Dry Needling (Tendon Fenestration)

Ultrasound guided tendon fenestration involves passing a needle through the areas of tendinosis multiple times.

It changes a chronic degenerative process into an acute inflammation and disrupts area of tendinosis. Bleeding that occurs within the tendon during the procedure causes release of growth factors which stimulate tendon healing through scar remodelling. This method is applied in a chronic degenerative enthesopathies where the structure of tendon attachment is changed with developing of scars, ruptures, calcifications and spurs.

The most common conditions we treat with tendon fenestration:

Tennis elbow,
Golfer’s elbow,
plantar fasciitis,
Jumper’s knee,
gluteal tendinopathies.

Indication for the treatment:

Lack of good results in conservative treatment of chronic pain due to tendinosis.

Contraindications:

bleeding disorders,
infection,
prior steroid injection<three months ago,
allergy to local anesthetic,
pregnancy.

What does the procedure entail?

After local anaesthesia of the subcutaneus tissue the doctor punctures the affected area of the tendon multiple times with the needle. The whole procedure is performed only under ultrasound visualisation.

Post-procedure recommendation:

avoid ice,
avoid anti-inflammatory drugs, In the case of pain it is recommended to use paracetamol,
rest for two weeks,
after two weeks gradual returning to activities,
after two weeks start of rehabilitation.

Dr. Marcin Goczewski performs dry needling procedure only under ultrasound guidance.