Tendons are the tough fibers that connect your muscle to your bones. Through aging, overuse or injury, these tendons can get small tears and scarring that make movement very painful. This condition is most common in the elbow, shoulder, knee, hip, and Achilles heel tendons. You may know this as tennis elbow or chronic runner’s knee.
Tendinosis starts when you perform an activity over and over again, causing you pain for three months or more. Repetitive motions, no matter how ordinary, can cause you injury. You may feel burning, cutting, or stabbing, and the pain is interfering with your everyday activities.
Unfortunately, not every patient responds to conservative, non-invasive treatment for chronic tendon pain. In the past, the only option available to these patients was an invasive surgery with a long, debilitating recovery.
But today, patients have a minimally invasive treatment called percutaneous ultrasound tenotomy (PUT) that uses high-frequency sound waves—or ultrasound—to remove damaged and scarred tissue that causes the tendon pain. And this treatment allows patients to continue their normal lives with few restrictions.
Chronic tendon pain is caused by small tears in the tendon which form scar tissue and is usually caused by an overuse of the tendon. It can also be caused by physical trauma, such as a fall or sports injury.
Hobbies or professions that require putting repeated stress on the tendons can cause tendinosis. Athletes and manual laborers, for example, are more prone to this disorder.
Tendon problems are more common in older adults because the joints become less flexible as a person ages. People with joint conditions such as arthritis may also be more prone to tendinosis.
Chronic tendon pain is caused by small tears in the tendon which form scar tissue. This scar tissue causes much of the pain that we feel. This includes:
Tendons usually take a long time to heal, so the treatments for tendinosis aim to speed up the body's natural healing processes.
In most cases, patients can treat a tendon injury at home by following these steps:
If these steps don’t help, physical therapy may be needed. If the injury is severe or long-lasting, your doctor may have you use a splint, brace, or cast to hold the tendon still.
While these steps are generally effective, it may take weeks or months for your tendon injury to heal.
If these treatments don’t help, the only option used to be an invasive surgical procedure to scrape out the scar tissue on the tendon. In addition to involving more complicated surgery, this requires a long, debilitating recovery and lost work time.
Tenex's Health PUT offers patients an alternative. It is a minimally invasive procedure done in one sitting - usually taking less than 20 minutes total - and the patient goes home with few restrictions in what they can do.
Ultrasound has been used for a long time as an imaging tool. What’s new is that PUT uses ultrasound as an energy source to cut and remove scar tissue on the tendon -- without harming healthy tendon tissue.
Patients may feel uncomfortable for a day or two, but they are encouraged to get moving again. Full recovery can be as early as six weeks.
During the procedure, the physician uses musculoskeletal ultrasound guidance for this procedure to ensure that the abnormal region of the tendon is accurately targeted. Then a needle is repeatedly passed into the damaged tendon tissue which precisely breaks down and extracts the damaged tissue that causes tendon pain. When the damaged tissue is removed and there is increased blood flow, the body stimulates a healing response.
Patient benefits include:
Our UPMC in Central Pa. board-certified sports medicine physicians perform this treatment at UPMC Lititz and UPMC Procedure Center in central Pa. For more information, you can contact us at 717-791-2620.
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