Pain Management

Pain Management 2018-08-27T15:16:38+00:00
Joint and Tendon Injections
Ultrasound-guided Injections

Introducing Pain Management

From young to old, people are trying to develop and maintain an active lifestyle for as long as possible. Exercise has been shown to be of great value and is an important component of overall wellness. It is prescribed for many health conditions including depression, obesity, heart disease, elevated cholesterol, high blood pressure, arthritis and osteoporosis. As people aim to increase their level of activity and/or extend their sporting careers, many orthopedic and musculoskeletal injuries, can impede these goals.

Treatment of musculoskeletal injuries requires a multifaceted approach addressing a patient’s biomechanics, posture, activity modifications, flexibility, and supporting muscle strength. Focused therapies and rehabilitation can be quite helpful, and in some cases, might be all that is needed. In cases that do not respond to these methods, a therapeutic injection and/or ‘needling’ may be offered by a physician.

The most common type of injection involves a combination of a local anesthetic medication called lidocaine, with an anti-inflammatory medication called a corticosteroid. This is what is known as the traditional “cortisone injection.” Although these injections do not heal the injured tissue, the goal of these injections is to decrease the inflammation allowing patients to continue with rehabilitation and conservative measures so it might heal on its own.

In the case where such conservative and traditional measures have been exhausted, Regenerative Medicine and/or Stem Cell therapies might offer a more definitive and healing solution.

Commonly Treated Conditions


  • Occipital Neuralgia

  • Cervicogenic Headache

  • Trigeminal Neuralgia

  • Cervical/Lumbar Myofascial

  • Pain Syndrome

  • Cervical/Lumbar Spinal Stenosis

  • Post-Laminectomy Syndrome

  • Degenerative Disk

  • Disease/Disk Herniation

  • Sacroiliac (SI) Joint

  • Arthritis/Dysfunction

Upper Extremity

  • Shoulder Arthritis
  • Rotator Cuff Tendinosis

  • Labral Tear

  • Subacromial Bursitis

  • Biceps Tenosynovitis

  • Scapular Dyskinesis

  • Tennis Elbow (Lateral Epicondylosis)

  • Golfer’s Elbow (Medial Epicondylosis)

  • Olecranon Bursitis

  • Wrist/Thumb (CMC) Arthritis

  • Carpal Tunnel Syndrome

  • TFCC Injury

  • Carpal Tunnel Syndrome

  • Trigger Finger

Lower Extremity

  • Hip Arthritis
  • Labral Tear

  • Iliopsoas Bursitis

  • Greater Trochanter Bursitis

  • Gluteus Medius Tendinopathy

  • Iliotibial Band (ITB) Syndrome

  • Runner’s / Jumper’s Knee

  • Pes Anserine Bursitis

  • Patello-femoral Syndrome

  • Chondromalacia Patella

  • Meniscus Tear

  • Baker’s Cyst

  • ACL / PCL / MCL / LCL Tear

  • Achilles Tendinosis

  • Plantar Fasciitis

  • Ankle/Great Toe Arthritis

  • Morton’s Neuroma

Joint and Tendon Injections

Intra and peri-articular and soft-tissue injections to relieve pain and inflammation and improve mobility have been an important adjunct for the management of musculoskeletal pathology for more than 60 years.

Injections can provide diagnostic information and are commonly used to control pain during rehabilitation from injuries such as rotator cuff syndrome and lateral epicondylitis (tennis elbow). They are the preferred and definitive treatment for soft-tissue conditions such as de Quervain tenosynovitis and trochanteric bursitis. Intra-articular steroid injection provides pain relief in rheumatoid arthritis and osteoarthritis.

As with any procedure, success depends on knowing the right diagnosis (who to inject), performing the correct procedure (how to inject), and using the most appropriate pharmacologic or biologic agent (what to inject).

Commonly Treated Conditions

Shoulder/Elbow/Wrist/ Hip/Knee/Ankle/Finger/Toe Arthritis, Rotator Cuff Tendonosis, Subacromial Bursitis, Biceps Tenosynovitis, Tennis/Golfer’s Elbow, TFCC, Trigger Finger, Hip/Shoulder Labrum Tear, SI Joint Arthritis, Greater Trochanter Bursitis, Gluteus Medius Tendinopathy, ITB Syndrome, Pes Anserine Bursitis, Baker’s Cyst, Achilles Tendonosis, Plantar Fasciitis

Ultrasound-guided Injections

Traditionally, injections have been given “blind,” based on anatomic landmarks; meaning that a physician feels for certain bones, muscles, or tendons, and then injects into the desired area. The concern with this method of injection is that there is no way of definitively knowing where the tip of the needle is, and where that injection is going. Many of the structures that we are aiming for are only millimeters in size.

More recently, ultrasound-guided injections have been gaining in popularity. In this method, ultrasound imaging using high frequency sound waves helps to visualize the body structure of the injection. Studies show that ultrasound-guided injections are associated with significantly less procedural injection pain and provide significantly more pain relief. The needle can be seen on the ultrasound screen and the precise location of the injection is assured. Nearly every single injection is performed under ultrasound guidance at Regeneration Pittsburgh.

If you are experiencing joint pain that could be helped by an injection, ask your doctor for a referral to a provider with experience in musculoskeletal ultrasound-guided injections.

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