Services

Therapeutic Injections

joints

At times, diagnosis of a condition may involve aspiration of the joint and examination of the fluid under microscope. The characteristics of the fluid can help us differentiate between different types of arthritis. Most joints can also be injected with anesthetics and corticosteroids for rapid pain relief. Almost every joint can be injected to relieve pain.

These are some of the joints that Comprehensive Rheumatology Center will aspirate and inject:

  • Hands
  • Feet
  • Shoulders
  • Elbows
  • Wrists
  • Knees
  • Ankles
  • Jaw (temporomandibular joint)
  • Lower back (facet joints)
  • Lower back (sacroiliac joints)

tendons/bursae

At times, diagnosis of a condition may involve aspiration of the joint and examination of the fluid under microscope. The characteristics of the fluid can help us differentiated between different types of arthritis. Most joints can also be injected with anesthetics and corticosteroids for rapid pain relief. Almost every joint can be injected to relieve pain.

These are examples of such injuries:

  • Carpal tunnel syndrome (wrist)
  • Tarsal tunnel syndrome (ankle)
  • Lateral epicondylitis (tennis elbow)
  • Medial epicondylitis (golfer's elbow)
  • DeQuervain's tenosynovitis (thumb)
  • Subacromial bursa (shoulder)
  • Trochanteric bursa (hip)
  • Patellar bursa (knee)
  • Trigger finger (locked finger)

Frequently Asked Questions

When you take a medication orally, it gets dispersed through your entire body. This is a good option if multiple locations are affected, but if you have only one area that is involved (like one joint, tendon or bursa), it may not be the most efficient way to treat the area. Injections target the medication directly to the problem area therefore may be more effective. Usually a smaller dose of medication is needed, sparing the rest of the body from potential side effects.
Generally, it is recommended to limit steroid injections to no more than 3-4 per area per year, to prevent wear and tear to the area.

The frequency of treatments will depend on the individual case. In general, shots should be spaced at least 6 weeks apart.

It is not recommended that you have more than 4 treatments per year.

Since the skin is punctured by a  needle, there is a small chance of infection. The area is prepped in a sterile fashion to minimize this risk. Although a local anesthetic spray is used, there may be pain associated with the needle insertion. Corticosteroids can cause wear and tear in the area and should not be used more frequently than advised (see previous question). Steroids can cause atrophy of the fat tissue, so occasionally there may be dimpling in the injected area or discoloration of the skin. These are often reversible over time.
During your visit we can determine the best course of action for you, including injections if indicated.
Corticosteroid injections do not repair joint damage or cure arthritis. They can reduce inflammation, decrease pain, and increase mobility.  
 

Hyaluronic Acid Injections

Hyaluronic acid is a viscous material that lubricates the joint and is thought to also stimulate cartilage growth.

These injections are given every few months depending on the severity of the arthritis, and are sometimes uses to prolong for prevent surgery

These injections are currently approved for the knee joint:

  • Synvisc
  • Synvisc-one
  • Hyalgan
  • Supartz
  • Euflexxa
  • Orthovisc

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