Pain Therapy

Orthopedic Injections and Therapies

Discover Non-Surgical Solutions for Joint Pain

For patients whose joint pain does not improve with medication or physical therapy, injections may provide much-needed relief.

The duration of pain relief from an injection varies according to the treatment chosen and the individual patient. Injections are commonly recommended as a way to manage pain and delay surgical intervention. However, joint replacement may be needed as the joint worsens with time.

Depending on the type of injury or pain you are experiencing, different types of injections may be chosen.

 

Steroid Injections

Intra-articular corticosteroid injections (cortisone) are administered to reduce moderate to severe pain. They can provide quick pain relief and reduce inflammation, which, in turn, could help improve muscle function. However, the effects are not long-lasting, possibly up to two months only. Typically no more than three or four injections should be given in a joint in a year. There is also the potential for long-term joint damage with frequent repeated injections over a long period of time. Knees, shoulders, hips, ankles and elbows can be injected.

Some injections require a visit to the hospital, where the injection is performed by radiology using fluoroscopy to visualize the joint. The shoulder and hip injections to the subacromial space are performed using this technique.

Other injections can be performed in the office. These include injecting steroids into the hip trochanter bursa, the ankle joint, wrist tendons and elbows for tendonitis (tennis elbow).

 

Viscosupplementation

Joints normally have a fluid (called synovial fluid) that acts as a shock absorber. When the synovial fluid thins and loses its elasticity, the cartilage of the joint can wear down causing osteoarthritis pain. Viscosupplementation is designed to mimic the shock-absorbing quality of healthy synovial fluid in the knee joints. This involves a preparation of Hyaluronic acid that is injected directly into the knee joint. Hyaluronic acid is a naturally occurring substance found in joint fluid.

Viscosupplementation injections can last up to several months for some patients and have been shown to relieve pain in patients who did not get relief from other non-surgical measures of treatment. 

Here in the U.S. it is currently only approved for use in the knee, although other joint trials have been ongoing. Two preparations of hyaluronic acid are available:

  • Synvisc: A natural product made from rooster combs.
  • Euflexxa: An artificial product made from bacterial cultures.

If you are allergic to egg or poultry products or have had a reaction with previous injections, Euflexxa may be the best option for you. Your physician can help you make that decision.

As of January 1, 2024, if viscosupplementation is prescribed to you by a physician, patients can fulfill their prescriptions at a local pharmacy and bring them to the office for our physicians to inject. 

 

Shockwave Therapy

Shockwave therapy, also known as EPAT (Extracorporeal Pulse Activation Technology), is a non-invasive treatment that uses sound waves to stimulate the body’s natural healing process. It is often used to treat injuries in tendons, ligaments, and other soft tissues.

During Shockwave therapy, a handheld device is used to deliver shockwaves to the skin of the affected area. The shockwaves increase blood flow around the injured tissue, promote natural cell regeneration, and reduce pain. 

This treatment is much less invasive than injections or surgical treatments, with minimal discomfort during treatment, and virtually no risks, side effects, or recovery time afterward. Typically, this treatment is administered once a week over multiple sessions.

 

Platelet-rich plasma therapy at Boston orthopaedic and spine

Frequently Asked Questions

What is the recovery after an injection?

Patients can return to their usual activity after the procedure, however, aggressive exercise should be avoided for 24 hours after the injection.

Are injections right for me?

If your Boston Orthopaedic and Spine physician has diagnosed you with osteoarthritis, or if you experience chronic pain and you haven’t found pain relief from physical therapy, application of heat and cold, or pain relievers such as Tylenol, then you should consider discussing injection options.

Are there any risks?

Pain, and swelling of the injection site, although rare, are the most common complaints after a injection. These normally clear up within 24-48 hours with just some ice and pain relievers. If severe swelling occurs you should return to the clinic as soon as possible.

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