Pain from chronic tendinopathy reminds you of its presence constantly. Ultrasound-guided percutaneous needle tenotomy (Tenex) can be the next step toward less pain and more activity. Sports medicine physicians at The Ohio State University Wexner Medical Center in Columbus, Ohio, use this procedure for common causes of tendon pain, such as tennis elbow, plantar fasciitis, jumper’s knee and Achilles tendinitis.
What is Tenex?
Tenex (a type of percutaneous needle tenotomy) is a minimally invasive, ultrasound-guided procedure for chronic tendinopathy associated with conditions like tennis elbow, jumper’s knee or plantar fasciitis. It’s effective at treating tendon pain from these conditions.
The Tenex procedure is guided by ultrasound and uses a needle-like probe that can both destroy and remove damaged tissue and stimulate growth in healthy tissue.
Other therapies for tendinopathy are available and range from physical therapy to surgery. Tenex is more invasive than physical therapy but less invasive than surgery.
What is Tenex used to treat?
Tenex can be used to treat several causes of chronic tendon pain, including:
- Tennis elbow
- Jumper’s knee
- Golfer’s elbow
- Plantar fasciitis
- Achilles tendinopathy
- Adductor tendinopathy
- Gluteal tendinopathy
- Hamstring tendinopathy
Am I a candidate for Tenex?
Before we recommend Tenex as a treatment, we’ll typically try less invasive therapies first. Those methods could include:
- Rest and activity reduction
- Physical therapy and therapeutic exercise
- Over-the-counter and prescription medication
If these treatments don’t provide relief from your chronic tendon pain, you could be a candidate for Tenex. It’s a step up from these noninvasive therapies but is less invasive than surgical intervention, which carries higher risk and longer recovery time.
If Tenex proves ineffective for your injury or the effects wear off, surgery is still an option for you and your doctor.
How is the Tenex procedure done?
Tenex is performed by primary care sports physicians at the Ohio State Wexner Medical Center in an outpatient surgical setting, meaning you’ll go home the same day. You’ll be awake and aware during the procedure, which lasts about 30 minutes.
Your provider will use a local anesthetic to numb the treatment area. They’ll then make a small nick in the skin to allow the insertion of the needle. The provider will use an ultrasound probe along your skin to direct the needle to areas of damaged tissue.
Tenex doesn’t require a lot of preparation, but you might be asked to:
- Fast overnight
- Avoid ibuprofen and naproxen for two weeks prior
- Avoid alcohol for 48 hours
- Consider quitting tobacco if you use it, since it affects healing
After the procedure, the nick on your skin will be covered with a bandage; no stitches are required. You’ll need someone to drive you home after your procedure, so make sure to prepare for that ahead of time.
How long does it take to recover from Tenex?
Recovery generally takes four to 12 weeks, depending on the location and severity of your injury. Physical therapy will be part of your recovery after the procedure. Your provider will give you specific instructions when you leave the office after the procedure. In general:
- You’ll have some pain for the first few weeks, which you can treat with acetaminophen (Tylenol) and an ice pack.
- Avoid soaking or submerging the treated area in water for one week.
- Follow your provider’s instructions about activity restrictions and progressive rehabilitation. These will advance incrementally up to returning to your sport or physical activity, which usually occurs about 10 to 12 weeks after the procedure.
- Attend a few follow-up visits with your provider.
Risks of the Tenex procedure
Tenex is considered a lower-risk outpatient surgical procedure. Light sedation is sometimes used. You may have some pain, swelling or bruising at the incision spot. There’s also a low risk of skin infection, so be sure to follow your provider’s instructions on cleaning the incision and changing your bandage.