Whenever possible, we provide injections that are ultrasound guided. This means that we can see the needle in the body and we can see the target as well. This reduces the risk of adverse events (damage, bleeding) and reduces pain as we avoid bumping into painful bony structures. We realize that nobody looks forward to injections. Reducing pain and the risk of the needle, while improving the condition or pain, is the ultimate goal.

Depending on the location of the injection, the risks to be aware are those of any injection. These include bleeding, infection, missing the target, pain flare, bruising, etc.

For most patients, the daily pain they feel, the pain that interferes with sleep or work or family time, is many times more painful than the pain from a needle. The majority of patients are quite surprised at how little the injection hurt compared to what they were expecting. We have had cases when patients are surprised that we are already done, as they were waiting for the ‘big’ pain.

We use a variety of injection fluids: Lidocaine, Dextrose, Hypertonic Saline, Cortisone, Hyaluronic Acid (synthetic joint fluid) are the primary injectates that we use.

Overuse of steroids has potential harms. Repeated injections of corticosteroids (cortisone) is not generally advised. In certain conditions, steroids should not be used at all. For example, steroids should never be injected into tendons as this increases the risk of tearing/rupture. However, the use of steroids – in the appropriate location and dosage – can effectively treat the condition and the pain.

Side effects include an increase in blood sugars for 2-4 days in diabetics by about 1-2 points, 1-2 days of trouble sleeping, infrequently seen is skin thinning near the injection site or a pale patch with injections near the surface of the skin. In some cases, blood pressure may increase slightly for a few days, and some people get flushing of their skin. With joint injections, there are rare flare ups of pain for the first 48 hours after the injection.

Local anesthetic (lidocaine), which is well known for numbing during sutures/stitching, is often used for immediate relief and to help with clarifying the diagnosis. Many times the exact location of the pain is not known. The use of local anesthetic allows us to confirm the pain location prior to offering the actual treatment.

Our office is in City Centre 3. This is located across from Surrey Memorial Hospital. We are right on 96 Avenue and right across from City Centre 1.

Our assessment (history/physical exam/ultrasound scan) is fully covered. For injections, patients are only expected to cover the cost of the injectates (injected medication) – we help with arranging this.

Unfortunately not. This is a referral based service. The family physician or nurse practitioner, or a walk-in/urgent care practitioner can send us a referral. Other physicians (MD) can also send referrals for their patients.

After our assessment, patients are provided options for therapy. In some cases, it is determined that an injection is not likely to help and no injection is offered. In most cases, an injection based therapy is appropriate and is offered and the best injectate options are presented. The patient can decide what option is best for them based on our recommendations/discussion with their referring care provider/costs involved etc.