Tendon and joint injection therapy using ultrasound guidance

Tendon and joint conditions can cause significant pain, stiffness, and reduced mobility. When these symptoms do not respond to conservative treatments such as physiotherapy or oral medication, injection therapy may be considered. In many cases, using ultrasound guidance improves the accuracy and effectiveness of the treatment, helping to relieve pain and support recovery.

What is injection therapy and when is it used?

Injection therapy involves delivering medication directly into or around a joint or tendon to reduce inflammation, improve mobility, and relieve pain. It is commonly used to treat:

• Osteoarthritis (particularly of the knee, hip, or shoulder)
• Tendonitis or tendinopathy (such as in the Achilles tendon, elbow or rotator cuff)
• Bursitis
• Frozen shoulder
• Joint inflammation related to autoimmune conditions

The type of injection used will depend on the condition being treated. Options include corticosteroid injections, hyaluronic acid (viscosupplementation), platelet-rich plasma (PRP), or local anaesthetics.

Why is ultrasound guidance important?

Ultrasound-guided injections use real-time imaging to accurately visualise the affected area. This allows the specialist to guide the needle to the precise location where the medication is needed.

Key benefits include:

• Improved accuracy: Ensures the medication is delivered exactly to the site of inflammation or damage.
• Increased effectiveness: Accurate placement often results in better pain relief and faster recovery.
• Reduced risk of complications: Helps avoid surrounding structures such as nerves and blood vessels.
• Enhanced patient comfort: The use of ultrasound can make the procedure quicker and less painful.

Without imaging guidance, injections rely on anatomical landmarks, which can be less precise, particularly in deep or complex joints.

What can patients expect during the procedure?

Ultrasound-guided injections are typically performed in a clinical setting and usually take less than 30 minutes. Patients can expect the following:

• The area is cleaned and prepared
• A small amount of gel is applied for the ultrasound probe
• Local anaesthetic may be used to minimise discomfort
• The needle is inserted while the clinician watches its path on the ultrasound screen
• Medication is injected directly to the targeted area

Most patients can go home shortly afterwards and resume light activity the same day.

What happens after the injection?

Some patients feel relief within a few hours, while others may take a few days to notice improvement. Injections can provide relief for weeks to months, depending on the condition and type of medication used.

Post-injection advice may include:

• Avoiding strenuous activity for a few days
• Following up with physiotherapy if recommended
• Monitoring the treated area for any unusual symptoms, such as increased redness or swelling

Who performs ultrasound-guided injections?

These procedures are typically carried out by specialists with expertise in musculoskeletal medicine, sports medicine, orthopaedics, or radiology. Their experience in ultrasound imaging is key to ensuring safe and effective treatment.