According to the findings of new research, use of platelet injections to treat Achilles’ tendon dysfunction does not appear to improve pain or function any better than a placebo.
Achilles’ tendinopathy is a condition that causes pain, swelling, and stiffness of the Achilles tendon that connects the heel bone to the calf muscle. It is thought to be caused by repeated injuries to the Achilles tendon from overuse or other causes. For most people symptoms clear within three to six months after beginning treatment, which include rest, ice, tendon exercises and orthotics.
While prior research has suggested platelet injections may help improve function and reduce pain in people who have tendonitis conditions, including the elbow and Achilles, a study published this month in the Journal of the American Medical Association (JAMA) indicates individuals who received the platelet-rich plasma injections experienced similar pain, function and activity as patients who had placebo injections.
In the study, researchers from the U.K. conducted a randomized clinical trial including 240 participants from 24 clinical sites who experienced pain at the mid-portion of the Achilles tendon lasting longer than three months. Patients were treated with a single injection of platelet-rich plasma or to a dry needle injection used as a placebo. Injections occurred between April 2016 to February 2020.
Throughout the study, patients were asked to rate their pain using the Victorian Institute of Sport Assessment-Achilles (VISA-A) score. The score range is 0, for worst symptoms, to 100, for no symptoms. The VISA-A score was measured 6 months after treatment and the assessment contains eight questions that cover pain, function and activity.
While the injections are purported to help reduce the need for painkillers and anti-inflammatories while helping with mobility, researchers found that individuals who had the platelet injection in the Achilles tendon had similar VISA-A scores as patients who had the placebo injection. Patients who had the platelet injection had a VISA-A score of 54.4 while patients who had the placebo injection had scores of 53.4 There was no statistically significant difference between the two scores.
“Among patients with chronic midportion Achilles’ tendinopathy, treatment with a single injection of intratendinous platelet-rich plasma, compared with insertion of a subcutaneous dry needle, did not reduce Achilles’ tendon dysfunction at 6 months,” wrote study authors. “These findings do not support the use of this treatment for chronic midportion Achilles’ tendinopathy.”
The most common side effect of the platelet injections experienced by patients was injection site discomfort, swelling, and bruising.
Researchers found no clinical benefit to receiving platelet-rich plasma injections used as a treatment for chronic mid portion Achilles’ tendinopathy when compared to a placebo. Both groups of patients experienced similar levels of pain, function and activity after receiving the injections and did not significantly improve Achilles’ tendon dysfunction.