Joint Injections

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Joint Injections

Shoulder Pain

Shoulder pain is any pain in or around the shoulder joint. Shoulder is the most movable joint in the human body. A group of four muscles and their tendons, called the rotator cuff, give the shoulder its range of motion. Swelling, damage, or bone changes around the rotator cuff can cause shoulder pain. You may have pain when lifting the arm above your head or moving it forward or behind your back.

The most common cause of shoulder pain occurs when rotator cuff tendons become trapped under the bony area in the shoulder. The tendons become inflamed or damaged. This condition is called rotator cuff tendinitis or bursitis.

Other causes of shoulder pain:


Cortisone Injections

Cortisone injections make up a very important part of the treatment of shoulder injuries. In combination with an active rehabilitation program they may significantly reduce the need for surgery in shoulder impingement syndrome.

Cortisone is a potent anti-inflammatory medication and acts on both acute and chronic phases of inflammation to reduce tissue swelling and subsequent scar formation. Cortisone injections are useful in the treatment of various musculoskeletal conditions, particularly those of acute inflammation (such as acute bursitis), and degenerative joint and tendon conditions.

In the shoulder, they are particularly useful in the management of:

Cortisone injections should only be performed in the setting of an appropriate diagnosis based on taking an accurate history, performing a clinical examination and commonly performing investigations. They will generally be used after failure of a 4-6 week trial of relative rest, anti-inflammatory medications and physical therapy.

Knee Pain

What is knee pain?

Whether from an injury, disease or basic wear and tear, knee pain is an extremely common complaint. Knee pain may include the dull ache you experience after sitting for a long period of time or a sharp shooting pain that occurs after a poor landing. No matter the pain you experience, if your knee pain is ongoing or making it difficult for you to manage your day-to-day activities, then you should contact the pain specialists at Advanced Pain Modalities for an evaluation.

What are common causes of knee pain?

Your knee is made up of many parts, including bones, muscles, ligaments, tendons, and cartilage. The pain you experience may be due to disease or damage to one or more of those parts.

The most common causes of knee pain include:

You may also experience knee pain from conditions that affect your feet or hips. These other joints share in bearing the weight of your body, and if they’re injured or diseased, your knee may need to support a heavier load, adding stress that may result in pain.

How is it diagnosed?

Finding the underlying cause of your knee pain helps direct treatment. The experienced team at Advanced Pain Modalities conducts comprehensive examinations to find the source of your joint pain so they can develop the most effective and beneficial treatment plan.

During your evaluation, the pain management specialists review your symptoms and medical history. They also perform a physical exam that may include an assessment of the strength and function of your knee. To confirm or rule out a suspected diagnosis, the team may request diagnostic imaging, such as an X-ray or MRI.

What are the treatments for knee pain?

Your specific treatment plan depends on the cause of your joint pain, the severity of your symptoms, and your overall health.

Treatment options may include:

If your knee pain continues after conservative treatments, the team may suggest a peripheral nerve block (Genicular Nerve Block), which is an interventional pain management treatment that blocks pain transmissions to your brain and may provide pain relief for an extended period of time.

Knee pain is extremely common and can develop from a range of causes. For expert care of your knee pain, contact Advanced Pain Modalities by phone or online today.

What Are Viscosupplementation or Gel (Hyaluronic Acid) Joint Injections?

The knee joints are one of the most frequently affected joints by arthritis. While knee degeneration has many possible causes, one of the most common is from osteoarthritis. This leads to cartilage breakdown in the knee which can lead to increased pain as bone-on-bone movement occurs. This pain can greatly impair movement, and as a result lead to a reduced quality of life.

How They Work

Hyaluronic acid, or viscosupplementation, is FDA approved for treatment of knee osteoarthritis. Hyaluronic acid is a substance that is naturally present in joints, and functions as a lubricant and a shock absorbent. The idea behind these injections is that they will temporarily restore the natural function of the knee by injecting a substance which will provide cushioning and reduce bone-on-bone contact. Most people get a shot a week for 3 to 5 weeks. Individual responses vary, but many patients experience months, if not potentially a year or more of relief. There are different brands of hyaluronic acid that haven’t been shown to differ in their effectiveness.

What are Platelet-rich plasma (PRP) Joint Injections

Platelet-rich plasma involves taking a small sample of the patient’s blood and spinning it in a centrifuge to concentrate and separate the platelets and plasma from the other components of your blood. This concentrated solution is then injected back into the body at the injury site.

How they work

Platelets are the part of the blood that contain growth factors and proteins. These are very important in the repair and regeneration of damaged tissue. PRP Therapy works by accelerating the body’s own healing process and bringing the healing to areas in the body that would not normally receive this healing. Your body’s joints, tendons and ligaments receive limited blood flow; therefore in most cases, it is very difficult for these areas to heal on their own. Injecting one’s own PRP directly to the injury site works by encouraging the growth and regeneration/healing of new, healthy cells.

At Advanced Pain Modalities, we are committed to reducing your pain and improving your overall quality of life. If you would like to discuss knee pain treatments, please give us a call and we would be happy to schedule an appointment to discuss your treatment plan.

Hip Pain

The hip joint is the largest weight-bearing joint in the human body. It is also referred to as a ball and socket joint and is surrounded by muscles, ligaments, and tendons. The thigh bone or femur and the pelvis join to form the hip joint. Any injury or disease of the hip will adversely affect the joint’s range of motion and ability to bear weight.

Problems within the hip joint itself tend to result in pain on the inside of your hip or your groin. Hip pain on the outside of your hip, upper thigh or outer buttock is usually caused by problems with muscles, ligaments, tendons and other soft tissues that surround your hip joint.


Hip joint injections involve injecting medicine directly into the hip joint to diagnose the source of the pain or treat pain due to conditions which can cause inflammation in the hip such as arthritis, injury, or mechanical stress of the hip joint. The procedure is performed under fluoroscopic (X-ray) guidance.

The injection solution is a combination of a local anesthetic and a cortisone (anti-inflammatory). The numbing medicine delivers temporary pain relief, provided the hip is the source of the joint pain. It thus serves a diagnostic function and helps to confirm or deny whether the joint is the source of the pain. Cortisone serves to reduce the inflammation in the joint providing long term pain benefit.

Risks and Complications

The possible risks of hip injections include: swelling and pain in the hip joint after injection, and in rare instances infection or local skin depigmentation. If the injected hip joint is the source of the pain, the patient may notice a reduction in pain after two to five days of the hip injection. This is due to the delayed onset of action of cortisone. If no improvement is found within 10 days of the injection, further diagnostic tests may be required to ascertain the cause of the pain.

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