Dry Needling / Needle Fenestration

 This is a treatment designed to stimulate a healing response in a tendon or other soft tissue (ligament, fascia etc) by causing some bleeding to the tissue affected. It is most commonly used for chronic tendon pain such tennis/golfers elbow, shoulder rotator cuff pain, patella tendon pain and also conditions like plantar fasciitis and lateral hip pain. 

We know that blood contains various growth factors which are involved in stimulating a healing reaction in damaged tissues. This is how the normal healing response works when we are injured. Chronic tendon and ligament problems are thought to be caused when the normal healing process becomes 'stuck'. This treatment is designed to kickstart this healing response by causing some controlled bleeding into the affected area.  

Ultrasound Guided Needle Fenestration for Tennis Elbow 

The treatment can be delivered by acupuncturists but a better option is to numb the area first with local anaesthetic and then use a normal injection needle under ultrasound image guidance to carefully 'fenestrate' the tendon or ligament. The procedure usually takes a minute or 2 and may need to repeated 2 or 3 times. You should not use anti-inflammatory medication for a week before and after the treatment as these can slow down the inflammatory reaction that you are trying to stimulate with the treatment. 



Video of an Ultrasound Guided Needle Fenestration

Because there are no drugs involved (other than local anaesthetic) needle fenestration is considered to be a healthier alternative to a Cortisone injection, which is another treatment commonly available for similar conditions.

Another treatment which takes this process a step further is called PRP (platelet rich plasma) and you can read about that treatment here.


This article provides general information related to various medical conditions and their treatment. It is intended for informational purposes only and  not a substitute for professional advice, diagnosis or treatment provided by a doctor or other qualified health care professional. The information provided does not constitute personal advice or guarantee of outcome and should not be used to diagnose yourself or others. You should never ignore advice provided by a health care professional because of something you have seen or read on this website. You should always consult a doctor or other qualified health care professional for personal medical advice.