A graphic depicting different elements related to a Tenex procedure.

Do you suffer from tennis elbow, plantar fasciitis, or some other nagging tendon pain? The UVA Health System now offers a minimally invasive, nonsurgical treatment for chronic tendon pain that has already been used in over 65,000 successful procedures–Tenex.

Reviewed by Nicholas Nacey, MD and Jennifer Pierce, MD

What Is Chronic Tendon Pain?

Tendons are bands of tissue around your joints that connect muscle to bones, allowing you to bend, walk, jump, and move in general. Healthy tendons are able to make these motions easily and smoothly, but when they are damaged, movement can become painful and restricted. Left untreated, this pain and reduced range of motion will worsen over time.

Chronic tendon pain is caused when a degenerative or injured tendon has developed scar tissue over a period of time. Scar tissue can form either from a sudden injury that has healed or from the repetition of a particular movement, which causes small tears that develop more and more scar tissue as the tendons tear and reheal over and over.

Some common names for chronic tendon pain are tennis elbow, golfer’s elbow, plantar fasciitis, jumper’s knee, or Achilles tendonitis. These conditions all fall under an umbrella category for tendon injuries called tendinosis or tendinopathy.

Symptoms and Risk Factors

Tendinopathy can develop in any of the body’s tendons over time.

An infographic with the risk factors and symptoms of tendon injury

Risk Factors for tendon damage include:
  • Repetitive motions over long periods of time
  • Aging
  • Improper technique when exercising or playing sports
Symptoms include:
  • Pain that is the worse in the morning and at night.
  • Pain that gets worse with use
  • Redness, warmth, or swelling where the pain is located


In order to diagnose tendinopathy, your doctor may do a number of different things. The diagnosis process usually starts with the doctor examining the affected limb or joint. After this, the doctor will usually order an x-ray, MRI, or ultrasound to diagnose the tendon more specifically.

Tenex As A Treatment for Tendinopathy

Tenex is a non-surgical procedure to directly treat tendinopathy. This procedure is performed by a radiologist, a physician specialized in imaging and image guided procedures. Tenex utilizes a specially developed ultrasonic needle that oscillates at high frequency. This ultrasonic needle removes the degenerated scar tissue in the tendon. The procedure is highly effective, has a comparatively short recovery time, and generally takes 20 minutes or less.

Walking Through A Tenex Procedure

The radiologist will start by cleaning off the appropriate area of the skin. Real time ultrasound imaging will be used to obtain a continual view of the damaged tendon. After this, a local anesthetic is applied to numb the area surrounding the tendon so patients feel no pain, just a little bit of pressure, during the procedure. Next, the radiologist inserts the Tenex ultrasonic needle through a very small incision (less than ¼ inch) near the affected tendon. The doctor uses ultrasound to see the scar tissue on the tendon, then uses the needle to break down and remove the scar tissue, leaving healthy tissue intact. After that, the needle is removed and the area is bandaged.

Patients are able to return home immediately after a Tenex procedure and recover quickly. Recovery time after Tenex is generally 4-6 weeks, about a quarter of the normal recovery time. Physical therapy may be added for some patients to improve the overall success of the procedure. After the procedure, most patients are able to use over the counter medications like Tylenol to relieve any pain.

If you’re tired of living with chronic tendon pain or tendinopathy, Tenex is a great option that will get you back to your regular activities quickly and without the prolonged recovery time that usually comes with surgical procedures.

Contact the UVA Hand Center (434-924-0782) for elbow pain and the Foot/Ankle Clinic (434-243-5432) for Achilles pain or plantar fasciitis to learn more about your eligibility for the Tenex procedure and schedule a consultation.

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