How We Use Injection Therapy
Injection therapy is a treatment option commonly used in conjunction with traditional physiotherapy.
To provide relief for a number of conditions, injections are administered to intra- and extra-articular tissues, joint spaces, and painful soft tissue lesions.
The expert consultants we employ from Core Physio will always advise you accordingly.
This form of therapy can be used as part of a treatment programme for a range of complaints:
- Inflammatory pain from a range of orthopaedic conditions
- Achilles Tendonitis
- Plantar Fasciitis
- Tennis Elbow
- Shoulder Tendonitis
- Joint stiffness and reduced range of movement
- Carpel tunnel syndrome
In most cases, injection therapy is not a standalone treatment but can help relieve pain to allow your physiotherapist a ‘window of opportunity’ to treat the underlying problems of a complaint, aiding rehabilitation.
Whilst injection therapy can help to provide pain relief, this is rarely used as a first course of treatment, as the symptoms will likely return without physiotherapy exercises and treatments to help prevent further pain and problems.
Some steroids occur naturally in the body, but man-made steroids reduce inflammation in much the same way. We can inject steroid mixtures into or around the inflamed joints to help reduce pain and ease restricted movement. Some steroids are fast to have an effect, but for a short period of time, whereas others take longer to have an effect, but stay effective for much longer.
Steroid injections are often used for treating rheumatoid arthritis and some cases of severe osteoarthritis.
Steroid injections help to reduce inflammation within a joint, help to provide pain relief.
As steroid injections can help to ease pain and symptoms.
Whilst steroids are in effect, it is often easier for your physiotherapist to continue with other manual therapy and exercise treatments.
Hyaluronic acid is a natural component of synovial fluid. Hyaluronic injections are often used as part of a wider treatment package for degenerative joint conditions. Whilst steroid injections are commonly used to help reduce inflammation, hyaluronic injections are best suited to treating joints where the smooth surfaces have worn, but there is no significant inflammation. This form of injection therapy is commonly used as part of a treatment programme for the knees, shoulders, elbows, thumbs or ankles.
WHAT WILL HAPPEN WHEN I HAVE A HYALURONIC ACID INJECTION?
The clinician, performing your injection, will help choose the most appropriate hyaluronic acid for your condition and your symptoms. Usually, they will inject the HA directly into the area of your pain, typically a joint such as your knee. Your treating clinician will explain the procedure in more detail on the day based upon examination findings to help choose the most comfortable and effective treatment. Most HA injections are surprisingly quick and comfortable to perform.
WHAT WILL HAPPEN AFTER THE INJECTION?
You should usually allow a week or two for the effect of the HA to begin. When having an injection into a joint, we recommend that you might avoid strenuous exercise for three days afterwards due to the possibility of some post-injection discomfort. When having an injection around a tendon, your treating clinician may advise you to avoid heavy impact and loading activities for a few days. This is due to potential discomfort following the injection.
To be safe, we usually recommend that patients remain at the clinic for around twenty minutes following the injection to allow observation for any possible adverse reactions and so that they feel happy to make their journey home.
WILL I NEED FURTHER INJECTIONS?
One of the very positive benefits of hyaluronic acid injections is that they can safely be repeated where patients find them to be helpful. Where other treatments have been unsuitable or may not have helped.
HA can provide a viable option or as an adjunct to ongoing treatments such as exercise.
There is currently no research evidence to suggest any significant long-term harm from having repeat injections of HA.
POTENTIAL RISKS AND SIDE EFFECTS FROM HA INJECTIONS?
The vast majority of people can have HA injections without any significant side effects.
A proportion of people, approximately 1 in 5, may have some pain for around 48hours after the injections.
This will usually fully resolve quickly and can be managed with relative rest, cold compress and over-the-counter painkillers.
WILL THE INJECTION HURT?
There may be a bit of discomfort at the time of the injection procedure, but many people report that they are not nearly as bad as they had feared. Ultrasound guidance and careful patient positioning mean that injections can be delivered much more comfortably. You can also request local anaesthetic which can also make the injection more comfortable.
WHAT HAPPENS IF I GET AN INFECTION?
Extremely rarely (around 1:50,000 according to the literature) patient may get an infection to the area shortly after an injection procedure. Your clinician will advise you about this again on the day. Should the joint suddenly become more painful, hot and swollen, in the days following your injection you should seek medical attention immediately, especially if you are feeling generally unwell.
WHAT ARE OTHER POTENTIAL SIDE EFFECTS?
There are very few other side effects that have been linked to the use of hyaluronic acid and they are generally regarded as a very safe procedure.
CAN I SAFELY TAKE OTHER MEDICINES ALONG WITH THE HA INJECTION?
Yes, it is safe for you can take other medications alongside the hyaluronic acid injection. There are currently no known significant drug interactions that occur with hyaluronic acid and other medications.
However, it is important to note that if you are taking a blood-thinning drug, you may need a blood test (test for INR) to make sure that your blood is not too thin to safely have the injection.
The reason for this is due to the risk of bleeding into the joint at the time of the injection which may raise the risk of infection.
Therefore you must tell the clinician performing the injection if you are taking an anticoagulant (blood thinning) medication as they may need to discuss this with your GP before proceeding with the treatment.
IS IT SAFE TO HAVE HYALURONIC INJECTIONS WHILST PREGNANCY OR BREASTFEEDING?
Unfortunately, we are not able to offer HA injections to patients who are pregnant. There are currently no known associated risks to having HA injections whilst breastfeeding, although we recommend that patients first discuss with their GP.
BELOW IS A SUMMARY OF THE KNOWN RISKS/SIDE EFFECTS FROM HAVING HYALURONIC ACID INJECTION – Serious side effects are extremely rare but can include:
- Joint and soft tissue infections – please see above
- Anaphylaxis (allergic reaction) – extremely rare
OTHER POTENTIAL SIDE EFFECTS MAY INCLUDE:
• A post-injection flare of pain at injection site – please see above
• Injury or trauma to neurovascular or soft tissue structures during the injection procedure -your therapist is trained to take all appropriate steps to minimise risks and avoid injecting or traumatising any soft tissue structures, nerves or vessels when performing the injection. However, there will always remain a very small risk that this could occur, particularly with injections at certain locations, this can also be discussed further at your appointment.
You will be asked to remain in the clinic for up to twenty minutes following your injection to allow observation for possible adverse reactions from your injection.
For further information on injection therapy, please call today on 01698 854474 or email us at email@example.com