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Injections

Injections are a conservative treatment used for a variety of orthopedic aliments.

Corticosteroids, or cortisone injections, which are most common, are frequently used when oral medications aren’t providing the desired pain control. Generally safe and effective, these drugs reduce inflammation and can sometimes take the place of surgery for some people. They may, however, become less effective over time, especially in cases of diseases that worsen over time, including degenerative joint disease or osteoarthritis.

Commonly used injections include:

Epidural Steroid Injections/Selective Nerve Blocks

These injections are generally used to reduce pain and swelling associated with disc herniation, arthritis of the spine, spinal stenosis, disc degeneration, sacroiliitis, hip arthritis, labral tear of the hip and pinched nerves. These injections can also help diagnose a spinal disorder. The active ingredient in the injection is usually a type of corticosteroid called Depo-Medrol.

Before the procedure: It is important to let our staff know if you are taking a blood thinner such as Coumadin or Plavix. You may be asked to stop this medication a week before your injection.  (Consult with your prescribing doctor to make sure it is safe to do so.) No anti-inflammatory medications, including ibuprofen (Advil), naproxen (Aleve) and aspirin, should be taken in the five days prior to the injection. If you have taken an anti-inflammatory medicine during this timeframe, please advise the doctor. You may resume taking blood thinners and anti-inflammatory medicines the day following your injection.

Fasting is NOT required prior to the procedure. For an Epidural Steroid Injection, you will normally be able to drive yourself to and from the appointment, unless the doctor specifies otherwise. For a nerve block involving the lower back, it is often necessary to have a driver bring you to and from the procedure.

After care: Soreness at the site of the injection is not unusual. Applying a cold compress at the site is helpful for reducing local discomfort. Tylenol is also safe to take the day of the procedure, unless otherwise specified. Any slight weakness and numbness that can occur after a nerve block will typically resolve within four to six hours.

We recommend calling Dr. Collard’s office five to seven days after your procedure to access your response and make any further treatment plans.

Trigger Point Injections

These muscle injections, which involve very small dosage of a cortisone agent diluted with a local anesthetic, are used to reduce pain and to improve mobility in patients with tight or irritated muscle tissue. Trigger point injections are often used in conjunction with physical therapy to speed recovery.

Before the procedure:  You may take blood thinning or anti-inflammatory medication as normal prior to a trigger point injection, unless otherwise directed by your doctor. It is not necessary to have a driver bring you to and from this appointment.

After care:  Soreness at the site of the injection is not unusual. Applying a cold compress at the site is helpful for reducing local discomfort. It is important to stretch the affected muscles at least once or twice daily to maximize the benefit of the trigger point injection(s).

We recommend calling Dr. Collard’s office five to seven days after your procedure to access your response and make any further treatment plans.

Cortisone Injections

Cortisone is a short-acting steroid that is produced naturally by the adrenal gland and released into your bloodstream when your body is under stress. Synthetically produced injectable cortisone is a powerful anti-inflammatory medication. Similar to your body’s own product, synthetically produced cortisone is not injected into the blood stream, but directly into a particular area of inflammation in high concentrations with minimal side effects.

The shot itself can be slightly painful, especially when given into a joint. Numbing medication is often injected with the cortisone to provide temporary relief. Topical anesthetics can also help numb the skin in an area being injected. Synthetic cortisone has many different trade names, including Celestone and Kenalog.

Cortisone injections usually begin working within 48 to 72 hours, and can last up to several weeks, months or even years. Many conditions are amenable to cortisone shots. Among them:

  • Osteoarthritic joint
  • Carpal Tunnel Syndrome
  • Epicondylitis
  • De Quervain’s Tenosynovitis
  • Shoulder Bursitis
  • Trigger Finger
  • Trochanteric Bursitis