What Are Ultrasound-Guided Tendon Injections?
Ultrasounded-Guided Tendon Injections are a way of delivering local anesthetic and steroids to damage tendons to promote healing, reduce inflammation, and improve range of motion and activity. Your doctor will first diagnose the area of the tendon to be injected and using an ultrasound for guidance will place a small amount of medication around the damaged tendon.
Ultrasound-Guided Tendon Injections Overview
The procedure itself can be done in an office setting or a pain clinic. The injections are limited to what is called the “soft tissue” of the body. They are not given into blood vessels, nerves, joints, or the spinal canal. You may be sitting or lying down in order to be comfortable. This allows the physician to localize areas of maximum tenderness. These areas are cleansed with a sterile solution. The injection is then performed using a local anesthetic and sometimes an anti-inflammatory steroid. You may experience some transient burning as the local anesthetic starts to take effect before it numbs the area. Injection of medication inactivates the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment. Several sites may be injected in one visit.
Before and After the Procedure and the Risks
Before the Procedure
Since you will be receiving medication, it is recommended that you do not eat within four or five hours before the procedure. If you are a diabetic, be sure to discuss your eating and medication schedule with your doctor. You may need to stop taking certain medications several days before the procedure. Please remind the doctor of all prescription and over-the-counter medications you take, including herbal and vitamin supplements. The doctor will tell you if and when you need to discontinue the medications. It is very important to tell the doctor if you have asthma, had an allergic reaction (i.e. hives, itchiness, difficulty breathing, any treatment which required hospitalization) to the injected dye for a previous radiology exam (CT scan, angiogram, etc) or if you have had an allergic reaction to shellfish (shrimp, scallops, lobster, crab). The doctor may prescribe some medications for you to take before having the procedure. Tell the doctor if you develop a cold, fever, or flu symptoms before your scheduled appointment.
After the Procedure
You may experience some weakness and/or numbness in your legs (lumbar injection), arms (cervical injection), or chest wall (thoracic injection) for a few hours after the procedure. If so, do not engage in any activities that require lifting, balance, and coordination. Drink plenty of clear liquids after the procedure to help remove the dye from the kidneys. Do not drive for the remainder of the day. Please have an adult drive you home or accompany you in a taxi or other public transportation. Depending on how you feel, you may resume normal activities and return to work the following day. If the doctor prescribes physical therapy, it is very important that you continue with the physical therapy program. Although you may feel much better immediately after the injection (due to the numbing medicine), there is a possibility your pain may return within a few hours. It sometimes takes a few days for the steroid medication to start working.
The risks, although infrequent, include Temporary numbness of the nerve; Nerve damage; Pain and Bruising at the injection site; Infection at the injection site; Sometimes a little bit of dizziness immediately after the procedure Puncture of dura resulting in a headache. If you experience severe back pain, new numbness, or weakness of your legs, a headache that will not go away, or signs of infection in the area of the injection, you should call the doctor right away.