Injection Treatment
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Overview
Corticosteroids act to reduce the chemicals in the body that cause inflammation. Inflammation is a vital part of the body’s immune response. It is the body’s attempt to heal itself after an injury; defend itself against foreign invaders, such as viruses and bacteria; and repair damaged tissue. However, the body’s immune response can also be problematic. Inflammation is often characterized by redness, swelling, warmth, and pain. Inflammation may occur within or around joints, tendons, and muscles that can make everyday activities painful. Initial approaches to managing this pain include activity modification, and anti-inflammatory medications. If the pain persists despite these approaches, corticosteroid injections can be a beneficial treatment option. The steroid is administered locally, therefore minimizing side effects. The effects of the injection are often observed 24-48 hours after and can provide lasting pain relief for several months.
Below is a non-exhaustive list of common musculoskeletal injuries that can be treated with corticosteroid injections:
- Rotator cuff tendonitis, impingement
- Osteoarthritis
- Bursitis of the hip
- Biceps tendonitis
- Tennis elbow
- Trigger finger
- Carpal tunnel syndrome
Risks and side effects include but are not limited to infection, skin irritation, and skin hypopigmentation at injection site. A trace amount of corticosteroids may be absorbed systemically and can potentially cause flushing, headache, sweating, and blood sugar spikes in diabetic patients.
Overview
During the past several years, much has been written about a preparation called platelet-rich plasma (PRP) and its potential effectiveness in the treatment of injuries.
Although blood is mainly a liquid (called plasma), it also contains small solid components (red cells, white cells, and platelets). The platelets are best known for their importance in clotting blood. However, platelets also contain hundreds of proteins called growth factors, which are very important in the healing of injuries.
PRP is plasma with many more platelets than what is typically found in blood. The concentration of platelets — and, thereby, the concentration of growth factors — can be 5 to 10 times greater (or richer) than usual.
To develop a PRP preparation, blood must first be drawn from a patient. The platelets are separated from other blood cells and their concentration is increased during a process called centrifugation. Then the increased concentration of platelets is combined with the remaining blood.
Although it is not exactly clear how PRP works, laboratory studies have shown that the increased concentration of growth factors in PRP can potentially speed up the healing process.
To speed healing, the injury site is treated with the PRP preparation. For example, in Achilles tendonitis, a condition commonly seen in runners and tennis players, the heel cord can become swollen, inflamed, and painful. A mixture of PRP and local anesthetic can be injected directly into this inflamed tissue.
Even though the success of PRP therapy is still questionable, the risks associated with it are minimal: There may be increased pain at the injection site, but the incidence of other problems — infection, tissue damage, nerve injuries — appears to be no different from that associated with cortisone injections.
Discuss PRP injections further at your next visit with Dr. Dedhia.
Overview
Viscosupplementation injections are another treatment option for knee arthritis. This option is typically tried if treatment with corticosteroid injections did not provide relief of symptoms. If pain continues to limit daily activities, viscosupplementation injections may be an option. These injections come in a series of five injections, a week apart.
In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. People with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints. The theory is that adding hyaluronic acid to the arthritic joint will reduce the pain from osteoarthritis of the knee, improve mobility, and provide a higher and more comfortable level of activity.
Not all patients are helped by the injections. Of those who note improvement in symptoms, the length of pain-relief can vary. For those who report pain relief with the procedure, it may take several weeks to notice an improvement. Most patients report the greatest pain relief 8 to 12 weeks after beginning treatment, while others report relief within the 5-week treatment period.
If the injections are effective they may be repeated after a period of time, typically 6 months from the date of the last injection.
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Locations
St. John Office
10200 Wicker Ave., Suite 1
St. John, IN 46373
P: 219-924-3300
F: 219-922-5424