Therapeutic Injections & Procedures

After history and examination, imaging and functional assessment, one of our specialists may suggest a therapeutic procedure as a part of your treatment program. Therapeutic injections and procedures may be helpful in treating a wide spectrum of injuries involving the muscles, tendons, joints, ligaments, hernias and nerves of the core. Depending on the type and severity of your injury, these minimally-invasive procedures may also provide treatment for athletes trying to get through a season or competition. In addition, sometimes therapeutic injections the day before surgery may be effective in addressing pain in areas that are difficult to address during surgery.

Therapeutic and diagnostic procedures are guided by imaging under local anesthesia (numbing medication) for the highest possible patient comfort, safety and accurate needle placement. We have specialized in minimally invasive procedures for a rapid recovery and rapid return to activity within a few days. Procedures are performed in an outpatient setting and generally last less than 30 min. Many patients come to us after they had tried injections before without improvement - we take that into consideration for our approach when planning the procedure.

Therapeutic injections and procedures are used to help manage

Injections and Procedures include:

  • Tenotomy.Tendon Release - manual or using Tenex (TX1)
  • Epidural injections
  • Radiofrequency ablations
  • Diagnostic lidocaine/bupivacaine injections
  • Steroid injections
  • PRP injections
  • Stem cell injections
  • Botox injections
  • Myotomy - manual or using Tenex (TX1)
  • Sympathetic blocks
  • Intra-articular injection therapy – shoulder, hip, knee
  • Sacroiliac joint injections
  • Discogram and discography
  • Trigger point injections
  • Prolotherapy
  • Synvisc Injections
  • Lavage/Aspiration for Calicification Tendinopathy
  • Diagnostic and cryo-ablation of neuromas developed at a peripheral nerve

What is tenotomy/dry needling?

An ultrasound-guided tenotomy procedure helps regenerate tendons and induces healing. After numbing the area with local anesthetic, small fenestrations are applied to the tendons. The fenestration sets a stimulus for incoming cells to release growth factors that help restore healthy tendon tissue. Tenotomies may be performed either manually or with a Tenex device which uses ultrasonic energy to induce healing. The tenotomy procedure can be combined with PRP (platelet rich plasma) or stem cell injections. The ideal treatment depends on the patient’s history, physical exam, imaging findings and goals.