ULTRASOUND GUIDED CORTICOSTEROID INJECTIONS

Ultrasound Guided Steroid Injections for faster pain relief ( joint pain relief & soft tissue pain relief)
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ABOUT ULTRASOUND GUIDED STEROID INJECTIONS

A corticosteroid injection offers pain relief from inflammatory signs, such as joint pain or soft tissue pain, swelling, and joint stiffness. These may, in turn, help you to return to normal activities/hobbies OR to commence physiotherapy.  

Ultrasound Guided Steroid Injections allow the clinician to visualize the needle and needle tip in real-time as it enters the body and navigate the needle to the treatment area accurately. This assures that the medication is accurately injected at the source of symptoms site. 

Beforehand, the procedure will be explained to you, Side effects, risks, and benefits will be discussed. You will be given an opportunity to discuss any other questions or concerns you may have. If there are any changes in your health or circumstances you must inform the clinician, before the injection. 

Musculoskeletal issues?

If you are experiencing painful joints, muscles, tendons or ligaments please get in touch for a diagnostic scan and or treatment

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ULTRASOUND GUIDED CORTICOSTEROID INJECTIONS
Richard Kilty

"My name is Richard Kilty, I am the current captain of the British athletics team. World 60m champion, double European 60m champion & European 4x100m relay record holder. I have been using Ram Rachaputi for many years now. I have used many of his different treatments for my performance, injuries & general training recovery. I have always had huge success after seeing ram. He is truly world class at what he does. I will continue to work with ram all the way throughout my career and will be forever grateful for his precise and incredible work"

 

Richard Kilty

Ultrasound Guided Steroid Injections faqs

What is a Ultrasound Guided Steroid Injection?

An Ultrasound Guided Steroid Injections is also known as Corticosteroid injection or steroid injection. This is a strong anti-inflammatory medication used for many of the inflammatory and arthritis conditions to control pain, swelling, stiffness and improve function. Corticosteroid injections are NOT the same used by bodybuilders.

Why should I have a Ultrasound Guided corticosteroid injection?

A corticosteroid injection can help to relieve inflammatory signs, such as pain, swelling, and stiffness. These may, in turn, help you to return to normal activities/hobbies OR helps you to carry out exercises to strengthen the muscles or improve cardio-respiratory fitness. If you struggle to carry out a prescribed rehab by a therapist because of pain, you should try steroid injection.

Why do I need Ultrasound Guided Steroid Injections?

Ultrasound allows the clinician to visualize the needle and needle tip in a real-time as it enters the body and helps while navigating the needle to the desired location accurately. This ensures the steroid is accurately injected to the source of pain. Thus success rate is extremely high.

Despite good intentions, even in the most experienced hands, injections performed without an imaging guidance are not always accurate and in some cases ( ex: hip joint injection) technically not possible or safer.  This can make you believe corticosteroid injections do not work for you.

In addition, Some of the ultrasound guided injections are less painful than blind injections. This is due to under ultrasound guidance we avoid touching the bone or passing the needle through tendons (unless unavoidable).

There are many different types of imaging guided injections. However, ultrasound has a few distinct advantages than other image guidances (ex: Fluroscopy or X-ray guidance), such as:

  • No radiation. 
  • Quick and simple.
  • Ultrasound is a real-time dynamic tool.

Ultrasound guided injections are also recommended when the traditional method (known as blind or anatomical guided injections)  is failed to achieve the optimal outcome. 

What are the risks ?

Majority of the patients do not experience an side effects / risk factors.  Our pre injection screening helps to identify the potrntial risks

Common :

  • Flushed face for few hours after the steroid injection. May last up to 48-72 hours.
  • Steroid flare-up: Pain may be worse for a few days (up to 2 weeks) before feels better. 
  • Temporary bruising and/or bleeding, especially if you are on blood-thinning medications.
  • A temporary rise in blood sugar levels, in diabetics.
  • Fat atrophy: thinning of the fat at the site of injection.
  • Change in the skin colour around the steroid injection site (depigmentation of skin).
  • A transient feeling of fainting or dizziness.
  • Light vaginal bleeding or irregular menstruation cycle. Usually corrects by 2 or 3 cycles.
  • The injection may not work. Sometimes it can be a partial success or temporarily successful, where another injection may needs to be considered. 
  • Weakening/damage/ tear to the tendons and neurovascular bundle.

Rare :

  • Infection is very rare (about 1 in 10,000 ).  If the injected area becomes swollen, painful and hot, or if you become generally unwell, contact your GP or Accident & Emergency (A&E) department, without a delay.

However, pre-injection screening, hand washing, and sterile techniques are employed to minimise the side effects.  

When should I not consider the injection?
  • Infection either at the site of injection or elsewhere in the body.
  • If you are currently on antibiotic therapy for an active infection.  Prophylactic antibiotics can be safer to perform Steroid injection.
  • If you are allergic to steroids /local anesthetic drugs.
  • If you are on anticoagulant therapy and your INR is too high.
  • If you are feeling unwell.
  • Metal at the targeted area of injection. Ex: Joint replacement, metal plate.
  • Having surgery soon to the area of injection. 
Are there any other alternatives?
  • Rest.
  • Physiotherapy.
  • Pain medication.
  • Avoid exposing the activities caused the injury.
  • Hyaluronic Acid or Platelet Rich Plasma injections are an alternative to corticosteroid therapy. New and natural way of treating the condition.
  • Surgery: speak to your GP or a specialist.
Consent

Beforehand, the procedure will be explained to you, Side effects, risks, and benefits will be discussed. You will be given an opportunity to discuss any other questions or concerns you may have. If there are any changes in your health or circumstances you must inform the clinician, before the injection. 

Written consent will be obtained from you.

What happens during the procedure?

Injection site will be cleaned with an aseptic material to minimise the risk of injection, and gently introduced a tiny needle to give local anaesthesia under skin, before advancing  to the target site under an ultrasound guidance. Plaster is applied (if not allergic to the plasters) to the injection site to keep the injection site clean. If you prefer you can watch the whole procedure on the Ultrasound screen and we can explain the procedure through out. 

Will it hurt?

Discomfort from the needle insertion can be minimised by using the local anaesthesia.

What happens after the Injection?

If the local anesthesia is used you may be pain-free up to 2 hours, after that, you may start experiencing the pain until steroid starts working. During this period, you can continue with your regular pain medication prescribed to you by your doctor.

There is no guarantee that steroid works for everyone. If it works, Steroid may take any time between 2-3 days to 2 weeks. It is not possible to estimate how long the steroid injection is effective in controlling the symptoms, usually 3-5 months.

What happens after returning home?

Driving is not recommended for the rest of the day. Your motor insurance may not be valid for at least 3 hours following the injection.  The first 2 days, avoid carrying out any activities that make the pain worse and gradually return to normal duties. 2 weeks of relative rest is recommended, especially when weight-bearing joints are injected. 

If the injected area is swollen or painful, apply ice packs in a wrapped towel to the injection site for 10 minutes each time, twice or thrice a day.

Do I need a follow-up appointment?

You may have a follow-up appointment with your referrer.   In some cases you may need another injection, if that is the case, you can talk to your referrer regarding this.  More than 3 steroid injections in a year to the same area of the body are not recommended. If you were seen directly by us, we will arrange the follow-up appointment for you.

AREAS COVERED BY JOINT CARE CLINICS

We cover a wide area throughout Warwickshire and surrounds, either by home visit or clinics in the following areas: Rugby,  Coventry, Warwick,  Aylesbury,  Milton Keynes,  Leamington Spa, Stratford, Kenilworth, Whitnash, Atherstone, Bedworth, Leicester and Nuneaton. We also have clinics throughout the West Midlands including Birmingham and Solihull. We have a clinic in Newcastle covering the North East.

If you do not see your area listed please still get in touch as we may be able to refer you to another practitioner in your area.

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