7901 SW 34th Ave
Amarillo, TX 79121
Victor M. Taylor, MD, DABA
Board Certfied Pain Management
What it is used to treat?
Pain in the joints due to arthritis, soft tissue problems around the joint or inflammation of the joint and the surrounding tissues.
What the goal/purpose?
The goal of the intra-articular joint injection is to put an anti-inflammatory substance/steroid into the joint to help decrease inflammation. The volume injected into the joints may help to break up small adhesions within the joint.
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.(link) 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.
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. (link) You may eat and drink afterward.
How is it done?
Patients lie on the treatment table. After sterile preparation of the injection site and appropriate draping, a fluoroscope is used to locate a precise target. Next the skin is anesthetized with 1% lidocaine. X-ray guidance is used in order to guide a very small needle into the joint. Once in place, radiocontrast is injected to make sure that the medication is going into the joint.
Once optimum placement within the joint is assured, the treatment medication is injected.
What is injected?
A local anesthetic such as ropivacaine, bupivacaine or lidocaine along with a steroid such as dexamethasone or methylprednisolone. Other substances such as Hyalgan can be injected to improve lubrication of the joint.
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.
The day of the procedure you may have a great deal of weakness. Particularly hip injections can lead to weakness of the leg on the side of the injection. After a hip injection it is extremely important to be careful when getting in and out of the car or walking up or down stairs as the leg can give out from under you without warning. This is due to the effects of local anesthetic on the femoral nerve which passes near the joint. With shoulder joint injections the arm on the same side as the injection may be very weak for up to a day.
Some minor bruising and minor discomfort at the injection site are normal with these type of injections.
What is the chance of success?
Approximately 80% of our patients get significant relief from this type of procedure. Some patients are able to go for up to year or more with good pain relief.
How often can the procedure be repeated?
A person gets very good relief, at least 50% or more reduction in pain in the area that last for a reasonable period of time, the injections can be repeated up to 3 or 4 times per year.
What can I do to maximize my chance of success?
Stretching exercises and rehabilitation/physical therapy specifically geared towards improving joint function can be very beneficial.
Why do I have a blue towel in my pants?
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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