ask is does acupuncture help tendonitis?   Many of my patients seek acupuncture  for tendonitis of the shoulder, elbow, wrist and knee.  Many have received cortisone injections but few understand the long term side effects of these injections.

Cortisone injections are a treatment option in biomedicine practices for pain due to tendon issues.  They can provide relief when rest, ice and non-steroidal anti-inflammatory drugs (NASAIDS) are ineffective.  They have become very popular because they can provide rapid pain relief that can last for several months.  However, this quick fix comes at a cost.

A review of approximately 48 trials published in the October 2010 medical journal The Lancet showed that patients who received cortisone injections for tennis elbow pain experienced a much lower rate of full recovery and had a higher chance of re-injury after 6-12 months.  Patients who received an average of 4 injections had an even worse outcome than patients who only received one injection.

Most tendon issues are not caused by inflammation but by a weakening and fraying of the tendon fibers due to over use, aging or diabetes. Cortisone works by interrupting neural pain receptors near the tendon so that pain is not felt.  Cortisone injections do not repair damaged tendons and at high amounts they actually prevent the production of new tendon fibers. This is why injections are not given to the same area more frequently than every 3-4 weeks and why it is recommended that patients receive a maximum of 3 injections per year into the same area. It is also not recommended that patients participate in sports that stress the area for 2 weeks after receiving a cortisone injection.

People often ask if acupuncture is effective for tendonitis.  Acupuncture not only alleviates the pain of tendon injuries but also plays an important role in healing tendons. Acupuncture increases blood and oxygen circulation to promote tendon healing.  This increased circulation also prevents age related tendon thinning and fraying. A study published in the 2015 Journal of Biological Chemistry showed that electro acupuncture actually increases collagen production and realigns the tendon fibers which leads to stronger tendons that are less vulnerable to re-injury.

Cortisone injections should be considered thoughtfully. For those of you who are struggling with tendonitis or pain due to other tendon injuries a course of acupuncture treatments can provide pain relief and strengthen the tendons to prevent re-injury.

In order to get the best results from your acupuncture treatments and insure a complete healing of your tendon injury it is important to follow all of the recommendations given to you by your practitioner and to complete your treatment plan.

Wishing you continued good health,

Dr. Denise Jenderzak

480-832-0966

References

Coombes, B. K., Bisset, L., & Vicenzino, B. (2010). Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. The Lancet, 376(9754), 1751–1767. https://doi.org/10.1016/s0140-6736(10)61160-9

Panwar, P., Lamour, G., Mackenzie, N. C., Yang, H., Ko, F., Li, H., & Brömme, D. (2015). Changes in Structural-Mechanical Properties and Degradability of Collagen during Aging-associated Modifications. Journal of Biological Chemistry, 290(38), 23291-23306. doi:10.1074/jbc.m115.644310