Efficacy of Hyaluronic Acid Injections versus Steroid Injections on Painful Tendinopathies

Abstract

Background: Tendinopathies are manifested by pain, swelling, and limited mobility functions. Corticosteroid injections have been a mainstay in the treatment of tendinopathy, and are widely used despite the controversy regarding their usefulness and safety. The peri-tendinous administration of hyaluronic acid (HA) has shown promising results in the management of tendinopathy.

Objectives: The aim of the current study was to evaluate the efficacy of peri-tendinous injections of hyaluronic acid versus steroid injections on pain reduction in patients with painful tendinopathies.

Patients and methods: A prospective study, including a total of 90 patients with tendinopathy who were recruited from the Rheumatology and Rehabilitation Outpatient Clinic at Sohag University Hospital. Demographic data including age, disease duration, and tendon affected were evaluated. Patients were divided into three groups, each group contained 30 patients. First group received peritendinous steroid injection, second group received peritendinous hyaluronic acid injection, and the third group received both peritendinous hyaluronic acid and steroid injections. Groups were compared using in visual analogue scale, tenderness and range of motion after one week, one month and after 3 months from injection.

Results: Best improvement was seen in the group of combined hyaluronic acid and steroid; followed by the group of steroid injection alone, which showed early response better than hyaluronic acid alone.

Conclusion: Local injection for tendinopathies by combined hyaluronic acid and steroid gives significantly better and more long standing effect compared to either hyaluronic acid or steroid alone. On the other hand, monotherapy showed non-significant difference between steroid and hyaluronic acid.