Injections are often used by doctors for acute and chronic pain management of many musculoskeletal conditions, or to reduce swelling of the spine and joints. Injections are generally used to:
- relieve pain associated with an underlying medical condition, such as arthritis, bursitis or tendonitis.
- remove fluid from an area near a joint or prevent the fluid from coming back.
- manage pain before surgery.
- manage pain for patients who are unable or do not wish to have surgery.
Patients most often receive an injection (or shot) of anesthesia, a steroid or a mixture of both into the affected area. Injections are often given using ultrasound guidance. Ultrasound is used to find the exact location for the injection by locating precisely where the needle should enter the skin for maximum effect.
At Atlantic Medicine & Wellness, we offer the following injections:
A joint injection (intra-articular injection) is a procedure used in the treatment of inflammatory joint conditions, such as rheumatoid arthritis or osteoarthritis, psoriatic arthritis, gout, tendinitis and bursitis. A needle is injected into the affected joint where it delivers a dose of either any one of many anti-inflammatory agents, the most common of which are corticosteroids, or a combination of synthetic corticosteroid with anti-inflammatories. The technique may be used to also withdraw excess fluid from the joint, which allows for more freedom of movement. The fluid may also be used as a diagnostic tool to detect the underlying pathologies of the inflammation.
About 5 percent of Americans suffer from carpal tunnel syndrome, which occurs due to pressure on a key nerve that runs from the forearm into the palm of the hand. It is a repetitive-motion injury that tends to affect people performing assembly line activities, typing or data entry work. The median nerve is housed within the tight confines of the carpal tunnel, a narrow corridor of ligament and bones at the base of the hand. Tendons located in the carpal tunnel can swell and squeeze the median nerve if they become irritated and inflamed. Sufferers feel pain, tingling and numbness in the affected hand and wrist, with pain sometimes shooting up their arm. Carpal tunnel steroid injections at the wrist are used to treat the symptoms of carpal tunnel syndrome by injecting a steroid solution into the ulnar bursa surrounding the median nerve. Patients frequently find they have significant benefits in relieving symptoms and in reducing the need for surgery.
When exercise and simple pain medications no longer effectively manage knee pain caused by osteoarthritis, Orthovisc® injections may be indicated. Orthovisc® (High Molecular Weight Hyaluronan) is the only FDA-approved treatment made from ultra-pure hyaluronan, a naturally occurring lubricant found in healthy knee joints. This knee pain injection is also the only treatment providing up to six months of pain relief. Orthovisc® aides to relieve knee pain, replace natural joint fluid to cushion, protect and lubricate knees, so that further degeneration is slowed or even halted, and helps restore mobility in the knee by treating the pain at its source.
Trigger Point Injections
Trigger point injections (TPIs) are used to treat extremely painful and tender areas of muscle and may be another effective pain management option for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or muscles that contract when muscles do not relax. Not all trigger points require injections. Many active trigger points will respond to physical therapy, especially in the early stages of trigger point formation. However, for chronic trigger points, trigger point injection is an effective treatment. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body. In the TPI procedure, our doctors insert a small needle into the patient’s trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Several sites may be injected in one visit. TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI may also be used to treat fibromyalgia, myofascial pain syndrome and tension headaches. TPIs improve muscle function and allow for more effective rehabilitation of an injury.
Facet injections (FI) are injections of medications into the actual facet joints. Facet joints are located between each set of vertebrae in the spine from the neck to the tailbone. Facet joints allow each vertebra to move against the vertebra just above and just below it. Facet injections are used to reduce the inflammation and swelling of tissue in and around the facet joint space. This may in turn reduce pain and other symptoms caused by inflammation or irritation of the facet joint and surrounding structures. Facet joint pain as primarily spine pain, though in some patients there can also be referred pain into the surrounding tissues and even into arms or legs. The injection consists of a mixture of local anesthetic and a steroid medication. For any particular facet joint, patients may only need one injection. Facet injections are sometimes used as diagnostic injections, used to confirm that a particular facet joint or group of joints is the actual cause of the neck or back pain.
SI joints connect the pelvic bones to the spine. They are small and don’t move much, but they absorb all the forces of the upper body before balancing and transferring the weight to the hips and legs. When one or both of these joints become irritated or injured, they can cause chronic discomfort and pain. Sacroiliac (SI) joint dysfunction is a common source of pain in the lower back, buttocks, groin, and legs. These generalized symptoms, however, can be easily confused with other causes of back pain. An SI joint injection enables physicians to confirm that irritation or damage to the SI joint is the source of your symptoms. This precise diagnostic tool is also a therapeutic procedure, offering significant pain relief. SI joint injections can accurately pinpoint and alleviate this pain. Guided by ultrasound, our doctors inject a local anesthetic into the affected SI joint. If the anesthetic relieves your pain, this confirms the diagnosis. A corticosteroid medication is also injected. This strong, long-acting medicine may reduce inflammation and provides pain relief over an extended period of time. Although they are not a cure, SI joint injections are very effective in reducing inflammation of the joint and providing considerable to complete pain relief for an extended period of time.
Prolotherapy involves the injection of an irritant solution into a joint space, weakened ligament, or tendon insertion to relieve pain. Also known as regenerative therapy, it is also indicated for patients with minor tears, damage or pain in tendons or ligaments or lower back pain. The treatment involves repeated injections of an irritant solution into part of a joint — the joint’s interior, for example, or a supporting tendon or ligament. The irritant, usually a sugar solution, is thought to trigger growth in the connective tissue of the joint, eventually leading to reduced pain.
At Atlantic Medicine & Wellness, all of our injections occur with little or no down time after the treatment. Patients receive their injections and are generally able to resume their normal daily activities immediately, often with relief. Injection therapies are only one of the therapies used to diagnose and effectively treat pain and discomfort. Along with our injection therapies, our team of highly qualified medical doctors, chiropractors, physical therapists, acupuncturist and nutritionists use education and our multi-disciplinary approach to treatment to alleviate pain, assist our patient in gaining strength and mobility, and prevent further incidents.