Injections
Dr. Hettrich performs ultrasound guided injections of the glenohumeral joint (shoulder), AC joint, and biceps tendon sheath. Using ultrasound greatly improves accuracy for diagnostic and therapeutic injections. Dr. Hettrich or her team also can provide PRP injections under ultrasound for tennis elbow, golfers elbow, or achilles tendonitis.
Frequently Asked Questions
For corticosteroid injections, we typically use Kenalog (triamcinolone) and ropivacaine. Kenalog is a corticosteroid, and ropivacaine is a local anesthetic that has been shown to not harm your cartilage.
You will feel some pain relief from the local anesthetic for a couple hours after the injection. The corticosteroid takes 4-7 days to take effect. Please do not be discouraged if your shoulder/elbow does not feel better for several days after the injection!
Injections can be used for treatment of certain conditions such as adhesive capsulitis (frozen shoulder) and bursitis. For most diagnoses, injections are used only for pain relief to allow for patients to do physical therapy with less discomfort. In this case, they do not address the underlying problem – they just decrease pain so that physical therapy can be successful. For arthritis patients, injections are used to relieve pain for a period of time until the patient elects to have surgery.
Yes, with any medication/procedure there are potential risks. One of the most serious is the risk of infection from the injection. There are several studies that show that intra-articular injections can increase the risk of infection with future surgical procedures as well. If you are considering an injection all of the risks will be reviewed at your appointment.
This depends on the diagnosis. For arthritis, patients can have an injection as often as every 3 months. For non-arthritic joints there are limits on the total number of injections that are permitted. For adhesive capsulitis (frozen shoulder), up to 2 injections are given, and for this diagnosis they can be given closer together.
For a surgical repair or shoulder replacement there needs to be a minimum of 3 months between the injection and surgery to reduce infection risks and increase chances of healing.
Ice, rest your arm, take Tylenol (acetaminophen) or Aleve (naproxen) if allowed by your medical doctor.
Yes, you will need to closely monitor your blood sugars for 48 hours after the injection. Please speak to your primary care doctor or endocrinologist prior to the injection to see if they would like you to modify your medications or your sliding scale.
You can shower 6 hours after your injection.
48 hours.
Right now, Dr. Hettrich will perform PRP injections for tennis and golfer’s elbow and partial UCL tears. As more high-level evidence comes out in the literature, this list may increase. Please ask Dr. Hettrich at your appointment if you are interested in an injection with PRP or another biologic.