When heel pain won’t quit: TAME offers a non-surgical option for chronic plantar fasciitis and tendon pain

Chronic musculoskeletal pain — nagging heel pain on the first steps of the morning, an aching Achilles, a tennis elbow that lingers for months — is one of the most common reasons adults seek care, and one of the most frustrating to treat.

For many patients, the pain persists despite rest, stretching, orthotics, physical therapy, anti-inflammatory medication, and even shockwave therapy or steroid injections.

Over the past two years, interventional radiologists in the United States, Japan, and Europe have reported growing experience with a minimally invasive, image-guided technique known as Transcatheter Arterial Micro-Embolization (TAME) — sometimes called transcatheter arterial embolization for musculoskeletal pain.

Recent studies have described its use for refractory plantar fasciitis and Achilles tendinopathy, adding to a broader movement toward targeted, image-guided therapies that aim to treat the source of chronic pain rather than simply mask it.

According to Dr. Noppachai Siranart, Postdoctoral Research Fellow at Brigham and Women’s Hospital / Harvard Medical School and founder of YOUNIFY Clinic, a healthy aging and wellness center focused on weight management, joint and pain medicine, and minimally invasive treatment, TAME belongs to the same family of image-guided embolization techniques as Genicular Artery Embolization (GAE) for knee osteoarthritis [1].

      “Many people with chronic heel or tendon pain have already tried nearly every treatment short of surgery, yet continue to experience pain,” Dr. Noppachai explained.

“TAME offers a less invasive option that targets the abnormal blood vessels thought to contribute to persistent inflammation and pain, without cutting or removing tissue. However, it is not suitable for everyone. Careful patient selection—including an accurate diagnosis, appropriate imaging, and a thorough review of previous treatments—is essential to determine whether the procedure is appropriate and to support the best possible outcome.” 

Treating the Source: Abnormal Blood Vessels and Nerves

Research over the past decade has shown that chronically inflamed tissue — whether in a joint, a tendon, or the plantar fascia of the foot — tends to grow abnormal new blood vessels, a process called neovascularization.

These abnormal vessels are typically accompanied by new sensory nerve fibers, and together they help drive a self-perpetuating cycle of inflammation and pain that can last for months or years.

TAME is designed to interrupt that cycle. Using imaging guidance, an interventional radiologist advances a very fine catheter to the small abnormal vessels supplying the painful area and delivers microscopic embolic material to reduce their blood flow.

Because the treatment targets only these abnormal microvessels while preserving normal circulation to the surrounding tissue, the risk to healthy structures is considered low.

How the Procedure Works

TAME is performed through a pinhole-sized entry point in an artery — commonly at the wrist, groin, or near the ankle — under local anaesthesia with light sedation.

Guided by real-time imaging, the physician navigates a micro-catheter to the abnormal vessels around the heel, tendon, or affected area and delivers small embolic particles precisely to the inflamed region.

The procedure typically takes around 60 to 90 minutes. There are no large incisions and no stitches at the entry site. Most patients are observed for a few hours and are able to return home the same day, with normal daily activities usually resumed within a short period. Some mild soreness at the treated area during the first few days is not unusual.

Who Might Be Suitable

TAME is generally considered for adults with chronic plantar fasciitis, Achilles or other tendon pain (such as tennis elbow or frozen shoulder) that has not adequately responded to conservative treatment — including rest, physical therapy, orthotics, anti-inflammatory medication, shockwave therapy or steroid injection — and who wish to avoid or delay surgery.

It is not suitable for everyone. Individual assessment by a physician remains essential to confirm the source of pain, review imaging, and decide whether TAME is an appropriate option. As with any procedure, results vary from person to person, and the evidence base — while promising — is still emerging.

The Future of Image-Guided Musculoskeletal Care

As medicine shifts toward precision-based, minimally invasive strategies, embolization techniques such as GAE and TAME reflect a broader change in how chronic musculoskeletal pain is understood and treated — focusing on the underlying vascular and inflammatory changes rather than symptom suppression alone.

With growing clinical experience worldwide, TAME is expected to become an increasingly discussed option for selected patients living with stubborn heel and tendon pain.

Results depend on each individual. Please consult a physician before undergoing any treatment.

 

Noppachai Siranart, M.D. Founder at YOUNIFY Clinic https://www.younifyclinic.com/

Reference:
[1] Siranart N. GAE offers non-surgical relief for osteoarthritis knee pain. The Nation Thailand [Internet]. 2026 Jul 10 [cited 2026 Jul 27]. Available from: https://www.nationthailand.com/the-opinion/commentary/40068410

[2] YOUNIFY Clinic. Chronic joint and tendon pain: TAME treatment [Internet]. Bangkok: YOUNIFY Clinic; [cited 2026 Jul 27]. Available from: https://younifyclinic.com/en/services/chronic-pain/joint-pain