Joint, Muscle, Nerve and Tendon Injections

All of the injections done at EISSR, with the exception occasionally of very superficial nerve or trigger point injections, are done using imaging guidance, a combination of ultrasound and/or fluoroscopy. We use multiple different injectates to treat problems, including steroids, low dose steroids (nanogram dosing), hyaluronic acids, platelet rich plasma, platelet lysate, and stem cells. The exact injectate depends on your exact problem, and our providers will help guide you to the treatment that is right for you.

Hyaluronic Injections

Hyaluronic Acid Injections are a procedure that can be used in the treatment of osteoarthritis (OA) of the knee. The theory behind these injections is, replacement or supplementation of the synovial fluid that is diminished with the loss of the articulating cartilage (arthritis), to help cushion and decrease the friction in the knee joint. These injections have often been referred to as viscos or rooster shots, the latter in reference to the fact that some brands use the rooster comb portion of the chicken as it is a natural form of hyaluronic acid.

For the appropriate candidate, these injections can provide excellent relief of the pain type symptoms associated with arthritis. As a bonus, because hyaluronic acid is a natural part of your knee joint, the injections will not cause any further degeneration of the knee like cortisone injections can. In essence, these injections should be considered a strong option if not tried in the past.

Perineural Injections

Perineural injections were developed by Dr. John Lyftogt. They consist of a series of small injections immediately under the skin that target painful areas where nerves are sensitive. These nerves can contribute to chronic neuropathic pain and by injecting these nerves with simple and natural substances (often dextrose 5% in sterile water) pain can be significantly reduced. After the first injection, patients may experience pain relief for up to 4 days. Repeated injections are often necessary to maximize results, with the goal to reduce pain at the treated site up to 80-100% depending upon the condition.