Ultrasound-Guided Injections
A powerful aid in rehabilitation.
Many people come to us struggling with persistent pain, inflammation or an injury that just seems to get stuck. Injection therapies, in the right hands, alongside a comprehensive treatment plan, can work wonders for many of these problems. Injections however are not without their risks and some are simply not safe without knowing exactly where to inject…that is why we are proud to be the first Podiatry clinic in the Scottish Borders to offer injection therapies, including, local anaesthetic, steroids and Ostenil®, in the safest and most reliably form possible - with ultrasound-guidance.
We believe in a light touch when it comes to injection therapies and don’t seek to over-treat. Meaning we will always take the time to think carefully about the use of injections in your individual case, discuss the intended benefits and potential downsides with you and only inject when we (and more importantly, you) have a very high degree of confidence we will be successful.
Knowing when and what to inject.
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.
Knowing where to inject.
An injection carried out by a member of our team has a distinct advantage over other Podiatry practices in the Scottish Borders - we are the first to offer an in-house, fully certified diagnostic ultrasound imaging service.
This makes a tremendous difference when it comes to planning injections as we can first ensure we are making exactly the right diagnosis and know how severe the condition is. Assessing the location and severity of tissue damage with clinical examination and the naked eye can only get you so far and ultrasound allows us a far superior level of precision so we can a) know precisely IF an injection is appropriate and b) know precisely WHERE that injection should go.
The where part is also huge. Whilst we are very experienced in performing landmark-guided injections (sometimes called blind injections) we are utterly convinced, from our own practice and from the mountain of clinical research on the topic, the most injections should really be performed under ultrasound-guidance.
Fundamentally, ultrasound-guidance means we can see where the needle is being injected in real-time. The result is much greater safety, accuracy and the ability to perform highly specialised procedures, such as High-Volume Image-Guided Injection (HVIGI) and Midfoot Arthritis injections, that are just not possible for most practices to carry out with the safety and precision you should expect.
Injection Guide Prices*
Ultrasound-Guided Steroid: £195
Ultrasound-Guided Ostenil Plus®: £245
Ultrasound-Guided Ostenil Plus® / Steroid Combo: £295
Ultrasound-Guided Ostenil Plus® 3 injection package: £675
High-Volume Image-Guided Injection: £295
* Consultation fees may also apply.
