7901 SW 34th Ave

Amarillo, TX 79121

Victor M. Taylor, MD, DABA

Board Certfied Pain Management

Ph: 806-352-7431

Fax: 806-352-2374

Physical Rehabilitation in Chronic Pain | Opioids and Chronic Pain | Approach to Treatment

Bursa - Tendon Sheath - Ligament Injection


What it is used to treat?


Pain and inflammation related to any bursa or tendon causing pain.  Tendons link a muscle to a bone and any tendon in the body can become inflamed and painful.  These most commonly occur around the shoulders, elbows, wrist, hips, knees or ankles.  Bursa help to cut down on friction at points where structures cross each other.  When they become inflamed the pain can be intense.


What the goal/purpose?


To stop inflammation within the tissue causing the problem.


What should I do to get ready for the procedure?


Stop taking any medication that thins the blood at least 5 days prior to the procedure. These medicines include Aspirin, and most over the counter pain medicines except Tylenol.   Read the list of medications that must be stopped that was given to you at your office visit.(This should link to list of meds that have to be stopped)  Make sure it is ok with your prescribing doctor before you stop prescription blood thinners used for treatment of heart disease, peripheral vascular disease, irregular heartbeat or history of stroke.  It is your responsibility to clear this with your doctor. (This should link to the list of medications to stop)


Continue to take your other medications.  Do not stop blood pressure or diabetes medicines.


Do not eat or drink anything on the morning of your procedure.(This should link to page on pre-procedure instructions)  You may eat and drink afterward.


How is it done?


Patients position themselves on a treatment table or in a chair.  Monitors are attached to keep track of your vital signs during the procedure.  The area over the procedure site is prepped and draped in a sterile manner to protect against infection.  A fluoroscopic x-ray or an ultrasound machine is then used to locate the target site.  The skin is numbed with lidocaine, and a needle is advanced toward the target under x-ray or ultrasound guidance.


Once the needle is properly placed, ropivacaine and steroid are injected.  The needle is removed. You are then taken to a recovery area for observation before going home.


What is injected?


Lidocaine to numb the skin.

Ropivacaine ( or other local anesthetic) and a steroid

In some instances saline solution or hyluronidase enzyme are injected


Will it hurt?


Most people tolerate these procedures very well.  There is some discomfort associated with numbing the skin and there may be pressure during the injection.  Some patients require some sedation for the procedure, and others do not. The vast majority of patients tell us ‘that wasn’t so bad” or “I can’t believe I was worried about that;” however some people do find it painful and may require sedation.


Important Warning!


You may have weakness for up to 24 hours after treatment. This is normal and will wear off, but if you have any concerns, call us.


What is the chance of success?


Approximately 80% of our patients get significant relief from this type of procedure.


How often can the procedure be repeated?


We normally do the injection and then reassess how you are doing.  Sometimes we will repeat this type of injection in another month or two.  If you are not making some progress after 2 procedures, we may not continue.

After the initial injection, you may need a booster or touch-up injection later.  We want to limit the procedures in one region to no more than 4-5 per 12 month period.


What can I do to maximize my chance of success?


Be consistent in your home stretching exercises.  Be careful not to reinjure the area.  Remember that even though you are feeling better you have to protect your gains and be conscious of how you move.  Do not go on a long trip right after an injection.  Do not do all the things you have been putting off.  Give yourself time to heal and get stronger.


Why do I have a blue towel in my pants/shirt?


We place a sterile towel over the injections sites to absorb any mild bleeding and protect your cloths.


Why are there EKG pads still in place?


If you have thin skin or hair in the area, we may leave the EKG pads in place so that you can gently remove them with soap and water at home.


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