Procedures

Corticosteroid Injection

Cortisone injections can be used to reduce inflammation (redness, swelling) and pain in a tendon, a joint and its surrounding structures.

Cortisone relates to a group of corticosteroids. They are powerful anti-inflammatory medications.  In arthritis or in condition following trauma cortisone injections  may be considered if the pain in a joint is not responsive to other treatments or there is evidence of tendon inflammation or bursitis.

How Cortisone Injection can help:

  • Reduction of pain and swelling
  • Removal of debris from the injury site
  • Greater range of motion
  • Proper alignment of scar tissue as injury repair takes place
  • A return to sport and other important life activities

Cortisone is a substance similar to a natural steroid hormone produced by the body.
Cortisone is also referred to as a ‘corticosteroid’. Corticosteroids (“catabolic steroids”, used to treat various medical conditions) are different from the steroids used by some bodybuilders and athletes – these are ‘anabolic steroids’.

Procedure:

We use local anaesthetic to minimise the discomfort during the injection.
Using an ultrasound machine a doctor, performing the injection, can guide a small needle precisely to the area of inflammation.

The ultrasound allows for accurate localisation of the needle and helps to avoid important structures like blood vessels.

Most patients report immediate relief after their injections.

Post Procedure Care:

Avoid excessive movement or stress the injected joint, tendon or bursa for the remainder of the day and over the next 5 days.

Sometimes there is increased pain after injection which settles within 24 hours  (you can apply ice and take pain relief such as paracetamol).

In one week time you can start recovery programme discussed with your doctor or physiotherapist.

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Autologous Blood Injection

Autologous Blood injection uses the growth factors and natural healing properties of blood to help repair tendon damage and treat the pain caused by injuries and chronic wear.  The injection is most commonly used for “tennis elbow” and “golfer’s elbow”,  hamstring origin tear, Achilles and patellar tendon (jumper’s knee).

Prior to treatment, an accurate diagnosis is essential which will usually require a diagnostic ultrasound or MRI scan.

Procedure:

About 2mL of blood is taken from a vein just like any other blood test. The skin is then cleaned with antiseptic and a fine needle is positioned into the abnormal area using ultrasound guidance to ensure precise placement. Local anaesthetic is also used.

Up to 80% of patient will obtain complete or significant relief from symptoms.

Post Procedure Care:

Some swelling or discomfort is common in the first few days because this injection works by activating “good” inflammation to promote the healing process. You may benefit from an icepack or paracetemol but avoid anti-­‐inflammatory medication (ibuprofen and voltaren)  as it may reduce the effectiveness.

A rehabilitation programme will need to be guided by your referring clinician but would typically involve:

  • Week 1: No deliberate exercise.
  • Weeks 2-4: A 3 week graduated program of stretching and eccentric exercises.
  • End of week 4: Reassessment

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