Does moxonidine reduce Achilles tendon or musculoskeletal pain in women with polycystic ovarian syndrome? A secondary an
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RESEARCH ARTICLE
Open Access
Does moxonidine reduce Achilles tendon or musculoskeletal pain in women with polycystic ovarian syndrome? A secondary analysis of a randomised controlled trial Jacob Jewson1,2* , Elisabeth Lambert3,4, Carolina Sari4, Eveline Jona5, Soulmaz Shorakae5,6, Gavin Lambert3,4 and Jamie Gaida7,8
Abstract Background: Sympathetic activity and insulin resistance have recently been linked with chronic tendon and musculoskeletal pain. Polycystic ovarian syndrome is linked with insulin resistance and increased sympathetic drive and was therefore an appropriate condition to study the effects of modulating sympathetic activity on Achilles tendon and musculoskeletal symptoms. Methods: A secondary analysis of a double-blinded, randomised controlled trial on women with polycystic ovarian syndrome was conducted. Participants received 12 weeks of moxonidine (n = 14) or placebo (n = 18). Musculoskeletal symptom and Victorian Institute of Sport Assessment – Achilles (VISA-A) questionnaires were distributed, and ultrasound tissue characterisation quantified tendon structure at 0 and 12 weeks. 2-way ANOVA was used for multiple comparisons. Results: There was no difference in mean change in musculoskeletal symptoms (− 0.6 ± 1.7 vs − 0.4 ± 1.8, p = 0.69) or VISA-A (moxonidine − 0.2 ± 8.8 vs placebo + 4.2 ± 14.6, p = 0.24) attributable to the intervention. There was no difference in any measures of Achilles structure. Moxonidine did not reduce sympathetic drive when compared to placebo. Conclusions: This was the first study to investigate the effects of blocking sympathetic drive on musculoskeletal and Achilles tendon symptoms in a metabolically diverse population. While the study was limited by small sample size and lack of sympathetic modulation, moxonidine did not change tendon pain/structure or musculoskeletal symptoms. Trial registration: ClinicalTrials.gov, NCT01504321. Registered 5 January 2012. Keywords: Tendinopathy, Musculoskeletal pain, Sympatholytics, Metabolic syndrome, Sympathetic nervous system, Insulin resistance, Polycystic ovarian syndrome
* Correspondence: [email protected] 1 Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia 2 Present Address: Olympic Park Sports Medicine Centre, Melbourne, Victoria, Australia Full list of author information is available at the end of the article © The Author(s). 2020 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by sta
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