Tendinopathy andchronic pain
Tendinopathy is a chronic degenerative tendon condition that fails to heal and affects daily function, participation in physical activity, and quality of life. Tendinopathy is generally thought to occur when the tendon is chronically overloaded and does not have time to heal appropriately.
The typical course of care involves months of conversative treatment, but this often fails to relieve symptoms and return the patient to pain-free function.
Tendinopathy is one of the most common causes of pain in the world.
While any tendon is susceptible to chronic injury or pain, the most commonly affected tendon and tissue areas include:
- The patellar tendon (jumper’s knee)
- The plantar fascia (plantar fasciitis)
- The Achilles tendon (Achilles tendinopathy)
- The tendons originating at the medial and lateral epicondyles of the elbow (golfer’s elbow and tennis elbow, respectively)
Tendinopathy has a fundamentally different composition than healthy tendon. The tendon is unable to engage with the healing cycle properly, leading to degeneration of the tendon and an inability to recover.
Treatment options for tendinopathy are not without challenges.
Open surgery and debridement
Debrides damaged tissue and repairs the tendon, if needed.
Requires anesthesia and exposes the patient to open surgery complications such as infection and/or nerve damage.
Extracorporeal shockwave therapy
Delivers low-energy shockwaves directly to the damaged tendon to increase blood flow and encourage appropriate healing.
This procedure is primarly recommended for calcific tendinopathy of the shoulder and has mixed result in the literature.
Percutaneous ultrasonic tenotomy
Delivers ultrasonic energy for fragmentation and debridement.
This procedure is considered experimental by many payors and can cause burns.
Percutaneous tenotomy is a cost-effective, time-saving, and lower-risk treatment option.
The Ocelot™ Nano is indicated for fragmentation and debridement of soft tissue. It can be used under ultrasound guidance to disrupt the damaged tendon and restart the healing process.