Ross Hauser, MD, Danielle Matias, PA-C, Demi Foster, APRN
You do not have to be a scientist to understand this research. Ibuprofen does not help tendinosis.
This research came from the University of Copenhagen and was published in the Journal of Applied Physiology in November 2017 (1).
Highlights of research
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to treat tendinopathy, but evidence for this treatment is lacking, and little is known regarding the effects of NSAIDs on the human tendinopathic tendon.
- This study investigated the effects of NSAID treatment (ibuprofen) on the human tendinopathic tendon, with changes in gene expression (generally: Gene expression is your cells talking to each other or signaling each other that they need to heal something) as the primary outcome, and tendon pain, function, and blood flow as secondary outcomes.
- Noteworthy of this research: “Nonsteroidal anti-inflammatory drugs are widely used in the treatment of tendinopathy, but little is known of the effects of these drugs on tendon tissue. We find that one week of ibuprofen treatment has no effect on gene expression of collagen and related growth factors in an adult human tendinopathic tendon in vivo . . . suggesting that tendinopathic cells are not responsive to ibuprofen.”
A February 2021 study in the journal Arthroscopy, Sports Medicine, and Rehabilitation (2) assessed whether patients who are prescribed ibuprofen after arthroscopic rotator cuff repair have significantly different patient-reported outcomes for pain, function, and overall health at baseline and 1 and 2 years after operation relative to patients only prescribed opioids.
- This study consisted of 463 patients who underwent arthroscopic rotator cuff repair, and patients were divided into 2 groups.
- There were 281 patients who did not receive ibuprofen/NSAID after the operation in Group I and 182 patients who did receive ibuprofen in Group II.
- Conclusion: “There were no significant differences in patient-reported outcomes for all metrics between the group prescribed ibuprofen and the group that was not prescribed ibuprofen at 1 and 2 years after surgery or in change from baseline.” The ibuprofen group and the non-ibuprofen group had the same patient-reported outcome measures assessing shoulder pain, function, and overall health.
A main reason for the lack of effectiveness in many following rotator cuff repair is outlined in a 2019 paper published in the journal Archives of Orthopaedic and Trauma Surgery. (3) “A higher degree of acute postoperative pain should be expected in patients undergoing arthroscopic rotator cuff tear repair compared to other arthroscopic shoulder procedures, and additional pain treatment is recommended.
Prolotherapy injections for rotator cuff tears and rotator cuff tendinopathy
References
1 Heinemeier KM, Øhlenschlæger TF, Mikkelsen UR, Sønder F, Schjerling P, Svensson RB, Kjaer M. Effects of anti-inflammatory (NSAID) treatment on human tendinopathic tissue. Journal of Applied Physiology. 2017 Aug 31;123(5):1397-405. [Google Scholar]
2 Kraus NR, Garvey KD, Higgins LD, Matzkin E. Ibuprofen use did not affect outcome metrics after arthroscopic rotator cuff repair. Arthroscopy, Sports Medicine, and Rehabilitation. 2021 Apr 1;3(2):e491-7. [Google Scholar]
3 Calvo E, Torres MD, Morcillo D, Leal V. Rotator cuff repair is more painful than other arthroscopic shoulder procedures. Archives of orthopaedic and trauma surgery. 2019 May 1;139:669-74. [Google Scholar]