There are a few reasons we may consider an injection in clinic:
The first, as already hinted at, is for situations where we are satisfied you are doing everything else right in your treatment plan (e.g. a good exercise programme / orthoses / footwear and so on) but your symptoms keep persisting. This may be due to persisting inflammation, swelling or restriction in movement. Some very common examples of this include Plantar fasciopathy, Morton’s neuroma and Midfoot Arthritis to name but a few.
The decision to inject local anaesthetic, steroid, Ostenil® or any combination of those will depend on lots of factors but they would often be used for these reasons:
Local anaesthetic: For pain relief either as a stand-alone therapy or in combination with other drugs like steroid OR as a “diagnostic block” where the aim is to numb the suspected source of your pain and back-up what we believe to be your diagnosis. Nerve entrapments and some hard to pin-point joint pains are good examples for this.
Steroid: Also used for pain relief but on a longer-lasting level by significantly reducing inflammation and swelling. As we use diagnostic ultrasound in our practice, confirmation of this swelling can be given so we know the steroid has an effective target to work on. Steroids are powerful and it is very important the injection is accurate which is why we, in our practice, generally opt for ultrasound-guidance when using this treatment option.
Ostenil®: This is kind of like WD-40 for humans! The active ingredient is Sodium Hyaluronate which acts as a lubricant similar to the synovial fluid found in joints and tendon sheaths (those being the main targets we use it on). It has an exceptional safety profile with very few side-effects, has been shown in numerous studies to have a protective effect on cartilage, and is also great for longer-term relief and improving mobility. In our practice, Ostenil® can be delivered as a single injection or as part of a treatment package, typically involving 3 injections, 1 week apart.