title: Clinical benefits and drawbacks of local corticosteroids injections in tendinopathies.
abstract: local glucocorticoids injections are widely administered for the treatment of tendinopathies. positive results have been observed in some tendinopathies but not in others. moreover, worsening of symptoms, and even spontaneous tendon ruptures has been reported. the characteristics of the tendinopathies, the clinical peculiarities of the patient, and the technique used to administer glucocorticoids, can influence the therapeutic response. Areas covered: After reviewing the pertinent literature on the clinical results, basic information, both on the pathogenesis of tendinopathies and the effects of glucocorticoids on tendons, is reported. The pharmacological properties of glucocorticoids are useful to counteract some pathogenetic mechanisms of tendinopathies. However, several experimental studies suggest that the direct action of glucocorticoids on tendons is detrimental. Loss of collagen organization, impaired viability of fibroblasts, depletion of stem cells pool, and reduced mechanical properties have been observed. Expert opinion: Drawbacks of local glucocorticoids injections could be predicted on an individual basis, after a careful appraisal of patient characteristics and concomitant medications, along with the specific stage of tendon disease.
authors.affiliation: a Department of Medicine and Science of Aging , University G. d'Annunzio, Chieti-Pescara , Chieti Scalo , Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Abate
authors.affiliation: a Department of Medicine and Science of Aging , University G. d'Annunzio, Chieti-Pescara , Chieti Scalo , Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Salini
authors.affiliation: a Department of Medicine and Science of Aging , University G. d'Annunzio, Chieti-Pescara , Chieti Scalo , Italy.
authors.forename: Cosima
authors.initials: C
authors.lastname: Schiavone
authors.affiliation: b BioCruces Health Research Institute , Cruces University Hospital , Barakaldo , Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Andia
mesh_terms: D000818:Animals; D003094:Collagen / Q000378:metabolism; D005347:Fibroblasts / Q000378:metabolism; D005938:Glucocorticoids / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D007267:Injections; D013234:Stem Cells / Q000378:metabolism; D052256:Tendinopathy / Q000188:drug therapy* / Q000473:pathology
chemical_list: D005938:Glucocorticoids; D003094:Collagen
keywords: Ankle; elbow; foot; glucocorticoids; knee; shoulder; tendons; ultrasonography; wrist