Tendinopathy: Same Disease Different Results—Why?

Tendinopathy is a diverse clinical syndrome which can involve any tendon and is associated with pain, swelling and decreased performance. Previous diagnostic terms such as tendinitis and tendinosis have fallen out of favor and are more suited to describing the histologic findings in tendinopathy. Despite tremendous interest in treating tendinopathy, many unanswered questions remain. This article addresses our current knowledge of tendinopathies from the host variation seen at the molecular level to the macroscopic lesions we are currently treating. Emphasis is placed on the results of percutaneous techniques, from injections to arthroscopy, to treat the disorder, which currently account for about an 80% success rate. While incremental improvements are being made, better randomized-controlled trials are needed moving forward to delineate the best treatment strategies for tendinopathy, particularly as they relate to pain sensitization and the placebo effect.