Non Surgical Treatments

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About non surgical treatments

Non-surgical methods of treatment are generally recommended and explored before more invasive techniques. Among the non-surgical treatments commonly offered for orthopaedic conditions are:

Hyaluronic Acid Injections
Platelet-Rich Plasma (PRP) Injections
Shockwave Therapy

Hyaluronic Acid Injections

Hyaluronic acid is a naturally occurring component of the synovial fluid that lubricates and cushions your joints, helping to act as a shock absorber. Osteoarthritis causes the hyaluronic acid in your joints to thin. Injections of hyaluronic acid (viscosupplementation) tops up the fluid in your joints to help relieve pain.

It is used to help relieve the symptoms of osteoarthritis of the knee, particularly in people who cannot take painkillers but whose osteoarthritis is not yet advanced enough to require joint replacement surgery.

There are different types of hyaluronic acid injection. Some may be given as a single injection while others may require a course of three or five injections a week apart. The skin is cleaned prior to the injection and you will be given a local anaesthetic.

If the knee is swollen, a needle will be gently inserted into the joint to draw off excess fluid and allow space for the hyaluronic acid. Hyaluronic acid will be injected directly into the knee joint. You will need to avoid strenuous activity for one to two days after treatment.

Hyaluronic acid injections help to lessen joint pain and reduce inflammation. They may be more effective than painkillers for some people and have been shown to be as effective as injections of corticosteroids for the relief of certain types of joint pain.

Sometimes you may experience pain, bleeding or blistering at the site of the injection. Skin may become irritated and you may develop a rash. Occasionally inflammation of the joint may occur.

Results can vary from person to person. In some people with osteoarthritis, hyaluronic acid injections may be more effective than painkillers and studies have shown the treatment to be as effective as injections of corticosteroids. However, hyaluronic acid injections may be less effective in people with severe osteoarthritis or older adults.

Platelet-Rich Plasma (PRP) Injections

Platelet-rich plasma injections are used to treat chronic tendon injuries, such as tennis elbow. Platelets occur naturally in the blood and play a vital role in clotting the blood and healing injuries due to the presence of proteins called growth factors.

If you experience an injury, platelets are dispatched by the immune system to the wound to clot the blood and begin the healing process. PRP injections harvest platelets from the patient’s own blood and re-inject them into the injury site to encourage healing.

PRP injections are used to treat chronic (on-going, long-term) tendon injuries, such as Achilles tendonitis, and sprains. It may also be used in certain circumstances to improve healing after surgery.

Blood will be taken, in the same way as a normal blood test. It will then be placed into a centrifuge which helps to separate the plasma from other blood cells, increasing the concentration of plasma by around five to 10 times. The platelet-rich plasma is then combined with the remaining blood and injected into the injury site.

PRP injections have the potential to speed healing, particularly in chronic tendon injuries such as tennis elbow, jumper’s knee and Achilles tendonitis.

The risks are minimal. They may include increased pain at the injection site but the risk of more serious complications, such as infection or nerve damage, is no more significant than with injections of corticosteroids, which are widely used in orthopaedics.

PRP is currently being evaluated by research studies. Its effectiveness can vary according to a range of factors, including the overall health of the patient, whether the injury is acute or chronic and the extent of the injury and area being treated.

Shockwave Therapy

Shockwave therapy – also called extracorporeal shockwave therapy – uses shockwaves passed through the skin to the site of injury and inflammation. These low-energy, audible sound waves work by increasing blood flow to the injured area and speeding the body’s natural healing process.

Shockwave therapy is used to treat Achilles tendinopathy, which is a condition that causes pain, swelling and weakness to the Achilles tendon between your calf muscle and your heel.

It may also be used to reduce the inflammation associated with plantar fasciitis. The plantar fascia is a thick, fibrous band of tissue at the bottom of the foot, between the toes and the heel. It can become inflamed due to repeated small injuries.

You will lie on your front with your legs supported by a pillow and ultrasound gel will be applied to the injured area. Shockwaves will be delivered to the injured area using a handheld device which sends pulses of compressed air through the ultrasound gel. Treatments take around five minutes. Some discomfort or pain is normal during treatment.

You will be able to take painkillers but not anti-inflammatories or ice therapy as these can interfere with the healing process. Most people return to their normal activities immediately but it is advisable to avoid strenuous activity for 48 hours. You will normally need a course of three treatments, one or two weeks apart.

Shockwave therapy can provide relief from pain in patients who have not responded to other treatments such as ice therapy, corticosteroid injections and orthotics.

There is a chance that pain and swelling will increase after treatment but this will normally resolve naturally within a few days. There is a small risk of tendon rupture or soft tissue damage.

Any pain experienced during treatment can usually be tolerated and the treatment may help to alleviate pain where other techniques have proved ineffective. It is not suitable for everybody but your orthopaedic surgeon will discuss your individual case with you.

Whatever your age, our expertise can help you feel healthy, active and pain-free again.