Injection therapy BARNSLEY
Roundwood Health Clinic is based in Barnsley and provides a range of treatments including ultrasound scans and injection therapy in conjunction with Injection Clinic.
Ultrasound scans can help to identify tissue that is inflamed or damaged and allow the clinical team to prescribe the most effective treatment. Injection therapy is an effective treatment for suppressing inflammation and can provide excellent pain relief.
By using ultrasound to guide the injection into the correct place the risk of injection therapy is reduced and the benefits are optimised. The first stage however is to establish an accurate diagnosis and this can be made during your clinical assessment.
What conditions can injection therapy be considered for?
• Joint degeneration / Osteoarthritis of the knees, ankles, toe joints, shoulder, elbow, wrist and finger joints.
• Hip pain caused by Trochanteric Bursitis
• Shoulder pain caused by shoulder impingement of frozen shoulder.
• Pain caused by irritation to a tendon. Common tendon problems include Tennis elbow, Golfers elbow, thumb tendons (Dequervains) and the Patella Tendon (Jumpers knee). Pain can also be generated from tendons around the foot and ankle.
• Heel pain or Plantarfasciitis responds well to ultrasound guided injection therapy.
How do I prepare for an injection?
There aren’t usually any special preparations you need to make before injection therapy. Plan to wear comfortable clothing which allows easy access to the affected joint. Towels and shorts are available at the clinic if required. Driving is not usually recommended immediately after an injection but it may be possible in some cases. Please ask your health professional for further advice. After an injection we would advise 3 days of relatively light activity.
What happens after an injection?
It may take several days before you feel the full benefit of the injection. Roundwood clinicians also emphasise the need to address any underlying mechanical problems including correcting your posture and the way in which you move (muscle patterning). This is essential if long term benefits are to be gained.
With degenerative changes a person may experience a flare up of symptoms. Along with their long term exercise programme, an acute episode of joint inflammation and associated pain experience can be eased with injection therapy. The most injections we would advise are 3 per year.
There is no problem with having an injection prior to your holiday or an important life event. A wedding or birthday party can be much more enjoyable when your experience of pain has been reduced.
What injections are available?
There are three key types of joint injection available for managing shoulder, hip, knee and other joint and tendon pain. These are Cortisone steroids, Hyaluronic Acid (Ostenil) and Platelet Rich Plasma
Helping to decrease inflammation
Cortisone (corticosteroid) are effective at suppressing inflammation. When your diagnosis identifies an excessive or prolonged inflammatory response then guided injections of cortisone are an appropriate treatment.
It is not however uncommon to hear people, including some medical professionals claim that they don’t work. They do. The trick to making sure they do relies on an accurate diagnosis and an accurate injection.
Not all experiences of pain are generated by inflammation. In this situation injections have little benefit. Not all injections are administered under guidance; non specific injections often end up being intra-muscular, which will disperse throughout the body.
Guided injections ensure the medication is intra-articular (inside the joint) or within fluid sacs such as bursa. Sometimes guided injections are used to dilate specific tissues and /or separate tissue deep in the body to enhance tissue movement.
Helping to maintain joint lubrication
Ostenil is a product containing Hydrolonic acid. All synovial joints (a joint between the two bones which is filled with fluid) have hydrolonic acid within them, but there are times during joint degeneration and inflammation when the acid balance is incorrect.
Ostenil is a well engineered chemical that helps restore this balance, which in turn optimises the joints fluid and chemistry.
Many people find Ostenil injections beneficial for the long term management of osteoarthritis. There are no reported side effects with the use of Ostenil and therefore it is a very safe medical to use.
Ostenil Plus is a stronger version of standard Ostenil and requires only one injection as opposed to three.
If you are suffering with joint degeneration and want to commence a treatment plan that helps improve strength, alignment and enhanced joint movement, then Ostenil is an excellent addition. You still need to exercise correctly, but optimising joint chemistry is another treatment aid that can ensure you get the best results.
PRP (Platelet Rich Plasma)
Optimising tissue repair
Platelet rich plasma (PRP) is a process that encourages healing. By extracting Growth Platelet’s from an individuals own blood, we can then inject the solution into areas of tissue damage.
Not all body tissues have a good blood supply. Ligaments and tendons in particular have limited access to essential nutrients within the blood and therefore healing is often a slow process. By extracting PRP and then injecting the growth factors into these damaged areas, it is possible to speed up the process.
PRP and Platelet Poor Plasma (PPP) is now showing good evidence as a long term treatment for joint degeneration and the management of symptoms caused by Osteoarthritis.
It is essential that these injections are administered with accurate needle placement and therefore guidance by ultrasound.
Platelet Rich Plasma (PRP) injections
A growing number of people are hearing about Platelet Rich Plasma (PRP) injections, but what are they and do they work?
All mammals, and that includes us, have cells within their blood. Different cells do different jobs. Most people have heard of red blood cells as these help carry oxygen and white blood cells that help fight infection.
There are however lots of other ‘bits’ within our blood and these are called ‘platelets’. Platelets are fragments of cells that originate in bone marrow cells. These fragments contain many different proteins and are most commonly associated with ‘plugging’ a hole in any damaged tissue. They form a blood clot and prevent excessive bleeding, but they also initiate the process of repairing tissue and some of the proteins within platelets are referred to as Growth Factors.
The idea behind PRP injections is that you take a persons blood and separate the red bloods cells away from the platelets. You then have a higher concentration of proteins and growth factors which you inject into the area of damaged or degenerate tissue. This is essential as you do not want red blood cells inside joints or ligaments as this can cause a further inflammatory response (red blood cells should not be in these places).
PRP separation of red blood cells leaving the plasma (yellow bit) containing the platelets.
The aim is to stimulate new cellular growth and therefore boost the repair process. Sounds good, but does it work?
Like most things there is no clear answer. Research is a mixed affair with animal dissection after injections showing an improvement in the surface of joint cartilage. We don’t tend to be that cruel to humans, so most outcomes in people are based on pain and disability scores. Research tries to compare the benefit of PRP to exercise and/or other medication. The results are not conclusive but there is a trend and as the use of PRP has grown there has been more widespread acceptance of PRP as a valid treatment option. It is now acknowledged by the NHS and in some areas of the UK offered as a treatment.
One big advantage of PRP is that it is safe and there are no long term side effects. The physiological basis has merit, mainly because usually platelets have difficulty reaching ligament, tendon and cartilage tissue. Consequently, I tend to refer to PRP as a fertiliser to aid healing and ensure the best outcome. It is not however a miracle cure or a stand alone treatment. Its needs to be used in conjunction with corrections to strength, alignment and patterns of movement.
Best health arises from rapid diagnosis and early treatment intervention. Injections such as Hyluronic acid (Ostenil) and Platelet Rich Plasma (PRP) are often excluded from NHS care.
If you wish to discuss ultrasound scans and injection therapy further please do not hesitate to contact us on (01226) 282560. Appointments can be made anytime via the online booking link to see Chris Creaghan who is a fully registered physiotherapist practitioner.