A Joint Effort

Image-Guided Steroid/Anesthetic Injections To Treat Chronic Joint Pain

by Dr. Jeffrey Browne // April - May - June 2021

Osteoarthritis and chronic joint pain impact more than 25 million Americans. If you’re a sufferer, you know how this pain can hinder your daily life, holding you back from your normal, daily activities. Maybe you’ve had to give up walking or golfing with friends because your ankles or knees won’t allow you to keep up. Maybe it has become too difficult to play with your children or grandchildren because your joints continue to ache. Or maybe your yard and garden have suffered because mowing grass, weeding, and trimming hedges are impossible with pain in your shoulders, elbows, or wrists.

Acute and chronic joint pain are common conditions that can certainly put a damper on life. Often this type of pain is caused by an acute inflammatory process or trauma – such as a sports or overuse injury – or a chronic, degenerative disorder such as rheumatoid arthritis or osteoarthritis. It may be that you have already tried conservative therapy for your pain, such as over-the-counter medication, physical therapy, massage, heat packs, stretching, and/or even acupuncture, but nothing seems to work. Fortunately, there is another option that doesn’t involve surgery.

Image-Guided Steroid/Anesthetic Joint Injections

For chronic joint pain sufferers, steroid injections can provide fast and long-lasting relief. These injections typically comprise of a short-acting anesthetic and long-acting corticosteroid – which allows patients to feel relief almost instantly. It’s a safe and effective pain relief method that comes with minimal side effects. While these injections are often given by orthopedic doctors, rheumatologists, or even in some cases, primary care physicians, there are benefits to having the treatment administered by a board-certified musculoskeletal radiologist who has image-guided technology at his or her fingertips.

Using ultrasound or low dose imaging, a radiologist can see directly into the joint to ensure the treatment is placed correctly every time. Image-guided joint injection therapy can also be used to diagnose the site of pain, control pain in non-surgical candidates, diminish pain to allow patients to begin physical therapy or exercise, and eliminate or delay surgical intervention.

“Radiologists will always use image guidance to confirm that the injection is going directly into the affected joint – where it will have the greatest impact,” explains Dr. Jeffrey Browne, a musculoskeletal radiologist with Raleigh Radiology. “X-ray guidance allows us to see inside the body in real-time, leading directly to the appropriate treatment location. This more exact science has been shown to have better outcomes compared to blind injections. It’s quick, more accurate, more effective, and reduces risk of complications.”

The Appointment – Quick and Easy

From start to finish, a patient having joint injection therapy will likely spend less than 30 minutes in the imaging center. He or she will lie down on a table and be prepped for the procedure by a radiologic technician. A musculoskeletal radiologist will then enter the room and discuss the procedure with the patient. He or she will confirm the correct joint for treatment and also explain the risks and benefits of the injection, before sterilizing and draping the injection site and applying a local anesthetic.

Once confirming the needle is in the correct location by ultrasound or fluoroscopy, the radiologist will then inject a short-acting anesthetic and an intermediate to long-acting corticosteroid into the joint. Complications are infrequent.

Immediate Relief and Long-Term Results

In general, a patient will feel immediate relief of his or her symptoms but may be sore for one or two days after the injection until the long-term steroid becomes effective. Patients with an acute inflammatory condition or trauma may only need one injection; however, patients with arthritis or chronic conditions may need multiple. Three to four injections can be given per year, and they typically provide three to six months of pain relief.

“As musculoskeletal radiologists, we are well-trained in performing these injections for multiple joints, including shoulders, elbows, wrists, hips, knees, ankles, and feet,” adds Dr. Browne. “During each appointment, I enjoy the opportunity for facetime with my patients, as well as the ability to relieve their pain using such a simple procedure.”

If you have been experiencing persistent joint pain and feel image-guided injections may be the right option for you, speak with your primary care physician, orthopedist, or rheumatologist, or contact a Raleigh Radiology’s imaging center near you directly today (919-781-1437).

Dr. Jeffrey Browne

A board-certified musculoskeletal radiologist and medical director with Raleigh Radiology. He earned his medical degree from the University of Connecticut School of Medicine and completed his fellowship at Duke University Medical Center. He has been with Raleigh Radiology since 2008.