Local Anesthetic Injection Resolves Movement Pain, Motor Dysfunction, and Pain Catastrophizing in Individuals With Chronic Achilles Tendinopathy: A Nonrandomized Clinical Trial.
Ruth L Chimenti, Mederic M Hall, Connor P Dilger and 3 others
PMID 32349638WHAT IT FOUND
In chronic Achilles tendinopathy, a local anesthetic injection immediately reduced movement pain, improved heel-raise performance to control levels, and lowered pain catastrophizing, but fear of movement stayed elevated.
Key findings
01After the injection, movement-evoked pain decreased, although one participant had increased pain and two had partial relief.
02Heel-raise performance improved after injection to a level similar to controls.
03Pain catastrophizing fell to control levels immediately after injection, but scores were still higher than controls at 1 week, and kinesiophobia did not resolve.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The trial was nonrandomized; participants were not assigned by chance to the injection or control condition. There was no sham injection, and the authors noted that expectation of pain relief could influence the results. The study measured only immediate effects during a single laboratory session, not longer-term function or treatment response. Three participants with Achilles tendinopathy did not get enough movement pain relief from the injection, and the subgroup sensitivity analyses were small (n = 7 to 16). The reduction in pain catastrophizing was immediate; at 1 week the tendinopathy group still had higher scores than controls. The final number analysed is not stated in the supplied text.
The easy way to misread this
Do not conclude that a local anesthetic injection is a recommended treatment for Achilles tendinopathy or that it produces lasting change. The study measured immediate laboratory effects, was nonrandomized, had no sham injection, and pain catastrophizing was still higher than controls at 1 week.