Treating Tendon Related Pain

You are likely having pain due to a disorder of a tendon or even multiple tendons in your body. A tendon is what connects muscle to bone. When a tendon is painful, abnormally structured, and not functioning properly, the problem if referred to as “tendinopathy”. Tendon disorders are common. The development of tendinopathy is likely due to multiple factors including overloading without adequate recovery, repetitive microtrauma, inflammation, and ageing.  
In most cases, tendinopathy will improve with simple measures such as activity modification, bracing, stretching and exercise.

Seeing a physical therapist or occupational therapist is a great and effective treatment option in most cases. A therapist can guide you on the appropriate exercise and stretching techniques you should be doing on your own at home. Anti-inflammatory drugs typically do not work well for tendinopathy. Steroid injections may help, but only temporarily. 

Procedures We Offer

Percutaneous Needle Tenotomy

Percutaneous needle tenotomy involves the passage of a standard needle through the irritated tendon multiple times. It is thought that needle tenotomy works by stimulating tendon healing and remodeling. It has been shown to increase the growth of new blood vessel formation to the area. 

Percutaneous Ultrasonic Tenotomy

Percutaneous ultrasonic tenotomy is a minimally invasive technique that can be used as an alternative to surgery. Ultrasonic energy is emitted from the end of a needle device that helps to debride and aspirate abnormal tissue. It is an FDA approved device to treat orthopedic related soft tissue conditions using debridement and aspiration.  This technology was FDA approved since 2012 and since that time, over 65,000 procedures have been completed. 
Ultrasonic energy rapidly oscillates the tip of a hollow needle to break down abnormal tissue. An inner tube vibrates which allows targeted debridement and aspiration of the injured tissue. 

Who May Benefit? 

If you have pain related to chronic tendon disorders that have failed to improve with physical or occupational therapy, bracing, activity modification, and over the counter oral and/or topical pain medicine, then tenotomy may be right for you. Appropriate candidates for the procedure would typically have had pain for at least 3 months.

Percutaneous ultrasonic tenotomy can be used to treat tendon disorders including:

• Tennis Elbow
• Golfer’s Elbow
• Rotator Cuff issues
• Hip Bursitis
• Hip Tendinitis
• Jumper’s Knee
• Achilles (ankle) tendinopathy
• Plantar fasciitis 
   

What to Expect 

Prior to the Procedure

You will meet with one of the sports medicine physicians who will perform a diagnostic ultrasound evaluation of the painful area to help assess the amount of injury. 
Prior to undergoing the procedure, it is recommended you stop all anti-inflammatory medicine for 1 week. These medicines include things such as ibuprofen and naproxen. Tell your doctor if you are on any strong blood thinners. 

Having the Procedure

This procedure is offered by Dr. Steven Makovitch located at: 

Newton-Wellesley Ambulatory Care Center
159 Wells Avenue 
Newton, MA 

A very small incision is made in the skin to properly advance the needle to the area of pathology.  There are no sutures required.  While the procedure is performed under local anesthetic. You may need a driver for after the procedure depending on what structure and what side of your body is involved.

Rehabilitation After the Procedure

After the procedure, you will have an increased amount of localized soreness for especially the first 3 days. It is best if you continue to avoid using all anti-inflammatory medicine for two weeks after the procedure. You will have limited activity for the first two weeks following the procedure, and then slowly regain strength. You will start physical therapy and practicing resistance exercise as tolerated.  You can expect to be fully recovered after twelve weeks. 

Let Us Help You 

If you are experiencing chronic tendon pain, then this procedure may be right for you. Schedule an appointment today by calling (617) 243-6142.