Tendon is a tough band of fibrous connective tissue that usually connects muscle to bone. It is responsible to transmit muscle force to the bone. A healthy tendon is up to twice as strong as the muscle, making the body of the tendon unlikely to tear before the muscle unless the tendon has already been weakened by degenerative changes. The effects of ageing, wear and tear, genetic pre-disposition and inflammation are known factors contributing to tendon injuries. Injured tendon can cause pain, loss of limb function and prevent exercise and activities of daily living. Injured tendons heal by fibrotic repair and are highly prone to re-injury.
Tendons consist of collagens, proteoglycans, glycoproteins, water and cells. It takes over 100 days to make new collagen.
The healing time for injured tendon varies. Tendon healing can be largely divided into 3 overlapping phases, inflammatory, repairing and remodelling phases: The initial inflammatory phase lasts about 24 hours. During this time erythrocytes, platelets and inflammatory cells migrate to the wound site, recruit tendon blast cell and clean the site of dead tissues and then initiate new collagen synthesis and deposition. After a few days of injury the repairing phase begins. Tendon fibroblast synthesise abundant collegan and other extra cellular matrix components. After 6 weelsthe remodelling phase starts. This phase is characterised by decreased cellularity and decreased collagen and glycosaminoglycan synthesis. During this period, the repair tissue changes to fibrous tissue, this again changes to scar like tendon tissue after 10 weeks. After 10 weeks remodelling continues
Treatment at an early stage can be as brief as 6–10 weeks. Once it becomes chronic the treatment can take 3–6 months. The effective treatment might take 9 months or longer when it is chronic. Knowing these timelines is part of creating an effective treatment plan.
Acupuncture helps release the pain. Acupuncture helps with tendon injury
Acupuncture is used to treat tendon injury and it improves pain and functional activity in patients with tendinopathy. This is suggested that acupuncture can modulate both anti-inflammatory and mechanotransduction molecular pathways which can increase type I collagen synthesis. Collagen synthesis is the main factor that influences tendon biomechanical properties. Therefore one reason of acupuncture for tendon healing is that acupuncture increases synthesis and subsequent reorganisation of type I collagen during tendon healing process.
Chronic pain is pain that lasts more than three months. It’s a very common problem. Results from the 2012 National Health Interview Survey show that:
About 25.3 million U.S. adults (11.2 percent) had pain every day for the previous 3 months.
Nearly 40 million adults (17.6 percent) had severe pain.
Individuals with severe pain had worse health, used more health care, and had more disability than those with less severe pain.
Acupuncture is a top choice for chronic pain management according to NIH.
Clinical investigators have found that chronic pain patients often have lower-than-normal levels of endorphins in their spinal fluid. Acupuncture activates endorphin systems and increases levels of endorphins in cerebrospinal fluid.
Almeida Mdos S et al Acupunct Med (2014) 32:178-82