Non-Surgical Treatments

Biologics

Platelet rich plasma (PRP) is platelet rich concentrated portion of blood plasma. Blood plasma contains vital growth factors that help in repairing the injured tissue and platelets contain Vitamin K that plays a major role in formation of blood clot.. This therapy is used to treat foot and ankle pain, tendon injuries, sports injuries, and others form of injury.

The tendons and ligaments have very poor blood supply and will delay the time of healing. Injection of PRP results in accumulation of excessive amounts of platelets at injured site. Platelets degranulate releasing several growth factors and cytokines which stimulate one or more phases of tissue regeneration.

In this procedure the blood is drawn from your body and centrifuged to separate blood plasma (liquid separated on top) and blood products (settled at the bottom). The plasma is taken and kept aside in a sterile injection. This is later injected in a sterile environment into the site of injury to reduce pain. An ultrasound is done by the physician to find out the actual place of injury. This will form blood clot and help in degranulation of platelets which releases the growth factors to the site of injury. These growth factors associate with other blood cells (monocytes, neutrophils, fibroblasts) which help in the healing the injury.

PRP therapy uses our own blood. Hence the treatment is associated with minimal or no risk factors, or any contraindication. However, it is also used in the formation of bone in cases of fractures which helps in the formation of new bone tissue. It helps in patients being active however is limited to activities like swimming and biking.

HA-Viscosupplementation Injection for Arthritis

Hyaluronic acid (HA)-viscosupplementation is recommended in arthritis and to treat knee, hip joints, shoulders, ankle, and other joints problems.

Arthritis is a condition of inflammation of joints causing stiffness, swelling, and severe pain in the affected joints. In arthritis, the cartilage which connects the bones and helps in smooth gliding of bones during movement is damaged. Therefore the bones rub against each other causing severe pain and inflammation. The risk of arthritis increases with age, family history, injury, over use of the joints, and others factors. There are different types of arthritis such as osteoarthritis, rheumatoid arthritis, infectious arthritis. Treatment includes anti-inflammatory medicines that reduce the pain and surgeries to repair the damaged cartilage.

In patients with osteoarthritis the concentration of HA is reduced and therefore the elasticity and viscosity of the synovial fluid, that acts as lubricant and reduces the friction between cartilages during the movement, is decreased. To treat patients with arthritis viscosupplementation injections are given. This injection relieves pain and brings back the elasticity and stability, and improves the functions of the joints.

Hyaluronic acid is found in higher concentrations in the connective tissues and body fluids, particularly in synovial fluid. It acts as a lubricating agent (help in the movement of joints) and shock absorber (protects the joints by withstanding high energy or high forces that hit the joints).

The HA-viscosupplementation injection is one of the most conventional methods recommended over surgery, that requires longer time to heal, and medications, that offer temporary relief from pain.

Allergic responses and mild pain are reported with the use of HA injection and no major risks are associated.

Trigger Point Injections

Trigger point injection (TPI) are used to treat intense pain in the muscles containing trigger points. Trigger points are tight bands or knots that are formed when the muscle fails to relax after the contraction. A trigger point may also cause referred pain (pain in another part of the body) by irritating the adjacent nerves.

Trigger point injections can be used to relieve pain in conditions such as myofascial pain syndrome when other treatments are a failure, fibromyalgia, and tension headaches.

During this procedure, nerve block will be administered by the orthopedist or pain specialist to numb the area of needle penetration and keep you comfortable during the procedure. Further, a small needle containing local anesthetic (lidocaine, procaine) which may or may not containing corticosteroid is directly injected to the trigger point. This makes the trigger point inactive and the pain is relieved.

This is a short procedure and may just take a few minutes. The injection may cause mild pain for a short time. If you are allergic to the local anesthetic medication, a dry-needle technique (without medications) is used.

Numbness at the site of injection may persist for about an hour after the procedure. A bruise may even form at the site of injection. Applying moist heat and ice alternatively to the area for two days relieve the pain. Your orthopedist may also recommended stretching exercises and physical therapy after trigger point injections.