The use of therapeutic medications for soft-tissue injuries in sports medicine.
The use of non-steroidal anti-inflammatory drugs (NSAIDs) to treat most muscle, ligament and tendon injuries should be reassessed. They have, at best, a mild effect on relieving symptoms and are potentially deleterious to tissue healing. Soft-tissue injury associated with definite inflammatory conditions such as bursitis or synovitis or involving nerve impingement does warrant short-term treatment with NSAIDs. Paracetamol has similar efficacy to NSAIDs in soft-tissue injury, is cheaper, and has a lower side-effect profile. It is the analgesic of choice for most soft-tissue injury. Cyclo-oxygenase-2 (COX-2) inhibitors should not be used to treat soft-tissue injuries unless impingement is a major feature and non-selective NSAIDs are contraindicated (eg, coexisting gastric disorder), and the patient is not at cardiovascular risk. Corticosteroid injections for tendon injuries may achieve a mild to moderate reduction in pain for up to 6 weeks. However, they do not promote tendon healing, so should generally be used only when healing is not a critical goal. Promising new therapeutic treatments for soft-tissue injuries include topical glyceryl trinitrate, aprotinin injections, and prolotherapy.
Paoloni
Justin A
JA
University of New South Wales, Sydney. pao_26@hotmail.com
Orchard
John W
JW
D000082:Acetaminophen / Q000627:therapeutic use; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D007611:Aprotinin / Q000627:therapeutic use; D001265:Athletic Injuries / Q000188:drug therapy*; D001905:Botulinum Toxins / Q000627:therapeutic use; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use; D005944:Glucosamine / Q000627:therapeutic use; D006801:Humans; D008022:Ligaments / Q000293:injuries; D018482:Muscle, Skeletal / Q000293:injuries; D005996:Nitroglycerin / Q000627:therapeutic use; D012597:Sclerosing Solutions / Q000627:therapeutic use; D015842:Serine Proteinase Inhibitors / Q000627:therapeutic use; D017695:Soft Tissue Injuries / Q000188:drug therapy*; D013178:Sports Medicine / Q000295:instrumentation* / Q000379:methods*; D013708:Tendon Injuries / Q000188:drug therapy; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D018712:Analgesics, Non-Narcotic; D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D012597:Sclerosing Solutions; D015842:Serine Proteinase Inhibitors; D014665:Vasodilator Agents; D000082:Acetaminophen; D007611:Aprotinin; D001905:Botulinum Toxins; D005996:Nitroglycerin; D005944:Glucosamine