Tendinopathy is a debilitating condition in athletic and sedentary populations for which a gold standard treatment strategy does not yet exist. While the pathophysiology of tendinopathy is well understood, a debate remains as to the nature of the pain mechanism in tendinopathy which makes treatment selection challenging. This clinical discussion presents evidence to suggest that acupuncture may have a role in the treatment of tendinopathy, through the facilitation of tendon blood flow and fibroblastic activity, making recommendations for further research.
ReesJD, MaffulliN, CookJ.Management of tendinopathy. Am J Sports Med2009;37:1855–67.
2.
AlfredsonH, CookJ.A new treatment algorithm for managing Achilles tendinopathy: new treatment options. Br J Sports Med2007;41:211–16.
3.
SharmaP, MaffulliN.Tendon injury and tendinopathy: healing & repair. J Bone Joint Su Br2005;87:187–96.
4.
MaffulliN, LongoUG. Conservative management of tendinopathy: is there enough scientific evidence. Rheumatology2008;47:390–1.
5.
ParamoreLC. Use of alternative therapies: Estimates from the 1994 Robert Wood Johnson Foundation National Access to Care Survey. J Pain Sympt Manage1997;13:83–89.
6.
AcharyaN, ChanR, CrispT, Achilles tendinopathy part 2: management of Achilles tendinopathy. Sportex Medicine2010;46:6–10.
7.
BradnamL.A proposed clinical reasoning model for western acupuncture. N Z J Physiother2003;31:40–5.
8.
CarlssonC.Acupuncture mechanisms for clinically relevant long-term effects: a reconsideration and hypothesis. Acupunct Med2002;43:82–9.
9.
JansenG, LundbergT, SamuelsonUE, Increased survival of ischaemic musculocutaneous flaps in rats after acupuncture. Acta Physiol Scand1989;135:555–8.
10.
KuboK, YajimaH, TakayamaM, Effects of acupuncture and heating on blood volume and oxygen saturation of human Achilles tendon in-vivo. Eur J Appl Physiol2010;109:545–50.
11.
LangevinHM, BouffardNA, ChurchillDL, Connective tissue fibroblast response to acupuncture: dose-dependent effect of bilateral needle rotation. J Altern Complement Med2007;13:355–60.
12.
LongoUG, RongaM, MaffulliN.Achilles tendinopathy. Sports Med Arthrosc2009;17:112–6.
13.
AndresBM, MurrellGC. Treatment of tendinopathy: what works, what does not and what is on the horizon. Clin Orthop2008;466:1539–54.
14.
CookJ, PurdhamCR. Is tendon pathology a continuum: a pathology based model to explain the clinical presentation of load induced tendinopathy. Br J Sports Med2009;2009:409–16.
15.
XuY, MurrellGC. The basic science of tendinopathy. Clin Orthop2008;466:1528–38.
16.
AlfredsonH.Where to now with Achilles tendon treatment. Br J Sports Med2011;45:386.
17.
MagraM, MaffulliN.Nonsteroidal anti-inflammatory drugs in tendinopathy: friend or foe. Clinical J Sports Med2006;16:1–3.
18.
PfeferMT, CooperSR, UhlNL. Chiropractic management of tendinopathy: A literature synthesis. J Manipulative Physiol Ther2009;32:41–52.
19.
TrinhKV, PhillipsSD, HoE, Acupuncture for the alleviation of lateral epicondyle pain: a systematic review. Rheum2002;43:1085–90.
MaffulliN, LongoUG, LoppiniM, Current treatment options for tendinopathy. Expert Opin Pharmacother2010;11:2177–86.
24.
JamesSL, AliK, PocockC, Ultrasound guided dry needling and autologous blood injection for patella tendinosis. Br J Sports Med2007;41:518–22.
25.
SandbergM, LundbergT, LindbergL, Effects of acupuncture on skin and muscle blood flow in health subjects. Eur J Appl Physiol2003;90:114–19.
26.
ShinbaraH, OkuboM, SumiyaE, Effects of manual acupuncture with sparrow pecking on muscle blood flow of normal and denervated hindlimb in rats. Acupunct Med2008;26:149–59.
27.
WardenSJ. Animal models for the study of tendinopathy. Br J Sports Med2007;41:232–40.
28.
LangevinHM, ChurchillD, CipollaMJ. Mechanical signalling through connective tissue: a mechanism for the therapeutic effect of acupuncture. Faseb J2001;15:2275–82.
