Chronic tendon pain (tendinopathy) can happen in your elbows (golfers or tennis elbow), knees (patella tendon), shoulders (rotator cuff tendons) and feet (achilles tendon or plantar fascia). Tendinopathy leads to pain with activity and can progress to pain at rest. Tendinopathy can lead to decreased range of motion at the joint and can significantly effect your ability to work or perform basic grooming activites.

Your initial office evaluation may include X-rays to access for arthritis or other causes of joint pain.  Treatment will likely include educating and encouraging you to change or eliminate the painful activities, may recommend bracing, encourage use of ice and/or anti-inflammatories and lastly participating in physical therapy. If your pain is not improving, it may be reasonable to try a cortisone injection, however in my clinical practice I don’t generally recommend cortisone for tendinopathy.  

If you still have pain after trying the conservative measures above it may be time to discuss Tenex or PRP (platelet rich plasma) injection(s).

Using the Tenex Health system, an ultrasound is used to guide the TX MicroTip needle to remove the diseased tendon.

Generally covered by insurance

Usually requires a pre-visit which will likely include an ultrasound evaluation to confirm the tendinopathy and plan the best approach to the diseased tendon.

At times I may recommend obtaining an MRI prior to procedure to access for / determine extent of tearing as this may change my recommendation to use Tenex. In these cases, I may recommend doing a PRP injection(s).

Done with local anesthesia in the operating room or an out-patient surgical center

Procedure takes approximately 15 – 20 minutes

Placed in a sling, knee immobilizer or boot after the procedure which you wear for approximately 3 days.  Non-weight bearing range of motion is encouraged and necessary during this time.

Formal physical therapy may be recommended and could start 1-2 weeks after the procedure

Return to normal activity is generally at 6-8 weeks

After a standard blood draw, your blood is spun in a centrifuge to separate the platelet rich plasma which is then injected, under ultrasound guidance into the diseased tendon.

Not covered by insurance, therefore this procedure will be an out-of-pocket expense. Please contact my office for costs.

Usually requires a pre-visit which will likely include an ultrasound evaluation to confirm the tendinopathy and plan the best approach to the diseased tendon. 

Done with local anesthesia in my office

Procedure visit will be scheduled for one hour but actual injection time is approximately 15 – 20 minutes

Placed in a sling, knee immobilizer or boot after the procedure which you wear for approximately 3 days.  Non-weight bearing range of motion is encouraged and necessary during this time.

Formal physical therapy may be recommended and could start 1-2 weeks after the procedure

Return to normal activity is generally within 6-8 weeks

May require 1-2 more injections

Learn more about PRP treatment from Dr. Dunbar here: What is PRP and can it help my pain?

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Author Dr. Siatta Dunbar

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