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April 16, 2024

Tendon Pain? Minimally Invasive Procedure May Help

ThedaCare Orthopedic Specialists Can Recommend Appropriate Treatment Options

Tendon injuries can cause pain and impact quality of life. Strain, overuse, and microtraumas can all lead to this common condition.

Options such as physical therapy, ice, heat, splinting, and cortisone injections typically alleviate most tendon pain. However, in some instances, those options may not work. To provide additional treatment options to people, ThedaCare Orthopedic Care has begun offering a minimally invasive procedure known as percutaneous tenotomy.

The procedure removes the injured tendon and then helps stimulate the body’s natural healing processes. This can help alleviate tendon pain, said Dr. David Hirschi, a Sports Medicine Physician with ThedaCare Orthopedic Care.

“Percutaneous tenotomy uses ultrasonic energy to remove damaged tissue, leaving the surrounding tissue unharmed,” he explained. “The manipulation of the affected area stimulates healing.”

Tendonitis Symptoms

Tendonitis most often occurs where a tendon attaches to a bone. It can affect any tendon, but it’s most common around the shoulders, elbows, wrists, knees and heels.

Symptoms often include:

  • Pain, often described as a dull ache, especially when moving the hurt limb or joint
  • Tenderness
  • Mild swelling

An orthopedic specialist can diagnose the condition and guide people to the most appropriate treatment options.

Understanding Percutaneous Tenotomy

Percutaneous means “affected through the skin,” and tenotomy means cutting or removing tendon tissue.

During a percutaneous tenotomy, a doctor numbs the area and then uses an ultrasound-guided needle to pierce the damaged part of the tendon multiple times. The procedure takes about 15 to 20 minutes.

Percutaneous tenotomy works by first removing the bad tendon and then creating inflammation in the tendon, breaking up any scar tissue, and bringing fresh, oxygenated blood to the tendon. This triggers the body’s own cells to begin rebuilding the tendon. The procedure also can break up any calcium deposits in the tendon.

Studies show a success rate of more than 85% with long-term pain relief. 

Who’s a Candidate?

Percutaneous tenotomy is an option for people of all ages and activity levels. The procedure can help with the following injuries and conditions:

  • Elbow tendon injuries, which happen through overuse of the elbow tendons, normally due to repetitive motions of the wrist and arm.
  • Rotator cuff injuries, which affect the tendons that move the shoulder joint.
  • Hip tendonitis, which most commonly occurs on the lateral hip. 
  • Achilles tendonitis, when the Achilles tendon connecting the calf muscles to the heel bone becomes inflamed.
  • Plantar fasciitis, when the thick band of tissue supporting the arch of the foot is inflamed.

“Anyone with chronic tendonitis who hasn’t found success with conservative, non-surgical treatment options is a great candidate for having a percutaneous tenotomy,” Dr. Hirschi said.

Recovery Time

Any pain from the procedure should go away within a few of days, Dr. Hirschi explained. He also noted that most people can return to their full regular activities as the tendon heals within six to eight weeks.

After the procedure, early range-of-motion and strength training exercises can encourage the body’s natural healing process and aid in recovery. A physical therapist also can help with rebuilding strength and avoiding re-injury.

Since percutaneous tenotomy relies on the body’s natural healing process, people should avoid all anti-inflammatory medications in the weeks before and after the procedure, Dr. Hirschi said. That means steering clear of non-steroid anti-inflammatory (NSAID) medications such as ibuprofen or Aleve. To help with pain after the procedure, people can take non-NSAID pain medications, such as acetaminophen.

“We’re pleased to offer a full range of treatment options to help people return to doing what is most meaningful to them,” Dr. Hirschi said.

To learn more about percutaneous tenotomy, or schedule an appointment, visit MyThedaCare.