PNT: percutaneous needle tenotomy Tendon Pain Relief Procedure

PNT: Treatment for Chronic Tendon Pain

Dr. Pam Rizza, who practices sports medicine at Atchison Hospital, helps patients suffering from chronic tendon pain using an innovative procedure known as percutaneous needle tenotomy (PNT). This minimally invasive procedure removes scar tissue on the tendon and promotes healing, allowing patients to get back to living their lives with significantly less pain in a short amount of time.

PNT Treats Tendonosis

PNT requires minimal recovery time, there are no stitches required, and patients experience rapid improvement in pain after the procedure. Compared to open procedures with large incisions that require a painful three-to-six month recovery period, PNT will have patients recovered from the majority of their pain within six to eight weeks. PNT is designed to treat patients suffering from the following types of tendinosis:

  • tennis elbow
  • golfer’s elbow
  • swimmer’s shoulder
  • jumper’s knee
  • Achilles’ tendonitis, and
  • plantar fasciitis

Watch Dr. Pam Rizza explain the PNT procedure at a recent Lunch and Learn presentation.

As we age, our bodies experience continued trauma and build up scar tissue due to overuse, excessive training, and repetitive actions. Chronic tendon pain can drastically alter a person’s quality of life. It’s difficult to enjoy a genuinely happy, healthy, full life when one is consumed by pain from the moment he wakes in the morning to the moment he crawls into bed at night.


  • Short recovery period: 6–8 weeks
  • Rapid improvement in pain shortly after the procedure
  • No stitches are required
  • Good insurance coverage

Patient Stories



  • Age: 40s
  • Occupation: Nurse
  • Procedure: Both Elbows

“I’ve dealt with chronic pain for 8 years. I had been treated with steroid shots and a few rounds of physical therapy that did not help. Initially, I had Dr. Rizza treat both of my elbows at the same time. Now my right elbow is perfect, and the left is greatly improved. I wish I had known about this procedure 8 years ago. The preparation for the procedure took longer than the actualprocedure. It was quick, painless, and so easy.”



  • Age: 50s
  • Occupation: Human Resources
  • Procedure: Left plantar fascia

“I had experienced pain for several months before I was referred to Dr. Rizza. Because the procedure was done on my foot, I was given a boot to wear. At my two-week check up, I was able to walk out of the office without my boot, and it was awesome! Six weeks after the procedure, I am about 60-70% better. I got to see the ultrasound where the area is starting heal, and it’s pretty exciting.”



  • Age: 30s
  • Occupation: Medical Assistant
  • Procedure: Left Elbow

“I had constant pain in my elbow for about five months. I tried rubbing, bands, and injections. These only helped for a little while. Then I saw Dr. Rizza. She did the ultrasound and showed the bad tissue in there. I had the procedure, and my now my elbow’s doing great. I’m 95% better and would definitely recommend this procedure.”

About the Procedure

To prepare for the procedure, Dr. Rizza numbs the affected area with a local anesthetic. She then uses a scalpel to make a tiny incision through the skin and inserts a small needle. The needle emits ultrasonic waves to identify and locate the scar tissue within the tendon. Once the damaged tissue is located, the ultrasonic waves break it apart. The tissue is then removed, creating an inflammatory reaction within the tendon that promotes healing. Inflammatory cells alert the body that there has been damage and that it can begin the healing process.

Dr. Rizza likes to perform this procedure on Thursdays so that most patients can take off work on Friday to recover over a three-day weekend and be back to work on Monday with a small adhesive bandage covering the site of the incision. The appointment typically lasts an hour with the actual procedure lasting no longer than fifteen minutes. Patients are free to go when they are finished.

Candidate Determination

PNT is a treatment used when a patient has been suffering from chronic tendon pain for longer than three months and conservative treatments such as rest, anti-inflammatory medications, and physical therapy fail to alleviate the problem. Even though the procedure is low risk, Dr. Rizza first consults with the patient to determine if he is a good candidate for the procedure. She makes sure that the patient is healthy enough for the procedure and that the pain is located in a treatable site. She then performs a diagnostic ultrasound that shows the diseased tendon.

Question & Answer

Will physical therapy be necessary after the procedure?

Will driving be restricted after the procedure?

Which tendons can be treated?

When can patients go back to work after the procedure?

What is the procedure process?

What can patients do to prepare for the procedure?

What can be used for pain control after the procedure?

Is the procedure covered by insurance?

How long do the results last?

For plantar faciitis, what are the restrictions after the procedure?

Can patients drive themselves home after the procedure?

To schedule an appointment please call 913-360-5829