Injection Therapy

The Ultimate Arthritis package is designed on the latest evidence and guidance for the management of Osteoarthritis (NICE Guidelines 2022)


Injection Therapy

The Ultimate Arthritis Package

The package consists of a steroid injection that target the acute nature of the pain commonly experienced by OA as well as uses the latest high weighted HA to help regenerate the joint. Finally, each patient is put through a tailored body screening to help target the main causes of the OA. The patient is also given advice and exercises to help prevent any future deterioration.


The joint is injected with a CORTICOSTEROID and ANAESTHETIC to reduce the pain and inflammation commonly caused by OA.


One week later the joint is injected with DUROLANE (high weighted Hyaluronic Acid) which helps lubricate the knee as well as improves the existing durability of the knee.


Finally, you will have a BODY SCREEN which is a unique cardio-respiratory and musculoskeletal screening that looks at how well 28 areas of your body can take your health and lifestyle, and this gives advice and exercises as unique as your DNA on how to reduce injury in the future.

The package runs over a 3-week period

RRP COST = £700

£599 (£100 saving)

Struggling with Arthritis?

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Injection Therapy

What is a corticosteroid injection?

A corticosteroid (or ‘cortisone’) is an anti-inflammatory medicine, which can be injected directly into the tissues or structures that are causing your symptoms. It is a safer alternative to taking anti-inflammatory medication by mouth. It acts directly in the area injected and is not the same as the steroids taken by bodybuilders or athletes.

What are the benefits of a corticosteroid injection?

The injection can help to relieve swelling, pain and stiffness caused by inflammation. This may in turn help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anaesthetic injected at the same time, which allows for temporary pain relief.

Generally, corticosteroids are used to relieve acute conditions whereas chronic conditions such as osteoarthritis is normally treated with hyaluronic acid injections. For the better results they are often used in conjunction.

Which conditions can corticosteroid injections treat?

Corticosteroid injections can be used to treat a variety of conditions, including the following.


Steroid injections can effectively treat the joint inflammation that is seen in people with rheumatoid arthritis. They can also be used to relieve the pain of osteoarthritis (the most common form of arthritis) and gout.


Bursas are small, fluid-filled pads that allow tendons and muscles to slide easily over bones. The pain associated with inflammation of a bursa (bursitis) — a condition which usually affects the shoulders, elbows, hips and knees — can be treated with steroid injections.


Tendons are the thick bands of tissue that connect muscles to bones. Repeated motion and stress to a tendon can cause it to become inflamed — this is known as tendinitis. Rotator cuff injury of the shoulder is a common example of tendinitis that can be treated with corticosteroid injections.

Carpal tunnel syndrome

Carpal tunnel syndrome is when the median nerve (which supplies sensation to your thumb and most of the first 3 fingers) is compressed within the narrow passageway in your wrist known as the carpal tunnel. This causes pain, numbness and tingling in the wrist and hand. By reducing inflammation in the carpal tunnel and relieving pressure on the median nerve, corticosteroid injections can ease the pain of carpal tunnel syndrome.

Frozen Shoulder

Multiple studies show that corticosteroids significantly help with the early stages of frozen shoulder by reducing the pain for up to 4 weeks. It is a highly effective when coupled with physiotherapy.

How much does a corticosteroid injection cost?

The injection costs £250 per injection (includes private prescription fee) and most injections are ultrasound guided for increased accuracy and efficacy.

When are corticosteroid injections used?

Although steroid injections can often effectively relieve the pain associated with musculoskeletal conditions, they are usually not used as the initial treatment option. Less invasive treatments, such as rest, oral pain reliever medicines, hot and cold compresses and physiotherapy, are usually tried first.

Make sure you tell your physician about any other conditions you have and any medicines (including complementary medicines and dietary supplements) you are taking before having a steroid injection.

Do I need to restrict my activities after the injection?

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

Is the injection painful?

Cortisone injections will be performed in clinic. Often, it is done ‘landmark guided’ based on knowledge of anatomy. It can also be done under ultrasound guidance, to improve accuracy. The injection itself can be uncomfortable, so your physician may give you a local anaesthetic to numb the skin before the injection.

A local anaesthetic medicine such as lignocaine is also usually added to the corticosteroid injection. This anaesthetic can relieve your pain immediately, confirming the injection has hit the right spot. After a few hours, the anaesthetic will wear off, and you may feel some pain or discomfort until the anti-inflammatory effect of the steroid kicks in, which is usually after a couple of days.

Putting ice on the area and taking a pain medicine (such as paracetamol) may help relieve any discomfort in the meantime.

Advantages of steroid injections

The main advantages of corticosteroid injections is that they relieve pain and inflammation. This can in turn can reduce swelling and improve mobility. The beneficial effects can last for several months.

In some cases, getting a steroid injection allows you to take part in physiotherapy or rehabilitation exercises to help longer-term improvement or recovery.

Risks and side effects

The most common side effects are pain and inflammation of the tissues surrounding the injection site. This temporary worsening of symptoms is known as post-injection flare, or steroid flare, and may last for a couple of days.

People occasionally report skin discolouration around the injection site. The skin may become lighter around where the injection was given. There is also a risk of nerve damage associated with steroid injections.

There is a small risk of infection associated with the injections. Joint infections (septic arthritis) are especially serious, and can result in permanent damage to the joint. See your doctor as soon as possible if:

  • you experience pain for more than 48 hours after the injection;
  • pain develops more than 2 days after the injection;
  • the area becomes red, hot or swollen; or
  • you develop a fever following the injection.

Corticosteroid injections should never be given if you have an infection, including an infection of the skin at the injection site.

Corticosteroid injections may weaken tendons, sometimes possibly causing tendons to rupture. Repeated injections of steroids may also damage joint cartilage and contribute to thinning of nearby bone (local osteoporosis). For these reasons, as well as the risk of general side effects, there are limits to how many times and how frequently corticosteroid injections can be used in the same area.

General side effects may include:

  • a rise in blood sugar levels that lasts for up to 48 hours after the injection (usually only noticed if you have diabetes);
  • a temporary rise in blood pressure lasting a few days;
  • sleep problems; and flushing of the skin on the face and chest – this usually lasts no more than a few hours.

Long-term problems associated with corticosteroid medicines

People who take steroid medicines orally (by mouth) for prolonged periods are at risk of several side effects, including weight gain, high blood pressure and osteoporosis. There is only a very small risk of these problems developing following injections of corticosteroid, because, unlike when a person takes corticosteroid tablets, only very small amounts of the medicine enter the bloodstream.


DUROLANE is a single-injection treatment of HA designed to provide powerful and lasting pain relief when you are suffering from pain due to OA. DUROLANE is the only high weighted HA injection on the market and it even improves the consistency of the existing fluid in your joint.

How does DUROLANE work?

DUROLANE is a HA which acts like a lubricant and shock absorber in the synovial fluid. A DUROLANE injection may cushion your joint and manage your symptoms.

What are the benefits of DUROLANE?

As early as two weeks after an injection, DUROLANE can reduce OA joint pain and improve the physical activity and quality of life of OA patients. Some patients have pain relief lasting between 12 -15 months.

Is DUROLANE right for me?

If you are an OA patient who is not getting enough pain relief from oral medications, physical therapy or steroids, DUROLANE might be right for you. Speak with your clinician about HA treatment with DUROLANE.

How much does a DUROLANE injection cost?

A DUROLANE injection costs £350 per injection and most injections are ultrasound guided for increased accuracy and efficacy.

Is there any reason why I couldn't have a DUROLANE injection?

You should not use DUROLANE if you have infections or skin disease at the injection site. DUROLANE has not been tested in pregnant or lactating women, or children. Full indications and contraindications information can be found in product labelling, at

DUROLANE Injection Therapy for Osteo Arthritis

Ostenil® Injections - Pioneering Treatment for Osteoarthritis

We are delighted to announce that PhysioNeeds now offers the pioneering treatment of Ostenil® injections, administered on-site by James Tomlinson, who has undergone extensive training in injection therapy.

Ostenil® injections are designed to treat the symptoms of osteoarthritis. Injections can be administered in the knee, hip or any other joints that are classified as ‘synovial.’

What is a synovial joint?

A synovial joint is one in which the ends of the bones are joined together and enclosed in a capsule containing a thick, slippery liquid called synovial fluid. Joints which can be classed as synovial include hips and knees.

The four main functions of synovial fluid are:

  • To keep bones slightly apart, protecting their cartilage coverings from wear and tear.
  • To absorb shock, protecting the cartilage.
  • To lubricate the joint, helping it to work freely and easily.
  • To act as a filter, allowing for nutrients to reach the cartilage and preventing the passage of harmful cells and substances.

The most important component of synovial fluid is a substance called hyaluronic acid, which allows for synovial fluid to perform all four of these important functions at the same time.

What is osteoarthritis?

Osteoarthritis is the most common form of arthritis in the UK. Knees, hips and small joints in the hand are the most frequently affected areas but osteoarthritis can occur in any synovial joint in the body.
Hyaluronic acid, vital to the performance of the synovial joints, is continuously being broken down and replaced in our bodies. Normally, there is an exact balance between the breakdown of old hyaluronic acid and the production of new acid but in osteoarthritis, this balance is disrupted and breakdown happens faster than production. As a consequence, synovial fluid becomes more watery and stops working properly.
Over time, this change in synovial fluid can cause the cartilage in the joint to gradually wear away and causes the symptoms of osteoarthritis – pain, swelling and stiffness.

Ostenil® injections – what are they and how can they help?

Ostenil® injections consist of a solution containing sodium hyaluronate. The injection needs to be administered, by a fully qualified practitioner, into the space in the joint that contains synovial fluid. It works by restoring the normal balance between the breakdown and production of hyaluronic acid within the joint. The effect is that it can decrease pain and stiffness, and improve the other symptoms of osteoarthritis. It is essentially like WD40 for the joints!

Ostenil® treatment can be particularly effective for osteoarthritis, as an alternative to steroid injections. Further evidence from Cochrane reviews (internationally recognised as the highest standard in evidence based health care) has concluded that these types of injections are effective treatments for mild to moderate knee osteoarthritis. It’s unfortunately not a treatment that is offered by the NHS.

Are there any side effects?

Thousands of patients have received Ostenil® treatment and it has not been found to cause any serious side effects. There is a very small risk of infection as with any injection and patients may occasionally complain of post injection pain, which may last for a day or two.

Download our patient information leaflet (PDF)...

What can I expect from this treatment?

Ostenil® injections are injected directly into the joint affected by osteoarthritis. You will receive one injection a week for three weeks. After each injection, you’re advised not to exercise for a couple of days.

While the benefits from the injections might not be immediately noticeable, you will gradually experience a reduction in pain and stiffness and this improvement will likely persist for up to nine months, depending on the progression of the degenerative change in the joint being treated.

Once the effects of the final course of injections wear off, you can choose to have another.


How much does it cost?

At PhysioNeeds we offer a course of 3 injections at £100 each for large joints (e.g. knee/hip) and a singular injection for small joints (e.g hand) at £80

Am I suitable for Ostenil® injections?

For further information and to discuss your suitability for treatment give us a call and we can arrange James Tomlinson to ring and speak to you directly to discuss it further.


A higher concentration of sodium hyaluronate, with the addition of mannitol. This formulation offers effective symptomatic relief with a single injection in knee and hip joints, and is well tolerated. OSTENIL® PLUS contains 40mg / 2ml sodium hyaluronate, plus mannitol, a free radical scavenger, which helps to stabilise the chains of sodium hyaluronate.

OSTENIL® PLUS is a single injection option. Please consult your clinician

Download our patient information leaflet (PDF)...

PhysioNeeds Clinics

PhysioNeeds Nottingham

PhysioNeeds Nottingham

Nottingham Sports Injury Clinic
736 Mansfield Road
Nottingham NG5 3FW


PhysioNeeds East Bridgford

PhysioNeeds East Bridgford

PhysioNeeds East Bridgford
1 Main Street
East Bridgford
Nottinghamshire NG13 8PA


PhysioNeeds Cotgrave

PhysioNeeds Cotgrave

PhysioNeeds Cotgrave
Suite H, Cotgrave Business Hub
Candleby Lane, Cotgrave
Nottingham NG12 3JQ


PhysioNeeds East Leake

PhysioNeeds East Leake

PhysioNeeds East Leake
71 Main Street
East Leake
Leicestershire LE12 6PF


Dear Nottingham Sports Injury Clinic patients

We hope you are all keeping safe and you and your families are managing okay in these very unprecedented times.

Our clinic is open for Face to Face treatment! We assure you that we have put enhanced measures in place to ensure the protection of both you the patient, our staff and the wider public. A full risk assessment of the working environment has been undertaken. We are following Public Health England COVID-19 infection prevention and control guidelines.

We are asking patients to wear a face mask at all times when inside the clinic.

Please see our PDF attached outlining our SCREENING-CLEANING-PROTECTING protocols

COVID-19 SCREENING QUESTIONS: When booking a Face to Face appointment you will be asked to confirm that you or any member of your household IS NOT presenting, or HAS NOT presented with the following symptoms in the last 14 days:

If you answer YES to any of the above then you will not be able to be seen Face-to-Face but we can still discuss and treat your injury via Telephone/Video Consultations. We can also offer Telephone/Video Consultations for those patients who are still shielding.

We have also been posting lots of videos on our Facebook page and YouTube channel (PhysioNeeds) so do check those out to try and stay as active as possible. We have also been putting top tips on our Facebook page to help with prevention/management of injuries. If you have any questions, please do contact the clinic.

Stay safe everyone!

From all the team at PhysioNeeds

Screening, Cleaning, Protecting