Ultrasound-Guided Injection

Viscosupplementation / Hyaluronic Acid / Ostenil Injection

What is it?

This is one of the non-surgical options for treating osteoarthritis (wear and repair arthritis). The goal of this treatment is to reduce pain and inflammation and to restore function of the affected joint.

What conditions does it treat?

Osteoarthritis (wear and tear arthritis)

How does it work?

It involves injecting a gel-like fluid known as Hyaluronic Acid (HA) into the affected joint.

How long does it take to work?

If effective they should work within days. The duration of effect is variable. Sometimes repeat courses will be recommended.

When can I return to work after the procedure?

Immediately as there is no specific need to rest after the injection.

 

Prolotherapy / Sclerosant injection

What is it?

A series of injections into the ankle, knee or shoulder to improve ligament laxity

What conditions does it treat?

Stretched, sprained or lax ligaments

How does it work?

A mixture of dextrose in local anaesthetic is injected into each end of the affected ligament, close to its attachment to the bone. This eventually stimulates the body to make new fibres, which are laid down within the substance of ligaments, thickening and strengthening them.

How long does it take to work?

Improvements are generally gradual and noted over a period of weeks to months.

When can I return to work after the procedure?

Immediately as there is no need to rest after the injection.

 

Autologous blood / Orthobiologic / Platelet rich plasma (PRP) injection

What is it?

It involves taking a patient’s own blood and concentrating the levels of platelets and growth factors to promote healing in injured musculoskeletal tissue. These platelets and growth factors are then injected back into the patient directly into the injured area

What conditions does it treat?

Any tendinopathy/tendinitis/tendinosis in the body (e.g. jumper’s knee, tennis elbow, golfer’s elbow, Achilles tendinopathy), early osteoarthritis (wear and tear arthritis), chronic muscle injuries, chronic ligament injuries, injuries involving the cartilage that surrounds a joint (chondral injuries), plantar fasciitis

How does it work?

The patient’s own concentrated platelets and growth factors are used to stimulate and enhance the body’s own healing response to treat acute injury, inflammation or chronic degenerative disease.

How long does it take to work?

Pain relief may initially occur 4-6 weeks later but can sometimes take several months

When can I return to work after the procedure?

High intensity activity should be avoided for up to 2 weeks. It is best to avoid all but necessary activity for 2 days.

 

Steroid / Cortisone injection

What is it?

An injection of a naturally occurring hormone directly into the joints (intra-articular), tendon sheath (peri-tendinous) or around the joints (peri-articular)

What conditions does it treat?

Arthritis, bursitis, synovitis

How does it work?

After injecting it into the affected area, corticosteroids work to reduce inflammation (heat, redness, swelling, & pain) in and around the joint. Eventually less pain, swelling, stiffness and warmth is felt and joint function improves

How long does it take to work?

This varies between different people, but usually improvement starts in 1–2 days. If it is helpful, the benefit usually lasts from a few weeks to several months.

When can I return to work after the procedure?

It is advised to rest the joint injected for 48 hours.

 

High volume injection

What is it?

Injection of a high volume of fluid (steroid, saline and local anaesthetic) into the space between achilles tendon and the tendon sheath it is encased in

What conditions does it treat?

Achilles tendinopathy

How does it work?

The high volume of fluid destroys the abnormal blood vessels and nerve endings that have grown into the tendon therefore reducing pain.

How long does it take to work?

Patients are often able to return to regular physical activity and healthy lifestyle within 4 weeks of presentation.

When can I return to work after the procedure?

It is advisable to be cautious with walking for 24 hours after injection, after which you can gradually return to normal activity as pain allows.

 

Hydrodistension/hydrodilatation

What is it?

An injection of high volume of fluid (a mixture of steroid, local anaesthetic and saline) into the shoulder

What conditions does it treat?

Adhesive capsulitis (frozen shoulder)

How does it work?

The high volume of fluid in the shoulder aims to stretch the tight shoulder capsule and disrupt adhesions (scar tissue)

How long does it take to work?

For some there will be immediate symptom relief. For others, it can take up to two weeks for symptom relief.

When can I return to work after the procedure?

Immediately, with caution in undertaking lifting and carrying, in case of any discomfort caused by the procedure.

 

Barbotage

What is it?

Insertion of needle into shoulder to inject warm saline

What conditions does it treat?

Calcific tendinopathy of the shoulder

How does it work?

Needle is inserted into shoulder which breaks up the calcium deposits and then saline is flushed through the needle to wash away the calcium

How long does it take to work?

Some patients will experience immediate relief. However sometimes it can take a week to two weeks to achieve pain relief

When can I return to work after the procedure?

It is advised that the patient does not drive or operate heavy machinery for a minimum of 6 hours after the procedure