Last week we discussed the expanded uses for ultrasound (US) in diagnosing tendon problems as well a way to improve the accuracy and efficacy of injections. Ultrasound also plays a role in the treatment of these types of injuries. And that role may be getting a bit bigger.
Most patients who have been to physical therapy have had some form of US treatment. Ultrasound is used to reduce inflammation and “loosen up” tissues through the sound energy it produces. It can also be used in techniques like phonopheresis or iontopheresis where the sound waves can “push” medicine into the affected tissues. This energy can be put to additional uses as well.
Tendonitis is a very common problem that most of us will experience at some point in our lives. It is by definition an inflammation in a tendon – a thick, strong tissue that connects a muscle to a bone. Because the force that the muscle generates has to pass through and pull on the tendon in order to make a joint move, the tendon experiences a pretty good amount of stress and strain. When its is overloaded, it will become inflamed. If that process continues unchecked, you can get small or microscopic tears in the tendon. Normally – and if you rest the tendon once it is inflamed – the body handles these stresses just fine and rebuilds the tendon quickly. But sometimes, the tendon cannot heal the microtears, either because the tendon is not rested or allowed to recover, or because the blood supply is too poor to allow the growth factors and the cells that initiate healing to reach the damaged area. This usually occurs in the deep parts of the tendon, closest to the bone and furthest away from the blood vessels. These tendons literally rot from the inside out! While this process is related to tendonitis, there is technically no inflammation so the correct term is tendinosis. And this is one of the biggest problems in sports medicine and orthopaedics today.
Just about everyone has had tennis elbow, golfer’s elbow, plantar fascitis, jumper’s knee, or bursitis in their shoulder and all of these can be examples of tendinosis. Most of the time, it resolves on its own or when the activity that brought it on is stopped for an extended period of time. But some people continue to experience symptoms. There are very few effective treatments for tendinosis short of open surgery. This is where US comes in. Tenex Health TX is an exciting new treatment option that uses the power of sound waves and the accuracy of US guided needle placement to treat and remove the rotten portion of the tendon. In less than a minute of treatment, we can identify the “bad” tendon, place a MicroTip needle into the area, and remove the damaged tendon leaving nothing but good tendon behind. In a recent paper published in the American Journal of Sports Medicine, patients who underwent the TX procedure had a significant decrease in their pain by 1 week and 19 out of the 20 treated were satisfied with the procedure at 6 months. There were also no complications reported and to date there has not been any serious problems reported from the use of the Tenex system. That’s significantly better than anything else we have to treat tendinosis!
The Tenex Health TX system is going to be featured on “The Doctors” this coming Monday, December 2nd. Tune in Monday to learn more and then return here to read up and find out how we can help your tendon pain.