Lancaster Physician Summer 2019 - 9

SUMMER 2019

Patients suffering from chronic tendon
pain now have a minimally invasive treatment option that uses high-frequency sound
waves-or ultrasounds-to remove damaged
and scarred tissue that causes the tendon pain.
Prior to this procedure, called Tenex, patients
who didn't respond to conservative therapy
had to undergo invasive surgery with a long,
debilitating recovery.
THE CAUSE OF TENDON PAIN
Tendons are the tough fibers that connect
muscle to bone. Through overuse or injury, the
tendon is damaged, often in the form of tiny
tears. Over time, these tears multiply.
Most tendon injuries occur near joints, such
as the shoulder, elbow, knee, and ankle, and
are the result of gradual wear and tear to the
tendon from overuse or aging.
Anyone can have a tendon injury. But people
who make the same motions over and over in
their jobs, sports, or daily activities are more likely
to damage a tendon. Tennis or golfer's elbow or
chronic runner's knee are common examples.
Tendinopathy, chronic tendon pain, is
caused by the microtears in the tendon. When
there is a tear, the tendon forms scar tissue,
which in turn causes much of the pain that
patients feel. This can include:
Pain, stiffness, and loss of strength in the
affected area.
Sharp pain when the tendon is used.
Pain and stiffness during the night or when
patients get up in the morning.
Tenderness or swelling in the affected area.
A crunchy sound or feeling when using
the tendon.
CONSERVATIVE TREATMENT
In most cases, patients can treat a tendon
injury at home. Home treatment includes:
Resting the painful area and avoiding
any activity that makes the pain worse.

Applying ice or cold packs for 10 to 15
minutes at a time, as often as two times
an hour, for the first 72 hours.
Taking over-the-counter pain relievers
such as acetaminophen or NSAIDs (e.g.,
ibuprofen or naproxen).
Doing gentle range-of-motion exercises
and stretching to prevent stiffness.
As soon as patients start feeling better, they
can return to their activities, but they should
take it easy for a while. They should build up
to their previous level slowly, and stop if it
hurts. Warming up before you exercise and
doing some gentle stretching afterward will
help prevent future injury. Patients may also
apply ice to prevent pain and swelling.
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 a tendon injury
to heal. It's important for patients to be patient
and stay with the treatment plan. If they start
using the injured tendon too soon, it can lead
to more damage.
THE TENEX DIFFERENCE
In the past when conservative treatment
didn't reduce patients' pain, the only option
was an invasive surgical procedure to scrape
out the scar tissue on the tendon. In addition
to requiring more complicated surgery, this
option required a long, debilitating recovery
and lost work time.
The Tenex procedure is minimally invasive.
It's done in one sitting-usually taking less than
20 minutes total-and patients go home with
few restrictions in what they can do.
The Tenex procedure achieves these incredible outcomes through the use of ultrasound.
It uses ultrasound imaging to view the affected
area and to remove the damaged tissue that
causes the pain. Removing the damaged tissue
allows the tendon to heal properly and relieves
the pain.

LANCASTER

9

PHYSICIAN

An ultrasound  is  sound waves  with  frequencies  higher than the upper limit of
human hearing. Basically, the sound vibrates
at a rate so fast that our ears can't detect it.
Ultrasound has been used for a long time as
an imaging tool to guide procedures. What's
new in the Tenex device is the use of ultrasound
as an energy source to power the pen-like device
that cuts and removes scar tissue on the tendon.
The Tenex tool is shaped like a pen and
contains two needles. The first needle, powered
by an ultrasonic wave of energy, breaks up
the scar tissue. Meanwhile, a saline flushing
system inside the second needle vacuums the
tissue debris.
The remarkable feature of the Tenex tool is
that the ultrasonic energy breaks up diseased
tendon without harming healthy tendon
tissue. It focuses solely on the damaged and
scarred tissue.
HOW THE TENEX PROCEDURE IS
PERFORMED
The doctor will use ultrasound imaging to
view the injured area and precisely identify the
location of the damaged tendon.
The doctor will numb the area with a
local anesthetic and then apply the Tenex
ultrasonic tool.
Using ultrasonic energy, the tool safely breaks
down and removes the damaged tissue, and the
surrounding healthy tissue is left unharmed.
The total time of the treatment is minimal-often less than a half hour. Stitches are
not required, so it just takes a small, adhesive
bandage to cover the wound.
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.
This is a great, minimally invasive option
for patients suffering from chronic tendon
pain. It's a huge step forward from traditional
surgical options which required a long, debilitating rehabilitation. Patients are encouraged
to contact Orthopaedic Specialists of Central
PA to talk about this innovative option.



Lancaster Physician Summer 2019

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