Home » MSK Injections

MSK Injections

Muscle-Skeletal Injections are a specialised ultrasound guided procedure which need to be done by highly skilled and experienced specialist. These injections are offered to people who suffer from various musculoskeletal conditions and sport related injuries.

London Private Ultrasound the injections are done by highly experienced NHS consultants who offer a complete consultation and assessment of your affected joint followed by a diagnostic ultrasound scan to confirm the diagnosis of your condition. Then they perform ultrasound guided injections where appropriate and will provide you a complete report of your ultrasound findings and the procedure detail.

Different MSK injections are an effective and fast way to relieve the joint pains related to various msk conditions such as Frozen shoulder, tennis elbow, plantar fasciitis, carpal tunnel syndrome, de Quervain’s tenosynovitis and etc. (Please see a complete list of conditions as below).

Conditions which can be treated ultrasound guided injections in Upper Limbs:

Elbow

  • Cubital tunnel syndrome
  • Golfer’s elbow (Medial Epicondylitis)
  • Distal Biceps tendinopathy
  • Osteoarthritis
  • Tennis elbow (lateral epicondylitis pain)

Hand & Wrist

  • Carpal Tunnel Syndrome
  • De Quervain’s Tenosynovitis
  • Joint Osteoarthritis
  • Trigger finger/thumb
  • Wrist joint
  • Wrist tendon tenosynovitis

Shoulder

  • Acromioclavicular joint
  • Adhesive Capsulitis/ frozen shoulder
  • Calcific tendonitis
  • Impingement/Bursitis
  • Biceps tendinopathy
  • Osteoarthritis of the shoulder joint
  • Rotator cuff tendinopathy

Conditions which can be treated ultrasound guided injections in Lower Limbs:

Ankle & Foot

  • Big toe osteoarthritis
  • Ankle and subtalar joint osteoarthritis
  • Inter-metatarsal bursitis
  • Morton’s Neuroma
  • Plantar Fasciitis
  • Retrocalcaneal bursitis

Knee

  • Baker’s cyst aspiration
  • Bursitis
  • Chronic ligament sprain
  • Osteoarthritis

Hip

  • Hamstring/Gluteal tendinopathy
  • Ilopsoas bursitis
  • Osteoarthritis of the hip
  • Trochanteric bursitis – lateral hip pain

We also provide treatment procedure for some more advanced procedures including: Barbotage for calcific tendonitis, Hydro distention for frozen shoulder and high volume injections for tendinopathy.

Various types of injections that can ease your pain and stiffness:

1) Corticosteroid injections

Joint pain is a common problem which affects 1 in 3 adult patients. This problem can causes impaired function and limited range of motion. Cortisone injections are treatments for joint related problems.

At London Private Ultrasound we use ultrasound tools to ensure the safest and the most effective method to guid the injection into the intended affected area of joint.

2) Hyaluronic acid injections

Hyaluronic acid (HA) injections are another treatments for joints related problems. However, they often are used if corticosteroid injections do not work.

Hyaluronic acid (also known as gel) are made of the elements similar to your natural joint fluid. The thickness of your joint fluid can be affected by conditions such as osteoarthritis (becomes watery). Therefore HA injection works as a lubricant and shock absorber. This will help your joint fluid to restore the natural thickness. In some cases it can stimulate the production of natural Hyaluronic Acid.

If you do not have any obvious signs of inflammation in your joint, HA injections can be considered as the first choice. HA injections might also be chosen as your 1st choice of treatment if you have diabetes (as Corticosteroids can raise the blood sugar levels).

 3) Plasma (PRP) injections

Plasma therapy, sometimes called autologous conditioned plasma (ACP) therapy is a method which takes advantage of your own blood component and healing properties to repair  attempts to take advantage of the blood’s natural healing properties to restore injured cartilage, tendons, ligaments, muscles, or even bone.

What is plasma? Plasma refers to the liquid component of blood. Plasma is mostly water but also includes proteins, nutrients, glucose, and antibodies, among other components.

What are platelets? Platelets are a normal component of blood. Platelets contain their secret substances called growth factors and other factors that stimulate tissue regeneration and promote healing.  

At London Private Ultrasound we use your own plasma and platelets to inject into your affected areas under the ultrasound guidance. Plasma injection can help you to Reduce pain, Improve joint function and Possibly slow, halt, or even repair damage to cartilage.

We will take your blood sample to produce a therapeutic injection which contains your own plasma with a much higher concentration of platelets.

Plasma injections are commonly used to treat osteoarthritis joint pain. It also alter the immune response to reduce inflammation.

1) WHAT ARE THE ADVANTAGES OF ULTRASOUND GUIDED INJECTION?

There has been proven in lots of research that ultrasound guided injections achieve better outcomes in compared with injections without ultrasound guidance. The results are: longer lasting benefits, higher progress in function of the injected areas and better improvement in pain relief results.  

Ultrasound guided injection is an evidence base practice which reduces the risk adverse events such as risk of trauma to local tissues or misplacement of needle and medication.  

Ultrasound guided injections improve the safety of the injections and reduces the risk of undesired side effects. Because the location of the injection is more precisely chosen. Many patients find ultrasound guided injections to be more comfortable.

2) How long do the effect of joint injections last?

Long lasting results of injections typically depend on the reason for the treatment. When you complete your treatment, your pain and inflammation of the affected joint should decrease, and can last up to several months.

3) Are joint injections painful?

The most common side effect after the joint injection can be intense pain and swelling in the joint. The pain and swelling usually gets better after a day or two. You may also get some bruising where the injection was given. This should go away after a few days.

4) Do I need to rest after a cortisone injection?

After you have had a joint injection, you need to rest the affected area for 24 hours and avoid strenuous activity for several days.

5) Possible Risks/Side Effects

i) There are occasional side effects reported including allergic reactions to the actual medicines injected into joints, tape used for dressing or the disinfectant lotion used to clean the skin.

ii) Extremely rare post injection complication can be infections. Infections occur in less than 1 times per 15,000 corticosteroid injections

iii) There is another uncommon complication reported as post-injection flare up. This appears with joint swelling and pain several hours after the corticosteroid or hyaluronic acid injection and will usually subside within few days. It is a very rare side effect which occurs in approximately 1 out of 50 patients and can usually be managed with an NSAID such as ibuprofen or naproxen.

iv) there are other reported rare complications such as depigmentation (a whitening of the skin), local fat atrophy (thinning of the skin) at the injection site and rupture of a tendon near the injection site.

Precautions:

-Repeated injections into the same joint/site is not advisable.

-Joint injections should not be done if there is any infection inside or around the effected area. If an internal joint infection is suspected, the doctor should aspirate the joint fluid to perform a culture.

– In the cases of existing history of serious allergy to the medications and substances injecting to the joints, the injection should not be given.

6) WHICH BODY PARTS can be injected?

The most common indications for corticosteroid joint injections are:

  • frozen shoulder
  • carpal tunnel syndrome,
  • osteoarthritis of the knee,
  • trigger finger / thumb,
  • osteoarthritis of any joint around foot or hand,
  • Corticosteroid injections can be given in soft tissues if there is any inflammation or tenosynovitis, such as de Quervains  or tendon inflammation.
  • A Range of Hyaluronic Acid joint injections can be used in patients with degenerative joint pain (such as osteoarthritis) who are keen to keep moving and active.

We strongly advise you to consult with your doctor/ our consultant to make sure that you are the right candidate for joint injection treatments.

7) HOW DO I BOOK?

If you are interested in injection therapy please click here or call us on 02071013377.

Injections are not given to any person of 16 years of age or younger.

8) What is included in the my appointment? 

  • Physical Assessment
  • Diagnostic ultrasound scan
  • Ultrasound-guided injection
  • A detailed report of your scan findings and the performed treatment

You will receive an expert clinical assessment by one of our NHS consultant. This will be followed by a diagnostic ultrasound scan to confirm that injection is the best choice of treatment for you. Having ultrasound guidance will help our doctor to evaluate the source of your pain and to localise the correct area to inject.  

If within this process, you decided that injection therapy is not the appropriate treatment plan for you, you will be given a full explanation of the findings and the most appropriate management plan. In that case you will be charge a for the ultrasound scan only.

9) Which medicines can interfere with steroid injections?

Certain medications might interfere with steroids. If you are have any physical health conditions that you have to take medication for, you need to let our doctor know. Some certain medications might interfere with steroid injections such as: diabetes medication, HIV medications, cancer treatments etc.

If you are taking blood thinning medication such as Warfarin you should consult your specialist first to obtain his/ her advice before having an injection.

You may also require a blood test prior to your injection and adjustment of your medication dose. These are to make sure that your blood is not too thin to cause any bleeding in the joint after your injection.