Treating Tendinopathy using dry needling and autologous blood injections
Patient Information and consent form
What is dry needling and autologous blood injections?
Dry needling and autologous blood injections are procedures used to treat
tendinopathy. These are commonly used in combination. Dry needling involves
repeatedly introducing a fine needle in to the abnormal tendon under ultrasound
guidance. Autologous blood injection involves injecting taking a small sample of your
own blood from your arm and injecting it in to the abnormal tendon under ultrasound
guidance. This procedure can be performed twice 4-6 weeks apart.
How does these procedures work?
Tendinopathy refers to failure of the normal healing process in a tendon leading to
areas of abnormal structure which generate pain. There is often a growth of abnormal
blood vessels in and around the tendon. The dry needling procedure has 2 effects; it
creates further mild trauma to the abnormal areas to encourage a better healing
response and also damages the abnormal blood vessels resulting in a small local bleed in
the tendon. Blood contains growth factors that are believed to promote tendon healing.
By adding in an autologous blood injection the blood pool is increased. This involves
taking a blood sample from one of the veins in your arm (like a normal blood test) and
injecting it directly back in to the tendon.
How is this procedure done?
The procedure is done by an experienced radiology doctor at the radiology department.
You will be asked to lie on your front on a bed. The skin over the tendon will be cleaned
with antiseptic. Local anaesthetic is then injected into a small area of the skin and
tissues over the tendon. This stings a little at first, but then makes the skin numb.
A fine needle is then passed through the skin and repeatedly into the tendon under
ultrasound guidance. The ultrasound helps the doctor to locate the exact areas of
abnormality in the tendon. The skin and tissues around the tendon are numbed but the
process is still uncomfortable.
A small amount of blood (1.5-2mls, approximately half a tea spoon) will be taken from
the arm and injected into the same area of the tendon.
How successful is the treatment?
This is a new treatment option used to treat tendinopathy. Therefore large clinical trials
are lacking, however from auditing our own practice approximately 50-60% with
troublesome tendinopathy that have not responded to exercise programmes will
respond well to this treatment.
Patient information sheet dry needling/autologous blood v5
Oxsport@noc
2011
What risks are involved?
From our experience associated risks are uncommon. There may be a temporary
increase in pain for 1-2 days and a small amount of bruising. This settles on it’s own or
paracetemol can be taken. There is a low (less than 1/1000) risk of infection. There is a
potential risk of tendon rupture with this procedure. This is very rare but it is important
that you follow the post treatment advice to further reduce the risk of this occurring.
You should seek medical advice if:
 There is a sudden increase in pain in the achilles tendon
 The procedure site becomes red or angry looking.
 You develop a fever or temperature.
What measures need to be taken to minimise tendon rupture?
To minimise the risk of tendon rupture you will need to avoid explosive activity in the
first week after the procedure. You are advised to walk short distances only. After the
first week, you can resume your physiotherapy eccentric programme. You should not
run for the first 2 weeks.
What happens once you have been referred for this procedure?
The clinician who reviews you at Oxsport clinic will discuss the treatment with the
radiologists and request the procedure to be done. Then the radiology department will
get in touch with you regarding an appointment date. If you would like to get more
information regarding the exact appointment date please call the NOC radiology
department on 01865 738189. Please allow 1-2 weeks for the request to be processed
before calling.
Can I drive after the procedure?
No, make sure that you have transport to go back home as you will not be able to drive
back yourself.
What happens after the procedure?
For the first week you are advised to walk short distances only and avoid any explosive
activity such as running/jumping/hopping etc.
After the first week you should gradually introduce the eccentric exercise programme
starting at stage 1 (please refer to achilles or patellar tendinopathy book received from
Oxsport clinic). Then you should gradually increase the exercises progressing through
stages 2 and 3.
After 4 weeks we ask you to e mail the Oxsport team to inform us of your progress.
How long before I notice any improvements?
Some patients get benefit within the first week but it can take up to 6 weeks.
Will it need repeating?
Patient information sheet dry needling/autologous blood v5
Oxsport@noc
2011
In about 50% of patients the procedure needs repeating at 4-6 weeks. We will have
booked a second appointment for you. When you e mail at 4 weeks we can decide
whether you need the second treatment. This can be cancelled if it is not required.
Follow up arrangements
You are requested to e mail the Oxsport team at 4 weeks to let us know your progress.
You will be seen in the Oxsport clinic at 10-12 weeks or earlier if needed.
When can I return to work?
This would be depended on the type of work you do. If you do a desk job you will be
able to work on the next day. However if you have a physically active job, you may not
be able to work normally for the first week. Please discuss this with your Oxsport doctor.
Please inform your employer well in advance.
Who do I contact if I have any questions?
You can contact the Oxsport team via email at oxsport@noc.nhs.uk. Alternatively you
could ring us on 01865 738285. However if you have urgent concerns please see your
GP or attend Accident and Emergency.
Consent
I confirm that I have read and understood this leaflet and consent to undergoing a dry
needing and autologous blood injection.
Signed
Name(block caps)
Date
In the case of parental consent
Signed
On behalf of:
Name(block caps)
Date
Patient information sheet dry needling/autologous blood v5
Oxsport@noc
2011