Injection Therapy, Orthopedic Medicine, Sports Medicine and Physical Therapy Services in Honolulu, Hawaii
Orthopedic injections offer an effective way to address more difficult cases of tendonitis, ligamentous sprains, joint inflammation, and disc and fascial problems in the limbs and spine. Commonly recommended only when more conservative methods have failed, these injections target specific areas affected by injury or disease to provide relief and improve mobility.
The orthopedic injections available at Portner Orthopedic Clinic help reduce swelling and manage pain so that our physical therapists, massage therapists and other specialists can work on a progressive orthopedic solution that eliminates your pain source for good. The concentrated dose of targeted medication allows our team to calm the injury site, also known as the pain generator, so that we may attempt noninvasive therapies to permanently help heal the problem and restore full functionality.
Injection remedies can cause a pain flare to subside for several weeks to several months — long enough to see if your issues respond to a combination of nonsurgical approaches. Injections are often done with the aid of needle guidance, either fluoroscopic or ultrasound, to ensure that the placement of the needle is accurate and safe.
Injection therapy is sometimes recommended for people with back or neck pain, arthritis, sports injuries, carpal tunnel syndrome, whiplash injuries, chronic tendonitis, sports injuries, torn tendons, ligaments and cartilage, sciatica, TMJ, and herniated discs. Dr. Portner and his team offer several types of orthopedic injections, including:
Cortisone shots, containing corticosteroid medications and anesthetic, are used to relieve pain and inflammation in a specific structure of your body. The most common cortisone injection sites are the ankle, elbow, hip, knee, shoulder, neck, back and wrist joints. Even the small joints in your hands and feet may benefit from cortisone shots. Cortisone is not generally applied as a first-line treatment and must be used sparingly and conservatively.
Platelet activation plays a key role in the process of wound and soft tissue healing. The use of platelet rich plasma (PRP), a portion of the patient’s own blood having a platelet concentration above baseline, to promote healing of injured tendons, ligaments, muscles, and joints, can be applied to various musculoskeletal problems.PRP injections are prepared from one to a few tubes of the patient’s own blood with strict aseptic technique. After being centrifuged, the activated platelets are injected into the abnormal tissue, releasing growth factors that recruit and increase the proliferation of reparative cells. Ultrasound imaging may or may not be used to guide the injection.
Several clinical studies have demonstrated that PRP injections have improved function and decreased pain to various maladies, including – but not limited to – elbow, wrist, shoulder, hip, knee, and ankle tendonosis. Early work is also showing promise for osteoarthritis.
The side effects of PRP injections are very limited as the patient is utilizing their own blood, which they should have no reaction to. Some relative rest is needed immediately following the procedure, then usually followed by a progressive stretching and strengthening program.
Prolotherapy, also known as sclerotherapy, is often an effective management technique for musculoskeletal pain. The prolotherapy shot utilizes a safe dextrose/phenol solution injected directly where a damaged ligament or tendon attaches to the bone. The dextrose creates a localized inflammation, increasing blood supply and encouraging tissue repair.
Trigger point injections target certain areas of tenderness called trigger points, or areas where aches and sharp pains are felt when the examiner pushes on the tender spot. Steroid medication and local anesthetic are combined to relieve muscles spasms and ease pain, swelling and stress.
Epidural injections improve pain in the spine, including both the neck and back. They come in a variety of types, including translumbar, where the needle is inserted between two vertebrae, transforaminal, where the injection targets a specific nerve root, and caudal block, which targets the collection of nerves at the base of the spinal canal.
Facet injections are made in the facet joints of the back and neck, the joints that hinge and allow you to bend and twist. The targeted medication essentially relieves the inflammation and pain in the joints and helps restore mobility.
Injections of cortisone medication combined with a local anesthetic such as Novocain target the sacroiliac joint in the lower back and buttock, effectively reducing inflammation and decreasing pain.
This type of orthopedic injection uses hyaluronic acid, a natural substance found in the body, to lubricate the knee joint, improve mobility and absorb shock. Commonly used for patients with osteoarthritis of the knee, viscosupplementation is available in a variety of brands, including Hyalgan®, Synvisc®, and Supartz®.