Polidocanol (aethoxysclerol 0.5%) is a medication typically used for the treatment of varicose veins. More recently, it has also been used in the treatment of tendon problems (tendinosis), as well as surrounding tendon inflammation, known as tenosynovitis. Though not well understood, in an attempt to heal the body of the tendinosis, new blood vessels and nerves grow into a diseased tendon, producing pain. Targeting these new blood vessels with polidocanol often results in relief of symptoms.
Ultrasound follow up of patients following a polidocanol injection into a tendon usually demonstrates an improved appearance of the tendon as well as decreased blood flow. This correlates well with improvement of the patient’s symptoms.Polidocanol injections are routinely used as a second line method of treating tendon pain at Melbourne Radiology Clinic.
As for an autologous blood or platelet rich plasma injection, polidocanol may be used to treat any painful tendon and is performed under ultrasound guidance to accurately and safely deliver the medication in the area of abnormality. Patients will require a test to confirm that the tendon is the source of their pain, usually with either an MRI and/or ultrasound scan.
This information is for patients who have undergone a polidocanol (aethoxysclerol) injection at Melbourne Radiology Clinic.
Following this procedure, please be advised of the following recommendations:
- Refrain from any significant activity involving the body part for ONE WEEK.
Necessary activities of daily living are permissible, but do not engage in any deliberate exercise, such as running, weight training or other sporting pursuits.
- Some discomfort may occur following the procedure. If this occurs, paracetamol and a cool compress may help.
If the pain is severe, anti-inflammatory medications are particularly helpful. This pain flare is usually most prominent in the first three days following the procedure and slowly decreases. If you are concerned, please call our clinic on 9667 1667 to discuss your specific situation and our doctor is only too happy to discuss this with you further.
- After the first week, you are advised to commence a three week program of rehabilitation under the supervision of a physiotherapist, concentrating on stretching and eccentric exercises. You may already have a physiotherapist that has assisted you in the past. If not, we can recommend one to you. The intensity of the rehabilitation program is gradually increased over the three weeks, being very gradual at the start and depends on your progress and pain. This is at the discretion of your physiotherapist.
- At this point, it will be four weeks following the injection (1 week rest followed by three weeks of a graduated exercise program).
- If you have no more pain, then no further action is required.
- If your pain has decreased but pain remains, then a second injection is recommended.
- If you have had NO benefit, a repeat injection is recommended. There are many patients that only respond after a second injection.
- If a second injection is performed, then the rehabilitation program as for the first injection is repeated. If you have had relief at this point but pain persists, then a further injection may be performed. If you have had no benefit after this, then you are unlikely to respond to a repeat injection. A different type of injection however may provide you benefit, such as an autologous blood or platelet rich plasma injection. The doctor at Melbourne Radiology Clinic is available to discuss other radiologically guided procedures to treat your condition should you wish to pursue further treatment.
The radiologist conducting the injection will send your referring doctor a report.
- Please ensure that you make a follow up appointment with your referring doctor or health care provider to discuss your results.
- Please bring to the clinic, any prior scans (eg. X-rays, ultrasounds, MRI, CT) and reports as these will assist the radiologist in assessing your condition.
- If you have any further queries please call Melbourne Radiology Clinic on (03) 9667 1667 – we are only too happy to help.
- Please note that any referral for a scan is valid at Melbourne Radiology Clinic, even if it has been written on a referral form from another radiology provider.
Whilst every effort is made to keep your appointment time, the special needs of complex cases, elderly and frail patients can cause unexpected delays. Your consideration and patience in these circumstances is appreciated.