People can experience chronic pain in a localized area. For example, buttock pain, heel pain, foot pain. This pain can appear spontaneously, with trauma (sprain or strain), with overuse (tennis elbow), sports related injury (achilles tendonitis) or can be associated with arthritis and aging (rotator cuff tendonitis). Steroid shots are often used to treat this type of pain successfully but repeated injections can cause unwanted side effects. In people who have chronic pain this pain often presents disordered healing of the injured structure. This can led to scaring that in turn causes pain. Relief of pain in often associated with repairing this scar tissue. This can be done sometimes with massage, and with percutaneous needle tenotomy (PNT). During a PNT procedure, the physician uses a needle tip and sterile numbing medicine to hydro dissect the scar tissue essentially repairing or  opening up the scar tissue.   Releasing the scar tissue can also allow the muscle or tendon to move freely again. The punctures from the needle tip also cause bleeding which brings healing substances to the area.  For example, platelets, small cells in the blood which contain growth factors which encourage healing.  In certain areas of the body PNT is more successful then steroid shots. This is specifically true with chronic elbow pain secondary to tennis elbow or golfers elbow.  Avoiding steroid injections is convenient for many patients with other illnesses, for example diabetes where steroids increase blood sugar levels.

Helping Your Body Heal Naturally With Platelet Rich Plasma (PRP)
An exciting new approach which can greatly enhance the effectiveness of PNT is the use of platelet rich plasma. In this situation, the patients own blood is drawn in the office and a highly concentrated (15 times more than whole blood) dose of the patients own healing material is  prepared for injection into the painful muscle or tendon during the same office visit.  Pain relief can be dramatic and is usually apparent within 2-6 weeks following the procedure.

This can be useful as an initial treatment or even after other treatments have failed in the following conditions:

• Elbow pain – medial and lateral epicondylitis
• Shoulder pain – rotator cuff tendonitis with or without tears or calcium deposits
• Hip pain – chronic bursitis, tendonitis or the gluteal muscles
• Ankle pain due to achilles tendonitis
• Foot pain due to plantar fascitis
• Knee pain
• Muscle tears