The pain of tendinopathy: physiological or pathophysiological?

Rio, Ebonie, Moseley, Lorimer, Purdam, Craig, Samiric, Tom, Kidgell, Dawson, Pearce, Alan J., Jaberzadeh, Shapour and Cook, Jill 2014, The pain of tendinopathy: physiological or pathophysiological?, Sports medicine, vol. 44, no. 1, pp. 9-23.

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Title The pain of tendinopathy: physiological or pathophysiological?
Author(s) Rio, Ebonie
Moseley, Lorimer
Purdam, Craig
Samiric, Tom
Kidgell, Dawson
Pearce, Alan J.
Jaberzadeh, Shapour
Cook, Jill
Journal name Sports medicine
Volume number 44
Issue number 1
Start page 9
End page 23
Total pages 15
Publisher Adis International
Place of publication Aukland, New Zealand
Publication date 2014
ISSN 0112-1642
Keyword(s) tendon pain
tissue disruption
painless tendons
nociception modulation
load and threat monitoring
Summary Tendon pain remains an enigma. Many clinical features are consistent with tissue disruption—the pain is localised, persistent and specifically associated with tendon loading, whereas others are not—investigations do not always match symptoms and painless tendons can be catastrophically degenerated. As such, the question ‘what causes a tendon to be painful?’ remains unanswered. 

Without a proper understanding of the mechanism behind tendon pain, it is no surprise that treatments are often ineffective. Tendon pain certainly serves to protect the area—this is a defining characteristic of pain—and there is often a plausible nociceptive contributor. However, the problem of tendon pain is that the relation between pain and evidence of tissue disruption is variable. The investigation into mechanisms for tendon pain should extend beyond local tissue changes and include peripheral and central mechanisms of nociception modulation. 

This review integrates recent discoveries in diverse fields such as histology, physiology and neuroscience with clinical insight to present a current state of the art in tendon pain. New hypotheses for this condition are proposed, which focus on the potential role of tenocytes, mechanosensitive and chemosensitive receptors, the role of ion channels in nociception and pain and central mechanisms associated with load and threat monitoring.
Language eng
Field of Research 110903 Central Nervous System
Socio Economic Objective 970111 Expanding Knowledge in the Medical and Health Sciences
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2013, Springer
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Document type: Journal Article
Collections: School of Psychology
School of Exercise and Nutrition Sciences
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