Information for patients
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What is tendinopathy?
Tendinopathy is a disease of the tendon caused by wear and tear, overuse or incorrect use of the joints in the body. Tendons connect muscle to bones and although tendinopathy is generally non-inflammatory, it can lead to pain and reduced mobility.
What causes tendinopathy?
Tendons transmit the power of the muscles onto the bones. This can put a lot of stress on the tendons which can be many times higher than the actual body weight.
Prolonged activity, repetitive movements or incorrect load bearing can all lead to irritation and inflammation, combined with pain and reduced mobility.
The Achilles tendon is the largest tendon in the human body found at the heel. It is surrounded by a covering called a tendon sheath, filled with lubricating fluid which improves gliding of the tendon. The sheath can get affected in the inflammatory process.
What is the Injection?
The injection used is OSTENIL® TENDON.
OSTENIL® TENDON is highly concentrated Hyaluronic acid (2%). Hyaluronic acid is present in the body wherever moisture is stored or lubrications between layers of tissue is required to eliminate friction.
How does hyaluronic acid work?
The lubricating characteristics of hyaluronic acid increase tendon gliding.
The tendon can work again as if well-oiled.
Hyaluronic acid also:
- Nourishes the tendon.
- Reduces inflammation and hence reduces pain and swelling.
The hyaluronic acid injections aims to normalise tendon function, reducing pain and improving joint function.
How is Hyaluronic acid administered?
Your doctor will give you an injection into the area around the most damaged part of the achilles tendon, usually using some form of guidance such as ultrasound, which helps ensure the injection is placed correctly.
They will inject hyaluronic acid into the tendon sheath itself. The lubricant will be distributed by the natural movement along the entire tendon. A repeat injection, normally given a week after the first, may be required in more established and persistent tendon disease.
What can you expect from treatment with Hyaluronic acid injection?
In some studies, the treatment described above has proved to be effective and safe. In most cases there is a quick and long-lasting improvement of joint function. Several tendons may be treated at the same time. If symptoms return the treatment can be repeated.
- Lynen, N. Treatment of chronic tendinopathies with
peritendinous hyaluronan injections under sonographic
guidance – an interventional, prospective, single-arm,
multicenter study. OUP Orthopäedische und
Unfallchirgurgische Praxis. 2012; 1 (10); pp 6-11.
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This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team, North Tees and Hartlepool NHS Foundation Trust, University Hospital of North Tees, TS19 8PE or:
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Leaflet reference: PIL1041
Date for Review: January 2027