FAQs on Ultrasound Guided Injections

Ultrasound guided injections have been widely used as an effective tool for musculoskeletal pain management in recent years. With greater accuracy and safety, these injections are used both as diagnostic and treatment purpose.

What is an ultrasound guided injection?

An ultrasound guided injection combines the advantages of both ultrasound procedure and medication injection. Ultrasound guided injections ensure the most accurate and precise delivery. The procedure is widely used to treat painful multrasound-guided-injectionusculoskeletal conditions associated with arthritis, sports injuries, nerve injury, and degenerative disorders.

Ultrasound provides real-time imaging of abnormalities in nerves, bones, muscles, tendons, and other body parts without exposing patients to radiation. Once the injury is identified, a needle is introduced precisely to the injured spot guided by real-time images. The procedure allows targeting deeper, smaller, and tougher pain spots that were not possible previously and inject medications precisely and effectively without injuring adjacent nerves, blood vessels, and other structures.

The greater accuracy of ultrasound guided injections, especially during Platelet Rich Plasma administration and steroid pain management, have become a viable alternative to surgery to relieve tendonitis, bursitis, arthritis, inflammation, and other types of musculoskeletal pain.

The procedure saves Colorado pain management doctors from administering high-value injection shots blindly to an area of inflammation. They are now able to see pathways and inject medication directly to the ideal spot in the most optimal manner. This also assures the most effective treatment.

Why should I go for ultrasound guided injections?

  • A viable alternative to surgery as far as many painful conditions are concerned
  • No blind injection and greater accuracy in injecting medications
  • Saves patients from radiation
  • Used as both diagnostic and treatment methods
  • Improved quality of injections and assured effectiveness
  • Higher precision ensures reduced risk of complications
  • Best to treat musculoskeletal pain without harming surrounding tissues
  • Minimally invasive and fast recovery
  • Injection access to deeper, smaller, and tougher areas in the bodyDSC00193

What are the different types of ultrasound guided injections?

There are different types of ultrasound guided injections used by doctors. These injections contain medications based on the condition to be treated and administered directly to the area of pain.

  • Cortisone shots, a type of steroid injection used to relieve pain and inflammation
  • Mixture of steroid and a local anesthetic to provide semi-permanent pain relief
  • Anesthetic shots or numbing injections used for nerve blocks and pain relief
  • Platelet rich plasma and stem cell injections used for prolotherapy or regenerative medication
  • Lubrication injections for joints containing Hyaluronic Acid and similar elements
  • Pain medication directly administered to the injured bone or tissue

What are conditions treated with ultrasound guided injections?

Ultrasound guided injections are considered an effective method to treat painful musculoskeletal symptoms. However, the procedure has also showed its effectiveness in relieving nerve impingement and inflammation of tendons, bones, and deep tissues. The following is a list of medical conditions currently treated with ultrasound guided injections.

  • Plantar fasciitis pain in the heel caused by injured and inflamed ligament arch underside the foot
  • Achilles tendinitis pain due to inflammation or injury to the tendon connecting calf to heel
  • Rotator cuff injury
  • Trochanteric bursitis leading to hip pain
  • Shoulder impingement
  • Shoulder bursitis due to inflammation of the bursa and consequent pain and disability
  • Shoulder tendon tear or tendinitis
  • Frozen shoulder
  • Golfer’ elbow (medial epicondylitis)
  • Tennis elbow (lateral epicondylitis)
  • Tendinopathy impacting the kneecap
  • De Quervain’s disease following inflammation of tendons responsible for controlling the movement of the thumb and associated pain and disability
  • Muscular and adductor tendon injury
  • Carpal tunnel syndrome impacting the wrist
  • Osteitis pubis causing abdominal and pelvic pain due to inflammation in pubic symphysis
  • Inflammatory or degenerative arthritis in knee, shoulder, and hip joints
  • Ligament disorders in joints
  • Neck pain
  • Chronic headaches
  • Back pain and sciatica
  • Cancer-related Pain
  • Peripheral vascular Pain
  • Nerve injury

How is an ultrasound guided injection administered?

The procedure is performed in an outpatient setting by pain management doctors in Boulder, Greeley and Loveland CO. The skin above the injured or pain spot is numbed using a local anesthesia. Needle and syringe are similar to those used in case of traditional injections. The ultrasound pod is pressed on the numbed skin to visualize muscles, tendons, bones, nerves, and soft tissues beneath.

Real-time image generated on the ultrasound monitor helps guide the path of the injection and access the exact location. During nerve blocks, a dye is injected prior to medication to double-check placement and ensure that the needle has reached the intended target.

How long does it take?

The injection procedure takes less than 30 minutes. However, it takes days or weeks before patients experience significant pain relief. Nerve blocks and corticosteroids start acting after two to three days. For prolotherapy, viscosupplementation and stem cell therapy, the impact is felt after a few days to a few weeks.

Do I need rest after ultrasound guided injections?

No. This is an outpatient procedure and very similar to traditional injections except the use of ultrasound and local anesthetic. You can go home as soon as the injection procedure is over. For nerve blocks, you can take rest for a day. Report to your doctor if there is any complication.

What is injected through ultrasound guided injections?

  • Pain injections have numbing, anti-inflammatory, and pain relief medications.
  • Steroid injections have cortisone or other steroids alone or mixed with a local anesthetic
  • Numbing or blocking injections have only local anesthetics, such as lidocaine.
  • Prolotherapy injections have platelet rich plasma or stem cells
  • Lubrication injections have viscosupplements, such as Hyaluronic Acid

What are the side effects of ultrasound guided injections?

Injection site infection, inflammation, or irritation is common after ultrasound guided injections. Error by doctors may result in bruising and bleeding. Temporary soreness, pain, and fever may impact for a few days. Many patients are allergic to certain medications and steroids and doctors must take notice of it.

The top Colorado pain doctors at Colorado Clinic use image guidance including ultrasound and fluoroscopy for the highest accuracy. The pain clinics in Boulder, Greeley and Loveland accept most insurances, with nonoperative outcomes being extremely impressive. Call the location closest to you today!

References

Lee DH, et al. “Sonographically guided tendon sheath injections are more accurate than blind injections: implications for trigger finger treatment” J Ultrasound Med. 2011 Feb;30(2):197-203.

Soh E, Li W, et al. Image-guided versus blind corticosteroid injections in adults with shoulder pain: A systematic review. BMC Musculoskelet Disord 2011;Jun 25;12:137. doi: 10.1186/1471-2474-12-137.

Peng PW, Cheng P. Ultrasound-guided interventional procedures in pain medicine: A review of anatomy, sonoanatomy, and procedures. Part III: Shoulder. Reg Anesth Pain Med 2011;Nov-Dec;36(6):592-605.

Peck E et al. Accuracy of ultrasound-guided versus palpation-guided acromioclavicular joint injections: A cadaveric study. PM R 2010 Sep;2(9):817-821.

Naredo E, et al. A randomized comparative study of short term response to blind injection versus sonographic-guided injection of local corticosteroids in patients with painful shoulder. J Rheumatol 2004 Feb;31(2):308-314.

Gruson KI, Ruchelsman DE, Zuckerman JD: Subacromial corticosteroid injections. J Shoulder Elbow Surg 2008;17(1 Suppl):118S-130S.

Sabeti-Aschraf M, Lemmerhofer B, Lang S, Schmidt M, Funovics PT, Ziai P, et al: Ultrasound guidance improves the accuracy of the acromioclavicular joint infiltration: A prospective randomized study. Knee Surg Sports Traumatol Arthrosc 2011;Feb;19(2):292-295.

Elkousy H, et al. Retrospective comparison of freehand and ultrasound-guided shoulder steroid injections. Orthopedics Apr 2011;34(4).