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This website is under development - The information contained on this site is for guidance only and is not intended for self diagnosis or self treatment. This will not replace professional medical advice or consultation. Always seek the professional advice of a qualified health care provider like your doctor or specialist before embarking on  any treatment. If you have a problem please consult your doctor or specialist.
Arthroscopic stabilisation    Reverse Replacement    Injections in and around the joints

Injections around the joint and tendon is one of the established and valuable technique allowing one to diagnose and treat a variety of conditions. Frequently I use combination of local anaesthetic and long acting synthetic steroid to understand the exact site of pain and possible pathology. This would allow me to treat the condition or at the least, it would allow me to plan future treatment(s). The steroid that is injection is not the anabloic steroid which is occasionally abused by some to get a quick build of the muscle mass. On the other hand this is a very powerful anti-inflammatory agent very much like taking a stronger version of tablets like ibuprofen or diclofenac sodium (which are called as NSAID’s - Non-Steroidal Anti-Inflammatory Drug). This is the steroid with anti-inflammatory property. This works by blocking the pain producing substances in the affected area and decrease inflammation and swelling. By depositing these agents in the precise area I will be able to ascertain accuracy of diagnosis, assess the severity of problem and to some extent estimate the success of any future intervention.


Common places where I inject are as below:








Process of injection & Recovery:

This is done as an outpatient procedure. I clean the skin with chlorhexdine gluconate and perform the injection taking due care and precautions. In shoulder, I tend to use a large volume of local anaesthetic agent (up to 10ml) and therefore, it is not advisable to drive for few hours after the injection. In fact, my advice is not to drive car for few hours after any injection with local anaesthetic agents. The pain can become worse for few days before settling down. One may take up to 2 weeks to appreciate the benefit of injection. If there is no improvement, then either the site where the injection was given was not where the pathology is or may be the problem is so severe and not amenable to injection. If the pain returns back after few weeks of relief, then diagnosis is correct; but pathology needs different approach.


Risks:

The risks of having an injection are very small and usually is under 1 in 500 or less. These include

Injection site

Diagnosis

Subacromial  space

   Impingement syndrome, calcific tendinitis, chronic tendon tear

Acromioclavicular joint (AC Joint)

   Acromioclavicular joint arthritis or inflammation

Glenohumeral joint

   Frozen shoulder, early arthritis of main shoulder joint

Elbow region

   Tennis or Golfer’s elbow, arthritis

Wrist

   Carpal tunnel syndrome, DeQuervain’s tenosynovitis

Trigger thumb/finger

   Around the tight pulleys