Injections are used to deliver a pharmacologically active substance direct to the site required. Depending upon the underlying pathology injections may be used to treat joints, tendons, ligaments or muscles.
It is best practice that injections are delivered with the aid of guidance to ensure they enter the correct structure. Usually this is achieved with an ultrasound scanner however some injection sites are best guided by a CT scanner or fluoroscopy. The following injections can be arranged as appropriate through the clinic.
Types of Injection
Cortisone is frequently referred to as a steroid however it is completely different to the anabolic steroids abused by bodybuilders. It has a powerful action in reducing inflammation and the pain associated with this. It is most effective for a synovitis or bursitis. Unfortunately it can have a detrimental effect on surrounding tissue so should be used sparingly.
Inside healthy moving joints is a thick lubricating synovial fluid. With the onset of osteoarthritis (wear & tear) this synovial fluid becomes more watery and therefore less efficient. Hyaluronic acids are enormous long molecules that give synovial fluid it’s thick lubricating properties. Synthetic hyaluronic acid can be injected into joints to reduce pain. Unlike the cortisone it does not damage the surrounding tissues.
High Volume Saline
When tendons become painful they usually become tendonopathic. Abnormal blood and nerves grow into the tendon (neovascularisation) causing some of the pain. A large volume of an inert liquid (saline) can be injected along side the neovasular vessels in order to strip them away without damaging the tendon. This is usually used in the Achilles and patella tendon. For further information click here.
Platelet Rich Plasma / Autologous Blood
Many chronic (ie long term) injuries represent a failure of healing. Normally after exercise the body is able to repair itself from the microdamage that naturally occurs. If this fails to occur repeatedly then joints, muscles, tendons and ligaments can become degenerative causing pain and loss of function. The rationale for injecting a patient’s own blood products into an injured tissue is to try and stimulate an inflammatory response that would kick start a healing response.
This is the application of a very thin needle through the skin into a structure; usually a muscle, tendon or ligament. This technique is used to provide pain relief, reduce muscle spasm and trigger point pain. It is most effective when used in conjunction with other therapies or rehabilitation.