Chronic foot pain can take the spring out of your step, making it tough to do the activities you want to do. Unfortunately, pain in the soft tissues of the feet is common—and not always easy to treat. But a minimally invasive procedure called Tenex can help relieve chronic pain in tendons and ligaments, both in the foot and in other parts of the body.
Nicole Brouyette, DPM, a podiatrist at Henry Ford Health, describes how Tenex works, what types of pain it can treat and who it can help.
Achilles Tendinosis and Plantar Fasciitis
Lots of things can cause foot pain, including stress fractures and arthritis. But two common conditions are caused by problems that trap inflammation in tendons and fascia bands.
“In podiatry, when these problems become chronic (lasting more than three months) and aren’t getting better with conservative treatments, we can treat them with microdebridement—also known as Tenex,” Dr. Brouyette explains.
- Achilles tendinosis: The Achilles tendon is a large tendon that runs along the back of your leg, connecting your heel to your calf muscle. When it becomes inflamed from overuse, it can cause pain at the back of your heel, where your tendon attaches to your heel bone. People with Achilles tendinosis might also feel a bulbous, swollen area under the skin at that attachment point.
- Plantar fasciitis: The plantar fascia is a thick band of tissue that runs along the bottom of your foot, connecting your heel to the front of your foot and helping to support your arch. Plantar fasciitis occurs when that band of tissue becomes irritated or degenerates over time, often causing sharp heel pain with your first steps in the morning.
When someone first develops plantar fasciitis or pain in a tendon, doctors usually recommend conservative treatments such as:
- Physical therapy and stretching exercises
- Ice
- Orthotic shoe inserts
- Anti-inflammatory medicines
- Rest
- Steroid injections
Treating Chronic Tendon Pain
Tendon injuries can be slow to heal because tendons have relatively limited blood flow, making the body’s natural healing process more challenging, Dr. Brouyette explains. “Even with conservative treatments, patients may continue to experience pain and discomfort for several months,” she adds.
If the inflammation continues for more than four to six months, the tendons or fibrous connective tissue can start to degenerate. Then, the condition becomes chronic—and can be even harder to fix with standard treatments.
“Once the problem becomes chronic and the tissue has degenerated, treatments such as stretching won’t be enough,” Dr. Brouyette says. That’s where ultrasonic technology such as Tenex can help.
Foot and Ankle Care at Henry Ford Health
“Tenex uses advanced ultrasonic (high-energy sound wave) technology to precisely target and break down damaged tendon tissue while preserving the surrounding healthy tissue,” explains Dr. Brouyette. “The device uses a tiny needle that vibrates at a high frequency, allowing us to remove the diseased tissue through a minimally invasive approach.”
As a podiatrist, Dr. Brouyette regularly uses Tenex to treat Achilles tendinosis and plantar fasciitis. But other sports medicine specialists use the tool to treat chronic tendon pain in other parts of the body, such as tennis elbow or golfer’s elbow, and shoulder conditions such as rotator cuff injuries.
What to Expect During Tenex Treatment
Tenex isn’t traditional surgery. It’s a minimally invasive option done in the doctor’s office, typically taking less than 20 minutes from start to finish. Patients are awake during the procedure, with a local anesthetic to numb the treatment area and minimize discomfort.
Using ultrasound imaging, the doctor identifies the thickened, unhealthy tissue. A small probe inserted through a tiny incision breaks down the damaged tissue and leaves the surrounding healthy tissue in place.
One of the biggest advantages of Tenex is the minimal downtime compared to traditional surgery, Dr. Brouyette says. Patients go home the same day with just a small bandage, and many don’t require formal physical therapy.
Discomfort can typically be managed with ice and over-the-counter pain medication. Depending on the area treated, patients may need a protective boot or activity restrictions for two to four weeks before transitioning to supportive footwear such as running shoes. Many people gradually return to full activity within four to six weeks.
The procedure itself doesn’t take long, but it’s not a quick fix. The treatment kick-starts the body to begin repairing the tissues.
“Healing varies from patient to patient, but most people can expect significant tissue healing within six to eight weeks,” Dr. Brouyette says. “Over the following months, the body’s natural healing process gradually replaces the damaged tissue with healthier tissue.”
Podiatry Treatment for Foot Pain
If you’re experiencing any kind of pain in your feet, it’s a good idea to see a podiatrist sooner rather than later, Dr. Brouyette says. They can rule out other problems such as stress fractures or large tendon tears that might need surgery to be repaired.
Doctors can also start you on a treatment plan to address tendinosis or plantar fasciitis before the conditions become chronic and cause the tissues to thicken. “It’s important not to put off treatment, since acute inflammation can become chronic, and then it’s much harder to treat,” she says. But if the conditions have reached that point, Tenex may be an option worth asking about.
Reviewed by Nicole Brouyette, DPM, FACFAS, a board-certified podiatric surgeon who sees patients at Henry Ford Hospital in Detroit, Henry Ford Medical Center-Fairlane and Henry Ford Medical Center-Grosse Pointe Cottage Building.
