Do you sometimes experience severe pain in your elbow, shoulder, or heel? Perhaps this pain increases during sports or lifting heavy objects. The cause of this may be a problem with one of your tendons. So today we are talking about a special treatment method for this type of condition. This is called tenotomy.
What is Tenotomy?
Simply put, a tenotomy is a procedure used to treat pain in a tendon (a strong piece of tissue that connects a muscle to a bone) in your body. In this procedure, your doctor may use a needle to insert a needle through your skin to treat the damaged tendon. Or, they may make a small incision in your skin and surgically remove a piece of the damaged tendon.
Although this treatment can be performed on any tendon in the body, it is most commonly performed in these locations:
- The tendon that connects your biceps muscle to your shoulder.
- The tendon in the elbow.
- Tendons in the feet and ankles.
Difference Between Tenotomy and Tenodesis (Biceps Tenodesis)
Both of these methods are used to treat biceps tendon disorders. But there is a difference between the two. Imagine that you have a problem with the biceps tendon in your shoulder.
| Treatment method | How to do it |
|---|---|
| Tenotomy | In this procedure, the surgeon intentionally cuts and separates the biceps tendon to reduce pain. When this is done, the biceps muscle moves slightly down the arm. This may cause a slight change in the shape of the arm. |
| Tenodesis | In this procedure, the doctor cuts the tendon from the shoulder and reattaches it to a new hole in the upper arm bone (humerus). This does not change the shape of the arm. |
Which method is right for you depends on how active you are, how quickly you want to recover, and whether you want your hand to look different after surgery. It's best to discuss this with your doctor before making a decision.
What conditions are treated with tenotomy?
This treatment is used for a variety of conditions related to the tendons in the body. The most common cases are:
- Biceps tendinitis
- Shoulder calcific tendinitis (calcification in the tendon of the shoulder)
- Tennis elbow or Golfer's elbow
- Plantar fasciitis (foot pain)
- Congenital foot deformities, such as club foot
- Hammertoes - a condition that occurs in the toes
- Knee pain (Patellar tendinitis - Runner's knee)
- Achilles tendon injuries
What do you do before a tenotomy?
A doctor will usually recommend a tenotomy only if other treatments have failed. Before doing so, they will advise you to try these non-surgical treatments:
- Rest: Give the tendon a break by avoiding sports or activities that cause pain.
- Ice and painkillers: Apply ice to reduce pain and swelling and take painkillers (NSAIDs) as prescribed by your doctor.
- Physical therapy: Exercises to strengthen and increase flexibility of the muscles around the injured tendon.
- Corticosteroid injections: A type of injection given to reduce inflammation.
If all of this doesn't reduce your pain, your doctor will tell you about tenotomy treatment as the next step.
How is Tenotomy treatment performed?
This treatment is done in two main ways. The method you need will depend on the extent of damage to your tendon.
| Treatment method | Description |
|---|---|
| Needle method (Percutaneous needle tenotomy) | This involves numbing the area with local anesthesia and inserting a needle through the skin into the tendon. Sometimes an ultrasound scan is used to guide the needle exactly where it goes. By making small punctures in the tendon in this way, the body's natural healing process is stimulated. This means that blood flow to the area is increased, helping the tendon to heal on its own . |
| Open tenotomy | This is a minor surgery. You may be put to sleep or numbed. The surgeon will make a small incision in your skin, remove the tendon, and cut it apart. Once the tendon is freed in this way, the pain will be completely gone. |
What are the risks of this treatment?
Tenotomy is generally a safe procedure, but as with any medical procedure, there are some minor risks.
- Cramping: After this treatment, especially for the biceps tendon, you may experience some cramping in the area. However, this does not happen to everyone. This discomfort will subside over time.
- Scar tissue: If scar tissue forms around the tendon where the surgery was performed, it can be painful.
- Recurrence of symptoms: For some people, symptoms may return even after years. This risk is especially high if you continue to do work or play sports that put strain on the tendon.
The important thing is that these risks don't happen to everyone, but it's important to be aware of them.
How long does it take to heal?
After treatment, you will need to avoid using the tendon as much as possible. The recovery time will vary depending on the type of treatment you had and the location of the tendon. Your doctor will explain this to you in detail.
Many people will not be able to do strenuous exercise or sports for several months. Be sure to consult your doctor before starting physical activity again.
When should you see a doctor?
See a doctor if you have these symptoms:
- A pain that doesn't subside even after a few days, but rather gets worse and worse.
- A swelling.
- Skin discoloration.
- If moving a part of the body is difficult or painful.
If you have had an accident, or if you are unable to move a body part that you can normally move, go to a hospital's Emergency Department (ETU) immediately.
Tenotomy is a method that can successfully treat many tendon-related problems. It is a safe and quick treatment. If you have a similar problem, do not hesitate to talk to a doctor and get the right advice.
Take-Home Message
- Tenotomy is a treatment for chronic tendon pain that has not improved with other treatments, such as rest and physical therapy.
- This is done in two main ways: through a needle (percutaneous) and through minor surgery (open).
- While this is generally a very safe and effective treatment, keep in mind that there are some minor risks.
- Rest is essential for recovery after treatment. It is very important to follow your doctor's instructions carefully.
- If you have long-lasting tendon pain, do not ignore it and seek medical advice.
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