November 13, 2018

Is Elbow or Heel Pain Stopping You?

By Randy R. Clark, MD and Aaron O’Brien, MD


Golfer’s elbow (inner elbow pain) is a commonly encountered orthopedic problem. It may affect as many as 8% of patients. Tennis elbow (outer elbow pain) affects up to 3% of adults each year. Plantar fasciitis is the most common cause of heel pain. It is estimated that 1 person in 10 may experience this heel pain at some time. Nearly two million patients receive treatment for plantar fasciitis each year in the United States, comprising 1% of all visits to orthopedic surgeons.

Repetitive stress on the tendon-bone interface results in microtrauma and degeneration. Symptoms include pain accompanied with swelling and decreased range of motion. Treatments include icing, anti-inflammatories, compressive wraps, physical therapy, night splints, and extension braces. Corticosteroid injections are often required if more conservative methods fail to relieve symptoms.

If these symptoms persist, surgical debridement is considered. Traditional, open surgical treatment may require postoperative splinting and several weeks of recovery. This also comes with the possibility of complications, such as infections and wound healing problems.

If you or members of your family have been suffering with this type of pain, a newer, minimally invasive, effective procedure is now available. Tenex Health offers a treatment based on advanced technology developed in collaboration with the Mayo Clinic. This minimally invasive procedure can treat your damaged tendon tissue, leaving healthy tissue undisturbed¹ ² while promoting a healing response.³ This procedure is performed in a minimally invasive fashion, often under local anesthetic.

The Tenex Health TX® System combines ultrasound imaging (to specifically target damaged tissue) with the advanced TX MicroTip, an instrument designed to cut and remove the diseased soft tissue that causes pain, facilitating the restoration of natural tendon and soft tissue function. No stitches are required. The procedure is performed in minutes and promotes rapid pain relief for a return to normal activities. Typical recovery time is approximately 6 to 8 weeks.


How does Tenex Health TX compare to open surgery? The goal of an open or arthroscopic approach is to visualize, cut, and remove the damaged soft tissue. The goal of Tenex Health TX is to replicate this approach but in a minimally invasive manner. Open surgery often requires an operating room suite with general anesthesia and support. In addition, the patient has a prolonged recovery that requires extensive physical therapy. The success rate for the open surgical procedure is around 50–60%, and recovery time is approximately 6 months.

Published clinical studies on the Tenex Health TX treatment reveal improvement from pain within 2 weeks, sustained through 12 months post-treatment. 95% of patients are pain-free up to the final point of measurement and have statistically significant pain relief at 6 weeks post-treatment, sustained at the 12 month follow-up period.  No device or patient related complications were reported in these studies. The low complication rate is attributed to the safety of the device, the minimally invasive approach, and the ultrasound imaging that precisely identifies the diseased area.

Dr. Randy Clark and Dr. Aaron O’Brien are trained to perform this innovative procedure. This procedure is not only effective for tendonitis around the elbow but also for jumper’s knee, plantar fasciitis, Achilles tendinitis, hip bursitis, and even calcific tendinitis of the shoulder.

If you are looking for options other than traditional surgery, please schedule a consultation today by calling Coral Desert Orthopedics at 435-628-9393.


1 O’Daly, B., et. al. High-power low-frequency ultrasound: A review of tissue dissection and ablation in medicine and surgery.  Journal of Materials Processing Technology, 2008.
2 Cimino, W.W., et. al., Physics of Ultrasonic Surgery Using Tissue Fragmentation: Part I, Ultrasound in Medicine & Biology, 1996.
3 Kamineni, S., et. al., Percutaneous ultrasonic debridement of tendinopathy—a pilot Achilles rabbit model, Journal of Orthopaedic Surgery and Research, 2015.
4 Koh, J., Fasciotomy and Surgical Tenotomy for Recalcitrant Lateral Elbow Tendinopathy, Am. Journal of Sports Medicine, 2013.
5 Barnes, D., et. al., Ultrasonic Percutaneous Tenotomy for Chronic Elbow Tendonosis: a Prospective Study, Journal of Shoulder and Elbow Surgery, 2015.
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