Injection Around the Tendon Sheath
“Tendinopathy — commonly referred to as Tendinitis or Tendinosis — is one of the most frequently encountered tendon disorders. It is characterised by pain during activity, localised tenderness, and a reduced range of motion in the affected joint. This condition can affect tendons throughout the body, with common examples including shoulder tendinitis, Achilles tendinopathy, patellar tendinopathy, and Tennis Elbow. Chronic tendinopathy is not merely an inflammatory condition — it also involves tendon degeneration and abnormal repair processes that progressively weaken the tendon over time. ”

When Tendon Pain Becomes a Barrier to Daily Life

Many patients seek relief through rest, cold therapy, non-steroidal anti-inflammatory drugs (NSAIDs), or physiotherapy. However, for a significant number of patients, these approaches alone may not provide sufficient or lasting improvement. Today, a more precise and clinically proven technique is available: Peritendinous Injection under Ultrasound Guidance — the injection of therapeutic substances (such as anti-inflammatory agents, Platelet-Rich Plasma (PRP), Hyaluronic Acid, or Dextrose solution) into the paratenon — the tissue surrounding the tendon — rather than into the tendon itself.

Who is a Good Candidate for Peritendinous Injection?

  • Patients with peritendinitis (inflammation of the connective tissue surrounding the tendon)
  • Patients with tenosynovitis (inflammation of the tendon sheath)
  • Patients with chronic tendon degeneration (Tendinopathy/Tendinosis)
  • Patients with peritendinous adhesions (scar tissue formation around the tendon)
  • Patients with calcific tendinopathy (tendon inflammation associated with calcium deposits)

Treatment Duration and Procedure

The duration of each session varies depending on the location of the pain. In most cases, peritendinous injection involves delivering therapeutic agents — such as anti-inflammatory medications, platelet-rich plasma (PRP), hyaluronic acid, or dextrose solution — precisely around the affected tendon. All injections are performed under real-time ultrasound guidance to ensure accurate needle placement and optimal outcomes.

Expected Results After Treatment

Peritendinous injection, whether using anti-inflammatory agents, platelet-rich plasma (PRP), or other therapeutic substances, can provide meaningful and lasting pain relief. In patients who respond well to treatment, pain reduction can be sustained for 3–6 months or longer.

Self-care After the Procedure

  • Rest: The treated area should be fully rested for the first 24–48 hours. Avoid high-impact activities, heavy lifting, and strenuous exercise during this period.
  • Activity Modification: If the injection was administered to a lower limb (e.g., the knee or Achilles tendon), minimize walking and weight-bearing activities for the first 48 hours.
  • Driving: Avoid driving on the day of the procedure .
  • Water Precautions: Refrain from soaking in a bathtub, hot tub, or swimming pool for 24–48 hours following the procedure to reduce the risk of infection. Showering is permitted.
  • Medication Precautions: Where possible, avoid non-steroidal anti-inflammatory drugs (NSAIDs) — such as Ibuprofen or Naproxen — for 1–2 weeks after the injection, as these medications may reduce the effectiveness of the treatment.

Substances Commonly Used in Peritendinous Injection

  • Corticosteroids: Administered to reduce inflammation and provide short-to-medium-term pain relief. 
  • Platelet-Rich Plasma (PRP): Derived from the patient's own blood, PRP harnesses the body's natural healing factors to stimulate tissue repair and regeneration.
  • Hyaluronic Acid (HA): Improves tendon gliding and mobility by enhancing lubrication around the tendon sheath.
  • Dextrose Solution (Prolotherapy): Stimulates and supports the body's natural tendon repair processes, promoting long-term healing.

Treat Pain at Bangkok Interventional Clinic

At Bangkok Interventional Clinic, we focus on personalised, in-depth pain management tailored to each individual.
  • Assessment and treatmentby board-certified pain management specialists
  • Targeted interventional procedures for fast and effective symptom relief
  • Patient education to support sustainable, long-term self-care

Our goal is to improve the quality of life for every person who comes to us for care. If you are experiencing pain that affects your daily life, an accurate diagnosis and the right treatment plan are the first steps toward meaningful change. Bangkok Interventional Clinic — Specialised Pain and Nerve Care by Multidisciplinary Specialist Physicians

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If you are living with chronic pain, Bangkok Interventional Clinic

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