A Question About the Difference Between Tendonosis and Tendonitis

Marc Darrow, MDMarc Darrow, MD

In some areas, chronic pain is caused by soft tissues, specifically tendons that have worn down and can’t repair themselves, we call this tendonosis. In tendonosis there is also an absence of inflammation.

Why didn’t the tendon repair itself?

Because tendons do not have a good blood supply to them. In tendonosis, the blood supply dead ends before it is able to irrigate the area with the necessary immune cells needed to heal and rebuild. What we do with this area is stimulate it to heal by creating new collagen (the building blocks of soft tissue) growth by inflaming the area with Prolotherapy.

Tendonitis is where there is inflammation and irritation. Where inflammation is present, we need to create a bigger, “healing” inflammation, because the inflammation that is going on, while it may be painful, is not strong enough to bring enough of the healing immune response to the area. The body is trying to heal itself with inflammation, because that is the way the body naturally heals. Prolotherapy tries to heal the body the same way and that is with inflammation.

A side note: ligaments and tendons are made of collagen. When the ligaments and tendons are injured, the body produces collagen to heal them. The problem with ligaments and tendons is that the body offers them a poor blood supply and, because of it, a poor chance to completely heal.

The poor supply of blood to the ligaments and tendons is very apparent from their white color. Muscles on the other hand are red because they have a very good blood supply. Ligaments and tendons therefore are prone to not heal completely from injury, because their limited blood supply does not offer, among other things, the supplies necessary to rebuild collagen.

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