Relieving Chronic Tendon Pain with Percutaneous Needle Tenotomy

Chronic tendon pain can be debilitating, but what if you have tried ice, medications, and steroid injections and are still in pain?

"They gave me shots in my hip to try, like steroids, to make it calm down. Nothing's working," chronic pain sufferer Connie Fisher said. "I'm hoping I can walk without hurting or having to stop. I play miniature golf. I have to stop and sit because it hurts that bad."

At Mercy Medical Center, Fisher undergoes an outpatient procedure called a Percutaneous Needle Tenotomy. Nicholas Anastasio, M.D., a board certified physician specializing in physical medicine and rehabilitation at Orthopedics and Joint Replacement at Mercy, performed the procedure.

"She was having chronic pain and dysfunction with her hip tendon because of years of having tendonitis and bursitis on her hip. Unfortunately over time those repeated bouts of inflammation can lead to scar tissue formation in the tendon, and then the tendon gets stuck in this chronic state where it's not healing properly," Dr. Anastasio said. "What we're doing is a small surgery on the tendon. Now obviously, open surgery creates scar tissue, so that would be counterproductive for what we're trying to achieve. So we do the same surgery, essentially, with a needle under ultrasound so that it can be done in the office without the need for general anesthesia."

The needle stimulates the tendon's ability to heal and improve pain and function. Percutaneous tenotomy is also used for chronic tennis or golfer's elbow, for Achilles or rotator cuff tendinitis, and for tendon pain in the knees. The procedure is done in about 15 minutes.

"I feel okay. I'm not hurting right this minute - that's wonderful," Fisher said.

Dr. Anastasio explained that it generally takes about three months for most patients to achieve little or no pain, and they can return to their normal activities in about a week.

View Mercy orthopedic specialist Dr. Nicholas Anastasio's interview regarding percutaneous tenotomy for chronic tendon pain.