Cuttting-Edge Alternatives to Surgery

Natural Tendon Treatment

Percutaneous Needle Fenestration in Raleigh, NC

At Wake Nonsurgical Ortho, we specialize in performing the percutaneous needle fenestration procedure for patients who suffer from tendinosis & tendinopathy in Raleigh, Durham and Cary, NC. As the triangle’s first practice solely dedicated to non-surgical/minimally invasive procedures, we make every attempt to return patients to the quality of life that allows them to enjoy recreational and daily activities they enjoy. For more information about percutaneous needle fenestration or how it can help restore your active lifestyle, please contact our office at (919) 719-2270.

What is a Percutaneous Needle Fenestration?

It is a minimally invasive intervention performed under ultrasound guidance (sonogram), utilized in the treatment of chronic tendon problems known as tendinosis or tendinopathy. A small needle is introduced through the skin, and small incisions are performed in the damaged tendon, ultimately creating an enhanced healing response resulting in tendon repair. It is a cost effective intervention with excellent results, minimal morbidity and early return to work.

What is Tendinosis/Tendinopathy?


It is a chronic degenerative condition caused by excessive strain, overuse and micro trauma which results in an abnormal tendon, not able to heal itself. There are other associated conditions which may predispose patients to developed abnormal tendon changes such as: anatomic mal alignment, inadequate mechanics, poor training, inadequate rest or medication related (certain antibiotics).

When is the procedure indicated?

Most of the time, tendon related problems can be treated conservatively. Usually physical therapy, orthotics, proper training methods, adequate rest, analgesics and rehabilitation, can improve or resolve the symptoms altogether. When conservative therapy fails and there is significant morbidity, a percutaneous needle fenestration should be considered.

What are the most commonly treated conditions?

  • Tennis elbow
  • Golfer’s elbow
  • Plantar fasciitis
  • Gluteus tendinopathy
  • Hamstring tendinopathy
  • Achilles tendinopathy

How is the procedure performed?

Percutaneous needle fenestration is an office based intervention, performed under local anesthesia. After consent is obtained, the skin is cleansed and under ultrasound guidance the affected tendon site is identified and marked. Local anesthetic is infiltrated in the skin and over the affected tendon. A small needle is then advanced through the tendon into the bony origin. Multiple perforations area carried under ultrasound guidance. The needle is removed and a bandage applied. The procedure usually takes 20 minutes.

Post procedure instructions:

Active range of motion is encouraged during the first 48 hours. Mild analgesics are usually prescribed, along with ice and electrical stimulation (if available). The use of non-steroidal is avoided for 2 weeks post procedure. Avoidance is forceful resistance exercises is recommended. Physical therapy is usually recommended for 4-8 weeks post procedure. A gradual tendon eccentric loading program is started.

Schedule a Consultation for Percutaneous Needle Fenestration

Percutaneous needle fenestration is an effective treatment option for patients suffering from tennis elbow, golfer’s elbow, plantar fasciitis and other orthopedic symptoms. Board-certified orthopedic specialist, Dr. Kanaan specializes in performing the percutaneous needle fenestration for patients in Raleigh, Cary and Durham, NC. He will provide a comprehensive diagnosis for your orthopedic pain and answer any questions you may have to determine if percutaneous needle fenestration is right for you. For more information, contact our office at (919) 719-2270 and schedule a consultation today!

Wake Internal Medicine
Rx Urgent Care
Wake Gastroenterol
Wake Women's Health
Wake Internal Medicine and Pediatrics
Wake Research Associate

OUR LOCATION - WHERE IS WAKE SPORTS MEDICINE?

3100 Blue Ridge Rd., Suite 203, 2nd Floor

Raleigh, NC 27612

Phone: (919) 719-2270

Mon-Fri: 8:30am-4pm, Wed 8:30am-Noon, (12-1pm Lunch)

View Map