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.

RELIEVE PAIN

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

REGENERATE

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.

STRENGTHEN

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)

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.

Arthritis

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.

Bursitis

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.

Tendinitis

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.

What is DUROLANE?

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.com

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.