Guide to Injection Therapy
Injection Therapy
All our injection procedures are performed by our Musculoskeletal Sports Medicine Consultant who has over 17 years of experience performing injections.
Book your appointmentGuide to injection therapy
You do not need a GP referral for our consultant to see you, but we advise you to have a referral from your GP whenever this is possible. Our doctor will seek your permission to inform your GP of any treatment or advice given. This is done in your best interest to optimise the care given.
Most local injections given into or around joints, tendons, muscles and ligaments are very well tolerated and the risks of adverse (side) effects and complications are very rare.
All our procedures are performed under ultrasound guidance to optimise accuracy.
Some injections may need to be repeated for optimal therapeutic effect (maximise benefit) while others need to be used sparingly. Our Sports doctor will discuss this with you during the consultation.
We have endeavoured to give you an informed choice prior to your consultation. Please consult our sports doctor to discuss any of the concerns. The information given below is to give you a balanced view of the benefits and risks associated with the procedures.
Steroid injections
Cortisones (corticosteroids) are anti-inflammatory particles produced in the human body by the adrenal glands. Injectable corticosteroids are synthetically produced in a high dose to be used as a local injection to help relieve pain and inflammation.
They are used to treat as well as to differentiate a diagnosis by telling us if the pain is coming from the suspected structure or from another source.
It is used in tendons, joints, ligaments, and muscles to treat pain, swelling and inflammation. They are also widely used to treat allergies, asthma, and inflammatory arthritis.
It is advised to reduce the load on the joint or structure for 1-2 week before commencing rehabilitation. You are able to do your day to day activities without much restriction.
The injected joint may feel numb after the treatment due to the local anaesthetic used in conjunction and can last up to 4 hours. We advise patients to arrange transport home after treatment, as driving could be unsafe.
Corticosteroids generally offer relief within a week after treatment though occasionally it might take longer.
Pain relief may last for weeks to months depending on the severity of each case.
Conditions which can be improved by steroid injections:
- Osteoarthritis – knee, hip, shoulder, wrist, fingers, thumb, ankle, and foot joints.
- Tendinopathy or tendonitis – rotator cuff, tennis and golfer’s elbow, De Querveins and intersection syndrome (wrist and forearm), planter fasciitis.
- Inflammatory arthritis – e.g., Rheumatoid arthritis, Gout affecting any joint.
- Bursitis – shoulder (subacromial bursa), hip (trochanteric bursa), gluteal (ischial bursa), knee (pre-patella bursa), ankle (retrocalcaneal bursa).
- Ligament sprain – knee (MCL), elbow (medial ulnar collateral ligament), thumb (UCL), ankle (ATFL).
- Neuropathies (nerve irritation) – Carpal tunnel syndrome (median nerve irritation at the wrist), cubital tunnel syndrome (ulnar nerve irritation at the elbow), tarsal tunnel syndrome (tibial nerve irritation at the ankle).
Hyaluronic acid injections (e.g., Ostenil Plus)
Hyaluronan is a highly viscous (thick) and elastic substance which represents the synovial fluid in joints. This is found naturally in the human body. The hyaluronic acid is a synthetically produced version of this complex viscous and elastic substance used in arthritis to replenish and hydrate the joint. It is water based and hence rarely causes any side effects.
It is an alternative for steroid injections and more suited when there is no active inflammation with in the joint.
The effects take longer to be noticed but usually last longer than steroid injections. It is likely that repeated injections are required for optimal results over several months to years. There are usually no restrictions to the amount of injections into any joint.
It is particularly useful in knee and hip arthritis. It can also be used in tendinopathies.
Possible side effects
In very rare cases local and general secondary phenomena such as pain, feeling of heat, redness, inflammation, swelling or joint effusion, tachycardia, hypertension, hypotension, shortness of breath, nausea and pruritus may occur during or after the injection of OSTENIL® PLUS.
Conditions which benefit the most from Hyaluronic acid:
- Knee osteoarthritis
- Hip osteoarthritis
- Shoulder osteoarthritis
- Tendinopathies – e.g. tennis elbow, patella tendinopathy
