Tennis Elbow
Lateral Epicondylitis
TENEX | MINIMALLY INVASIVE TENDON CARE
Table of Contents
Understanding the Condition
Tennis elbow is pain on the outer side of the elbow, most often involving the common extensor tendon, particularly the extensor carpi radialis brevis. It can develop with racquet sports, repetitive mouse or tool use, lifting, or gripping. Pain may worsen when lifting a cup, turning a doorknob, or extending the wrist against resistance.
Acute Injury vs. Chronic Tendon Pain
An acute overload can irritate or strain the tendon. With prolonged symptoms, the tissue may develop disorganized collagen and reduced load tolerance—often described as chronic lateral elbow tendinopathy.
In the early phase, the goal is to manage the load and allow recovery. When pain persists for months, the problem may involve tendon degeneration, disorganized collagen, and impaired remodeling rather than ongoing acute inflammation. Repeated overload, delayed rehabilitation, or an incomplete diagnosis can contribute to a cycle of persistent symptoms. Not every chronic tendon disorder is caused by inadequate treatment, and imaging findings must be interpreted alongside the clinical examination.
Treatment Options: From Rehabilitation to Targeted Procedures
Initial care emphasizes load modification, progressive forearm strengthening, physical therapy, technique changes, and short-term symptom relief. Braces, shockwave therapy, and selected injections may have roles, depending on the patient and evidence for the proposed treatment.
Most patients improve without a procedure. When pain continues despite an appropriate course of conservative treatment, reassessment can help determine whether there is a localized tissue abnormality that might respond to a more targeted intervention.
Tenex: A Minimally Invasive Option
For chronic tennis elbow with a clearly identified area of degenerative tendon tissue and persistent symptoms despite rehabilitation, Tenex offers a minimally invasive alternative to an open procedure. Under real-time ultrasound guidance, the physician makes a small skin opening and uses ultrasonic energy with irrigation and suction to remove targeted abnormal tissue.
The procedure is typically performed with local anesthetic and real-time ultrasound guidance through a very small incision. The ultrasonic tip fragments targeted abnormal tissue while irrigation and suction remove debris. Patients receive a personalized activity and rehabilitation plan afterward. Recovery timelines vary by site and severity, and improvement is not guaranteed. Potential risks include infection, bleeding, nerve or tissue injury, persistent pain, and tendon weakening or rupture.
Meet Dr. Nick Sadeghi
“The mission of Synaptic is to help people stay strong, active, healthy, and engaged throughout every stage of life by combining longevity medicine, regenerative therapies, recovery science, and athlete-focused care into one integrated system.”
Whether the goal is optimizing athletic performance, improving recovery, restoring energy, or supporting healthy aging, Synaptic focuses on helping the body function at a higher level for longer. Using modern therapies such as Hormone Replacement Therapy, NAD optimization, Regenerative medicine, Chiropractic body work, PRP, Tenex, EBOO, and advanced recovery modalities, Synaptic is designed to support performance, resilience, recovery, and long-term vitality.
Dr. Nick Sadeghi
The Synaptic Way: Integrated Recovery
The Synaptic Way pairs targeted treatment with rebuilding tendon capacity. We assess grip mechanics, shoulder and forearm function, and work or sport demands; then tailor rehabilitation and consider complementary modalities such as shockwave, laser, PEMF, or chiropractic care where appropriate. The goal is durable function, not simply temporary pain relief.
Our approach brings sports medicine, regenerative and rehabilitation principles, and recovery technology together—selecting the right intervention for the right stage of healing.