Iontophoresis with or without dexamethazone in the treatment of acute Achilles tendon pain

Abstract

The purpose of this double‐blind study was to evaluate the effects of iontophoresis with dexamethazone to iontophoresis with saline solution on patients who had acute (less than 3 months) pain from the Achilles tendon, in terms of range of motion, muscular endurance, pain and symptoms. Twenty‐five patients (15 men and 10 women), aged between 18 and 76 years (mean = 38), were evaluated before and after 2 weeks of treatment with iontophoresis, as well as after 6 weeks, 3 and 6 months and 1 year. Two groups were treated for 2 weeks with iontophoresis for each treatment. Three ml of dexamethazone were used for the experiment group (n = 14) and 3 ml of saline solution for the control group (n = 11). Both groups then followed the same rehabilitation programme for 10 weeks. Good reliability was found for the toe‐raise and range of motion tests. Poor reliability was, however, found for the pain on palpation test, which was therefore excluded. No difference was found between or within groups for the toe‐raise test. Several significant improvements were seen in the experiment group but not in the control group, in the range of motion test, pain during and after physical activity, pain during walking and walking up and down stairs, morning stiffness and tendon swelling. Even though the small sample size limits the possibilities to draw definite conclusions, we conclude from the present study, using a double‐blind, randomised approach and a 1‐year follow‐up period, that positive effects from using iontophoresis with dexamethazone were found in the treatment of patients with acute Achilles tendon pain.

Achilles Pain, Stiffness, and Muscle Power Deficits: Achilles Tendinitis

“…Both groups noted improvements in Achilles tendon pain during activity over the course of the study. 92 While the majority of differences between groups were observed at the 6-month assessment interval and iontophoresis was only administered 4 sessions at the beginning of the study, the strength of the inherent design suggests iontophoresis with dexamethasone is of benefit for patients with Achilles tendinopathy. Additional studies incorporating the use of iontophoresis are warranted.…”

Efficacy of betamethasone valerate medicated plaster on painful chronic elbow tendinopathy: a double-blind, randomized, placebo-controlled trial

“…Therefore, the lack of long-term benefit from corticosteroid therapy may have more to do with the delivery method than the medication. Several studies have investigated the use of topically-applied steroids for tendon pain treatment [18][19][20] , and directly comparing the effect of topically-applied corticosteroids with that of corticosteroid injections has demonstrated a significantly better outcome for patients treated with corticosteroid iontophoresis in the short-term and a statistically significant improvement in pain at the end of therapy, compared with injected corticosteroids 21 . A ready-to-use, self-adhering occlusive medicated plaster containing 2.25 mg of betamethasone 17-valerate (BMV, 0.1%) is currently marketed in several EU countries for the treatment of corticosteroid-responsive dermatoses (Betesil ® ; IBSA) 22 .…”

The Physical Therapist as a Musculoskeletal Specialist in the Emergency Department

“…This is particularly true during the early stages of the healing process. Various studies support the use of modalities commonly used by physical therapists, such as electrical stimulation, 9,45,62,72 for the purpose of managing acute pain and inflammation. Proper education on the use of cryotherapy for self-management of acute injuries has also been shown to be of benefit for increasing return to function.…”