What Is the Tenex Procedure?

Medically Reviewed by Tyler Wheeler, MD on February 26, 2024
3 min read

The Tenex Procedure is a nonsurgical procedure developed and trademarked by Tenex Health. It helps patients with chronic tendon pain - tendinosis or tendinitis. By using ultrasonic frequencies — or very high sound waves that humans can’t hear — this procedure breaks up and removes damaged tissue on the tendons, leaving behind only healthy tissue. 

This procedure is less invasive than surgery and can be performed in the outpatient department by a sports medicine physician. In most cases, only one treatment is needed to relieve pain. 

Tendons are the bands of tissue around your joints — which are like rubber bands, connecting your muscles to your bones. These bands allow you to freely bend, walk, jump, and do other body movements.

Injury, degenerative conditions, or repetitive movement can cause a buildup of scar tissue on your tendons, which can result in chronic pain and limit your movement. 

If it’s not treated, your tendon pain and mobility will worsen.

Traditional treatment of tendon pain includes:


Your doctor will recommend limiting activity near the affected tendon for several weeks to give it an opportunity to heal. 

Physical therapy

You may be asked to see a physical therapist who’ll help you do stretches including eccentric strengthening — which includes contracting your muscles while you are lengthening them. The therapy may also include various massages and lessons on how to avoid further injury.


Several medications can be used for treating inflammation caused by the damage in the affected tendons. The most common are over-the-counter pain relievers like aspirin, ibuprofen (Advil and Motrin), and naproxen sodium (Aleve). Your doctor may also recommend corticosteroids, medications they inject around the affected tendon to relieve pain.

Dry needling

While this treatment is invasive, it’s far less invasive than traditional surgery. In dry needling, a fine needle is used to make holes in your affected tendon in order to stimulate the tendon healing process. 

When all the traditional methods fail, your doctor may recommend the Tenex procedure.

The Tenex procedure is used to treat chronic tendon pain from tendinosis (chronic damage to a tendon) or tendinitis (acute swelling of a tendon).

The procedure is  most effective on tendons in the elbows, shoulders, hips, knees, and ankles — especially when you have:

Your doctor may recommend that you stop taking anti-inflammatory drugs or blood thinners one week before the procedure. 

Depending on how much scar tissue needs to be removed, the procedure takes 10 to 30 minutes or less.

The Tenex procedure starts with the radiologist using real-time ultrasound to locate the scar tissue. After applying numbing medication on the area or areas, the radiologist will use the ultrasonic needle to target, break up and remove the scar tissue. The healthy tissue is unharmed. You’ll need a bandage and you can go home.

You'll want to rest the area for a few days as you may have some mild soreness in the treated area for up to 1 week.

Most patients recover in 4 to 6 weeks after the procedure, but it may take up to 12 weeks for you to get back to strenuous activities or sports. Physical therapy may be recommended to improve the success of the procedure. Most patients can use over-the-counter pain relievers to reduce the pain after the procedure.

Your radiologist will schedule a follow-up appointment 2 weeks after the procedure to see how your recovery is progressing.

Only one treatment is needed for most patients.

Side effects of the Tenex procedure may include pain at the incision site, soreness, or some swelling for a few days after the procedure.

Only 0.001% of people who got the Tenex procedure have reported complications.