Injection Clinic news Archives - Page 2 of 2 - Injection Clinic Sheffield Barnsley

Platelet Rich Plasma (PRP) injections

The search for best treatment of joint degeneration and OA changes continues.

A growing number of people are hearing about Platelet Rich Plasma (PRP) injections, but what are they and do they work?

All mammals, and that includes us, have cells within their blood. Different cells do different jobs. Most people have heard of red blood cells as these help carry oxygen and white blood cells that help fight infection.

There are however lots of other ‘bits’ within our blood and these are called ‘platelets’. Platelets are fragments of cells that originate in bone marrow cells. These fragments contain many different proteins and are most commonly associated with ‘plugging’ a hole in any damaged tissue. They form a blood clot and prevent excessive bleeding, but they also initiate the process of repairing tissue and some of the proteins within platelets are referred to as Growth Factors.

The idea behind PRP injections is that you take a persons blood and separate the red bloods cells away from the platelets. You then have a higher concentration of proteins and growth factors which you inject into the area of damaged or degenerate tissue. This is essential as you do not want red blood cells inside joints or ligaments as this can cause a further inflammatory response (red blood cells should not be in these places).

platelet-rich-plasma-prp

The aim is to stimulate new cellular growth and therefore boost the repair process. Sounds good, but does it work?

Like most things there is no clear answer. Research is a mixed affair with animal dissection after injections showing an improvement in the surface of joint cartilage. We don’t tend to be that cruel to humans, so most outcomes in people are based on pain and disability scores. Research tries to compare the benefit of PRP to exercise and/or other medication. The results are not conclusive but there is a trend and as the use of PRP has grown there has been more widespread acceptance of PRP as a valid treatment option. It is now acknowledged by the NHS and in some areas of the UK offered as a treatment.

One big advantage of PRP is that it is safe and there are no long term side effects. The physiological basis has merit, mainly because usually platelets have difficulty reaching ligament, tendon and cartilage tissue. Consequently, I tend to refer to PRP as a fertiliser to aid healing and ensure the best outcome. It is not however a miracle cure or a stand alone treatment. Its needs to be used in conjunction with corrections to strength, alignment and patterns of movement.

If you wish to discuss your problem further or arrange an appointment for PRP treatment please visit with main website and book an appointment.

Further information can be viewed in the article written by Arthritis Health.

Hip Pain

Hip Pain: a joint that often gets over looked.

The hip is a weight bearing joint and is affected by degenerative changes and inflammation. But despite these common and shared problems with the knee joint, treatment for hips is more limited.
Whilst there are some GP’s that will provide knee injections and day case surgery for knee arthroscopy’s is widespread practice; injections and surgical intervention for the hip joint is much more difficult to access.
This is mainly due to the depth of the joint and the costs involved with guided injections performed in Theatre .

However, with appropriate diagnosis and modern ultrasound scans the hip joint does not need to be a poor relation to the knee. For a new patient examination and ultrasound guided cortisone injection the cost is only £150.

There are two key areas that can benefit from injections; the Trochanteric Bursa and the joint capsule. Both these areas can be visualised on ultrasound scans and allow for accurate guided needle placement. The worry of touching a nerve or deep vascular structure is gone, because they are clearly visible.
Secondly, hip injections are relatively painless. In the Journal of Arthroscopic Surgery 49 out of 50 patients preferred ultrasound guided injections over x-ray guided. Most people comment ‘is that it’. The worry of the injection is typically far worse than the injection itself!

Hip joints also have a large number of surrounding muscles and therefore with appropriate exercises the mechanical stability of the joint can be improved.

The key to all muscle and joint related problems remains the same: Improve the joint chemistry by decreasing inflammation or adding joint lubrication and then optimise the movement pattern and supporting muscle strength.
If you feel you may benefit from a clinical examination and ultrasound scan of your hip joint and surrounding tissues then please phone 0114 267 1901 to check on appointment availability.

Book an appointment

Frozen Shoulder

Frozen shoulder is a common shoulder problem; it typically starts without any trauma and last for around 18 months. Quite often it affects the persons non dominant arm and after a period of several weeks it can cause the shoulder joint to loose its range of movement. Washing hair, fastening bras, putting on jumpers etc all become problematic.

Diagnosis is established by the presenting loss of movement and ultrasound scans can further ensure there is no tissue damage. A frozen shoulder on both ultrasound scan and x-ray will look normal.

Due to the high level of pain and limited movement, the condition has a significant impact on a persons life. Whilst treatments such as gentle exercises and soft tissue massage to the surrounding muscles can benefit, the main change in symptoms and movement is provided for by injection therapy.

Guided corticosteroid injections help reduce inflammation and in so doing decrease the pain experience. Hydro-dilitation or distention helps to stretch the shoulder joint capsule from the inside and can provide immediate improvement in joint range of movement.

It must be noted that all injections have to be administered under guidance. The joint space is relatively small and can be as deep as 6cm on some individuals. For Hydro-dilitation, the use of ultrasound scan enables a clear image of the expanding joint capsule.

Guided injections work well to suppress excessive inflammation. This can often improve night time rest, enabling better sleep.

To book an appointment with Injection Clinic and find out if you could benefit from a guided injection please ‘click here’.

Pain Scores: are they damaging us?

Are ‘Pain’ scores damaging the public’s health!

Ever been asked to score your pain out of 10?

Ever been asked to describe your pain and even draw a picture of where it is?

Ever wondered why?

We are taught to believe that a description of our pain and its intensity will help us to find out what’s wrong. This approach has grown in popularity, in part fuelled by a trend in cultural expectations that we should be pain free. In part driven by commercial practice that attempts to sell a ‘pain free’ lifestyle. It is both tempting and financially lucrative.

So does this approach work?

No. The number of people with long term pain is rising, mental ill health associated with pain is rising, the financial cost for the management of long-term pain is increasing and the health of the nation is decreasing.

So why is it that a standard medical consultation spends time discussing a persons experience of pain and how it affects them?

There are several reasons, the key ones include:

All NHS contracts in orthopaedics stipulate that outcome measures based on pain scores are put in place as part of service contracts. Consequently, the clinicians have to ask and patients have to score high in order to gain access to care.
It is cheaper to talk about pain than it is to investigate.
Many clinicians are taught to ask about pain and there is trend in becoming more empathetic as opposed to diagnostic. ‘How do feel’ has gained priority over ‘this is what’s wrong’.

Is this pain discussion really that bad?

At its current level, yes. As a consequence of our focus on ‘pain’, our time and financial resources are being spent on ‘pain’ driven pathways instead of appropriate investigation and medical intervention. The focus on ‘pain’ is like having focus on the noise a fire alarm makes. The alarm is not the real problem, the alarm is a warning. It is the resultant investigation that determines if there is a problem and if so, where it is and how big it is.

Side note: Veterinary practitioners have the luxury of avoiding the whole pain score and pain discussion because animals don’t speak. Veterinary clinics have ultrasound scans, x-rays, some even have MRI’s. Many have blood laboratories on site and as a result our pet animals have immediate focus on ‘what is wrong’.

So, if we don’t measure ‘pain’ what should we do?

Firstly, we should make a tissue based diagnosis to determine the nature of the problem. Then we should deliver treatments that are backed by research.

Corrections to posture, alignment and strength, including surgery; all help improve body mechanics.
Corrections to chemistry within our bodies will always promote health.

If we stop chasing pain and start chasing after best health, then our healthcare resources will be used to improve the health of the nation.

Book an appointment to find out what is causing your pain

If you are in pain but don’t know what tissues are damaged or irritated, then a physical examination enhanced by ultrasound is a great place to start. It costs £75.

Book your initial consultation including ultrasound scan

www.injectionclinic.co.uk

Shoulder Pain

What does shoulder pain look like?

INJECTION CLINIC·SUNDAY, 17 FEBRUARY 2019

Shoulder pain and ‘pain’ in general cannot be seen. What can be seen are changes to the tissues that make up our shoulder joints.

Shoulder Bursitis

Common problems include shoulder bursitis, which is the inflammation of a fluid sac within your shoulder joint. This can be seen on the ultrasound image below (see the darkened band pointed to by the white arrow) . It is a common painful condition that responds very well to ultrasound guided cortisone injections.

Rotator cuff tendon tear

Another common shoulder problem is a tear within the rotator cuff tendon. The image below shows a comparison between a normal supraspinatus tendon (left image) and a torn supraspinatus tendon (right image). This problem is not for injection, but requires surgical consideration and appropriate rehabilitation.

rotator-cuff-tear-diagnosis-of-shoulder-problem

Acromio-clavicular joint inflammation

A common and often over looked problem is inflammation of the acromioclavicular joint (ACJ). When inflamed the joint responds really well to injection therapy.

Category: Injection Clinic news