Overview
Whether you are dealing with tennis elbow (lateral epicondylitis) or golfer’s elbow (medial epicondylitis), chronic tendon pain can turn simple actions such as pouring coffee, shaking hands, or gripping a steering wheel into agonising experiences.
When the tendons on the outside or inside of the elbow are damaged by repetitive use, they can enter a state of chronic inflammation. That prompts the body to grow abnormal, microscopic new blood vessels in the tendon tissue, and those vessels are accompanied by highly sensitive nerve fibres, creating a constant cycle of pain.
Transcatheter arterial micro-embolization (TAME) is a cutting-edge, minimally invasive procedure that safely blocks these abnormal blood vessels and stops the pain at its source. It is a breakthrough alternative for patients who have plateaued in physical therapy and want to avoid open surgery or tendon debridement.
TAME stops the cycle of chronic inflammation, significantly reducing elbow pain and restoring grip strength without major surgery or a long rehabilitation.
Who it’s for
Most patients considering TAME come to the clinic after months, and often years, of elbow pain. They have typically exhausted conservative treatment such as physical therapy, bracing, rest, and cortisone or PRP injections without lasting relief, and the pain is actively interfering with their quality of life, their work, or their ability to play sport.
Who is not a candidate
If your elbow pain is caused by a complete, acute tear of the tendon, an active joint infection, or severe arthritis in the elbow joint, TAME is not the appropriate treatment. In those cases we will direct you to the right orthopedic specialist for your care.
How the procedure works
1. Accessing the artery
An interventional radiologist cleans and numbs a small area, usually at the wrist. A tiny tube called a catheter, about the width of a piece of spaghetti, is inserted through a small needle puncture access into the artery.
2. Navigation and imaging
Using real-time X-ray guidance (fluoroscopy), the catheter is navigated down the arm directly to the tiny arteries supplying the inflamed elbow tendons. You will not feel this happening inside your body.
3. Embolization: blocking the vessels
Once the catheter is precisely positioned near the abnormal vessels, either crystallised antibiotic particles or tiny gel particles are injected. These wedge safely into the inflammatory vessels and block their abnormal blood flow, while preserving the healthy surrounding tissue.
4. Relief and restoration
Deprived of their abnormal blood supply, the inflamed tissue shrinks and the extra nerve endings recede. That breaks the cycle of chronic pain and allows the tendon to heal. The catheter is removed and a simple bandage is applied.
What to expect on the day
When you arrive, our team will get you comfortable and start an IV. This is not a painful procedure, and it can be performed awake with local numbing alone. We may also provide “twilight” sedation if desired, in which case you will be relaxed and sleepy but breathing on your own, without a breathing tube or general anesthesia.
The procedure itself typically takes about 45 minutes. Because there are no surgical incisions, you go home the same day.
You will rest in our recovery room for about an hour afterward.
Recovery
Recovery is highly manageable. On day one, plan to rest at home. You may have mild soreness at the wrist access site, and your elbow may feel slightly achy or stiff. This is completely normal and is easily managed with over-the-counter pain relievers such as ibuprofen or acetaminophen.
By the end of the first week most patients feel back to their baseline. You can typically return to a desk job or normal daily activities within two to three days. We ask that you avoid heavy lifting, forceful gripping, and strenuous arm exercise for about a week so the access site heals properly. As the pain subsides, your physical therapy exercises become much easier and more comfortable to perform.
What is normal, and when to call
Mild bruising at the entry site is completely normal. Call our office if you experience severe or worsening pain, a fever above 101°F, active bleeding at the access site, or any sign of infection.
Risks and considerations
Transcatheter arterial micro-embolization is very safe, but as with any procedure there are potential risks, and we would rather set them out plainly.
Common, minor side effects include bruising at the access site and temporary skin discolouration around the elbow. This looks like a mild rash or a mottled patch and resolves completely on its own within a few days.
Rare but more serious risks include infection, injury to the blood vessel, and non-target embolization, where the particles block blood flow to healthy tissue. Because the procedure is performed by a highly trained interventional radiologist using advanced, real-time imaging, the risk of major complications is extremely low.
Results and evidence
The clinical evidence supporting TAME for chronic epicondylitis is very promising and continues to grow. Studies show a technical success rate of nearly 100%, meaning the target arteries can almost always be reached and treated successfully.
For symptom relief, most patients experience a significant, rapid decrease in pain both at rest and during activity. Because the pain is relieved, patients are finally able to regain their grip strength and return to the activities they love.
Early clinical registries show that these results are durable over time, allowing patients to regain their independence and avoid surgery.
Common questions
- Is it painful?
- The procedure is well tolerated. We numb the entry site with local anesthesia and may provide IV sedation if desired, and you will not feel the catheter inside your body. Afterward your elbow may ache mildly for a few days, which is easily managed with over-the-counter pain medicine.
- Will insurance cover it?
- Coverage can vary, because TAME is a newer and highly specialised application of embolization for sports medicine. Some major carriers cover it once standard treatments such as steroid injections and physical therapy have failed, while others currently consider it investigational. Our office will work closely with your insurance provider to verify your exact benefits and out-of-pocket costs before you proceed.
- How soon will I notice a difference?
- Many patients notice a significant reduction in elbow pain within the first two to three weeks. As the inflammation settles you will find it much easier to lift and grip, with continued improvement in function over the next one to three months.
- What happens if it doesn’t work?
- If you do not have adequate relief after a few months, we will re-evaluate your elbow. And if embolization ultimately does not relieve your symptoms, it burns no bridges: you remain a full candidate for traditional orthopedic treatment, including surgical tendon repair if that becomes necessary.
