INJECTION THERAPY
Injection therapy can be a useful treatment to improve pain to enable you to engage with rehabilitation or to manage a chronic painful condition. There are two main types of injections which have proven benefits for a variety of painful conditions: corticosteroid injections and hyaluronic acid injections.
WHAT WE TREAT
SHOULDER
Frozen shoulder
Osteoarthritis
Subacromial / rotator cuff pain
KNEE
Osteoarthritis
WRIST & HAND
Carpal tunnel syndrome
Base of thumb osteoarthritis
Trigger finger / thumb
De Quevain's Tenosynovitis
ANKLE & FOOT
Ankle or big toe osteoarthritis
Plantar fasciitis
HIP
Trochanteric bursitis
OTHER
Contact us for any other requests
HYALURONIC ACID INJECTIONS
What is a hyaluronic acid injection?
Hyaluronic acid (HA) is a naturally occurring molecule in all synovial joints. Synovial joints produce synovial fluid which is the joint’s natural lubrication. HA has viscoelastic (viscosity and elasticity) properties which enables load absorption and free movement within the joint. HA is similar to hydraulic fluid in your car which both lubricates and absorbs forces. Inflammation associated with OA reduces the viscoelastic properties within the joint and HA injections provide a barrier to inflammation, increase joint lubrication, and improve shock absorption (ref. 1).
How long do hyaluronic acid injections last?
Whilst corticosteroid injections typically provide early relief of symptoms of osteoarthritis for up to 12 weeks, HA injections have demonstrated longer lasting benefits up to 6 months (ref. 2). The severity of osteoarthritis, patient activity levels, and individual patient factors will influence the response to injection.
What hyaluronic acid injections do you offer?
We offer both Durolane and Ostenil Plus HA injections. Durolane is a purified form of HA which has been engineered to resist being broken down, which extends the time the HA remains within the joint. It is a single-injection treatment for symptomatic relief of knee osteoarthritis which has demonstrated longer-lasting pain relief compared to steroid injections. Ostenil Plus is an isotonic solution of highly purified HA and mannitol, which helps to stabilise the chains of sodium hyaluronate. It is a single-injection treatment for symptomatic relief of osteoarthritis in large synovial joints such as the knee and shoulder.
Are they safe and effective?
HA injections have been shown to be a safe and effective long-term treatment option for knee osteoarthritis (ref. 3). The European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) recommends the use of HA injections in knee osteoarthritis patients with mild to moderate disease, and for patients with severe osteoarthritis who are either contraindicated for total knee replacement surgery or wishing to delay the surgical procedure.
CORTICOSTEROID INJECTIONS
What is a corticosteroid injection?
Corticosteroid injections contain steroids which are medicines which reduce pain and inflammation associated with a variety of musculoskeletal conditions. These are different to the anabolic steroids used by bodybuilders to increase muscle mass.
How long do steroid injections last?
The steroids can take around two weeks to reach maximal effectiveness and typically improve symptoms for weeks to several months. Depending on the condition, steroid injections can resolve symptoms completely, although repeat injections are often required for conditions such as osteoarthritis.
Are they safe and effective?
Most people do not experience any side effects following a steroid injection. Occasionally some people experience a flare-up in their pain in the initial 24 hours after an injection, which usually settles by itself within a couple of days. The potential risks and side effects for the specific injection will be explained to you following the pre-injection screening questionnaire. Steroid injections are recommended for a variety of conditions if people are not responding to initial treatment strategies such as advice, pain medication, activity modification and exercises. We can provide information on the evidence-based recommendations for injection therapy for your condition.