Injections for Pain
If you suffer from chronic nerve or joint pain, our board-certified sports medicine doctors in Helena, Montana can help you find relief without surgery. Learn about your treatment options below and call Performance Injury Care & Sports Medicine today at (406) 422-5817 to schedule an appointment or you can request one online.
Many people suffer from chronic nerve-related pain and are told nothing can be done except to take pain medications. What if a treatment could resolve your pain and help decrease your use of pain medications?
Most nerve pain stems from nerve entrapment syndromes that can be difficult to diagnose using traditional testing like MRI and nerve conduction studies. In the Northwest, Performance Injury Care & Sports Medicine (PICSM) is the leader in diagnosing and treating these often overlooked nerve pain syndromes. We specialize in looking at nerves using high-resolution ultrasound imaging.
Using diagnostic ultrasound, we can trace nerves as they exit your spine, follow their course as they travel to your extremities, identify any swollen and/or compressed areas, and administer an injection to break down the areas that are entrapping the nerve and causing your pain. This procedure is called nerve hydrodissection.
At PICSM we are specially trained in this technique, and Dr. Phillip M. Steele lectures widely on the topic of nerve entrapments and hydrodissection treatment.
Who Can Benefit from Nerve Hydrodissection?
- We have helped hundreds of patients suffering from chronic cervical, occipital, and temporal headaches using ultrasound-guided nerve injections to break up scar tissue that is causing pain.
- After surgery, a buildup of scar tissue can cause entrapment of nearby nerves, resulting in chronic pain and stiffness. We have helped relieve chronic pain in patients after joint replacement, rotator cuff surgery, and even abdominal surgery.
Neural prolotherapy (NPT) is an exciting regenerative treatment for nerve pain. Using a 5% dextrose (sugar) solution, we inject the solution into the surrounding area of an inflamed peripheral nerve. The goal is to reduce the neurogenic inflammation, swelling, and pain. We use NPT to treat nerve pain from head to toe:
- Back and neck pain
- Shoulder pain
- Wrist and hand pain
- Knee pain
- Foot and ankle pain
- Achilles tendonitis
The injection is placed just beneath the skin, so the pain is minimal. Patients will often have immediate relief. Depending on the severity of your pain, however, you may require multiple treatments to become pain-free. Treatments are given 2-4 weeks apart.
How Does Neural Prolotherapy Work?
Dr. John Lyflogt expanded on the treatments that were introduced in 1989. He has since been using this technique to treat various pain and musculoskeletal conditions with outstanding results.
The theory of NPT was based on “Hilton’s Law,” named after Dr. John Hilton, a British surgeon. He stated that the nerve that provides sensation to a joint also provides sensation to the skin overlying that joint as well as the muscles that move the joint.
Dr. Lyflogt found that an irritated nerve that supplies sensation to the skin over a joint may also cause dysfunction and pain to the muscles and tissue around that joint. He theorized that restoring peripheral nerve function would lead to healing in deeper structures and a reduction in pain. NPT is now being taught around the world.
Joint, Ligament, Tendon Injections
Is your pain or injury just not getting better? PICSM has many different options to diagnose and treat your issues. A common treatment option is injection to the injured joint, ligament, or tendon. The most common type of injection uses steroid, but other substances may be appropriate based on your condition. Common conditions that injections treat are osteoarthritis, rheumatoid arthritis, gout, tendinitis, and bursitis.
Steroid is a type of medication that has strong anti-inflammatory effects. The medication is injected directly into the target structure and typically shows improvement in the condition in 1-2 days. Injectable cortisone is a powerful anti-inflammatory medication, a synthetically produced steroid that lasts for a longer period of time than the cortisone your body naturally produces. It is injected directly into joints such as shoulders, elbows, wrists, knees, and ankles to decrease inflammation, which can subsequently decrease pain. Cortisone injections usually work within a few days, and the effects can last from 6 weeks to 6 months.
Viscosupplementation therapy is an appropriate treatment for people with knee arthritis that has failed to respond to more conservative therapy. Viscosupplement is a thick, gel type substance that provides lubrication and cushioning to a joint after being injected. Some research shows that viscosupplementation may have some anti-inflammatory effects as well. Viscosupplements are only FDA approved for injections into the knee joint. This is commonly used as treatment in knee osteoarthritis after other conservative treatments have failed. Viscosupplement injections can only be given every 6 months.
While many surgeons question the evidence of regenerative treatments for common orthopedic injuries, some well done studies raise considerable questions and concerns for many common shoulder arthroscopic surgical procedures. Shoulder Impingement A recent article (July 2018) in the British Medical Journal compared patients who had surgery against those who did not for impingement symptoms. 210 […]