24/01/2024
We at NSIC have decided to try to put up some interesting and informative topics for those who like to read. Hopefully we’ll get into a bit of weekly habit, so if you have something you’d like to know more about, send in some ideas and we’ll get to work!
This is something that I personally find interesting (and therefore put Chloe to work on, so thanks to Chloe for putting this together…..
Tendinitis vs tendinosis vs tendinopathy
Why does the medical profession keep changing the names of conditions and are they actually different things?
In this case, scientists who have dedicated their lives to studying the minutiae of tendon structure have improved our understanding of what we once thought was an inflammatory condition and thus an “itis” to an “opathy” as in pathology of. So really just a more accurate description of the process.
Here is a more detailed bit of interesting information for anyone who may be interested!
An article by Alex Scott et al, discussed the change of clinical terminology for what is now known as Tendinopathy.
In the late 1990's Maffulli et al advocated for a shift in clinical terminology from tendinitis to tendinopathy. Previously both terms were being used as a generic descriptor for pain and swelling to an injured tendon without specifically distinguishing the involvement of a tendon vs paratendon or if there was presence/absence of inflammation.
Tendinopathy has become the accepted term to describe a spectrum of changes that occur in a damaged tendon. Over the last 20 years new insights into tendon pathology or relevance to clinicians has led to the change of clinical terms. Better characterisations of the overuse injury process and the resultant structural and functional disruption in chronically painful tendons.
Improved understanding and greater knowledge of the pathomechanics associated with chronic tendon injury and the influence of lifestyle factors and drugs on tendon pathology.
Since the early 1990's inconsistencies with the use of describing a tendinopathy were found as it was common for tendons suffering from various painful presentations to be clinically diagnosed under tendinitis. Tendinitis is an outdated term underpinning the notion that patients presenting with such condition have a largely inflammatory based condition of the tendon.
Whereas tendinosis was previously used to describe chronic mid portion tendon pathology, however specific definitions varied. In some cases tendinosis is used by some preference to tendinitis to shift the focus away from inflammation
Literature demonstrates minimal and trivial evidence to support this view for the underlying pathophysiology and clinical presentation of common tendon conditions.
Newer evidence has indicated that inflammation does accompany and can cause the development of tendon overuse injury.
Physicians and therapists should acknowledge that insidious, overuse tendon conditions predominantly have a non-inflammatory based pathology. Hence, the refined term – tendinopathy – has recently been more readily accepted as a clinical hypothesis to more accurately depict the pathophysiology and clinical presentation.
The outcomes of all of this research translates to better managed injuries throughout the lifespan. With proper management injuries that were once considered “career ending” can now have favourable outcomes. This allows us to be active later into life.
