Today’s article “No Additive Clinical or Physiological Effects of Short-term Anti-inflammatory Treatment to Physical Rehabilitation in the Early Phase of Human Achilles Tendinopathy A Randomized Controlled Trial” by Malmgaard-Clausen et al is from Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.
Achilles tendinopathy can be a very debilitating injury that affects athletes. Runners are the most common athlete I see in my practice with Achilles pain. Based on previous research showing inflammation in the course of the disease, the authors set out to determine if a 1 week course of naproxen would affect short or long term clinical outcomes, tendon thickness, neovascularization or MRI findings.
The age of participants in the study reflects the typical patient at ~40 years old. All patients had symptoms for less than 3 months as the authors wanted to focus on early Achilles tendinopathy. Interestingly, they found that participants with symptoms < 1 month had an earlier response to rehab than participants with symptoms for > 2 months.
Takeaways from the study: There is no benefit to a 1-week course of 500 mg naproxen twice daily. It is unknown if a longer course would be beneficial. Neither rehab or naproxen resulted in a significant change to tendon thickness, neovascularization, or cross-sectional area of the tendon at 1 year. The course of tendinopathy is difficult with both study arms showing a significant decrease in physical activity at one year compared to baseline despite improvements in reported outcome measures. It may be beneficial for patients to begin treatment sooner as patients with symptom duration < 1 month showed significant improvements in Victorian Institute of Sports Assessment–Achilles score compared to those with symptoms > 2 months. This difference was not present at one year.
If you have pain in your Achilles or have had an Achilles injury, you can call to schedule an appointment with Dr. Villarreal.