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Percutaneous Disc Nucleoplasty

Overview
This minimally-invasive procedure uses a small needle and advanced radiofrequency technology to reduce a herniated disc, quickly relieving pain in most patients. The procedure may be performed on an outpatient basis using a gentle, relaxing medicine and local anesthetic.

Cannula Inserted
After some anesthetic is injected to numb the area, a thin needle called a cannula is inserted through the back and into the herniated disc. The surgeon uses x-ray images to guide the placement of the cannula.

Disc Nucleus Treated
A small radiofrequency probe is carefully inserted through the cannula and into the disc. The device sends pulses of radio waves to dissolve small portions of the disc nucleus. Because only enough of the disc is removed to reduce pressure inside the disc, the spine remains stable.

Herniation Relieved
The empty space created by the probe allows the disc to reabsorb the herniation.

End of Procedure and After Care
The probe and needle are removed, and the insertion area in the skin is covered with a small bandage. Because no muscles or bone are cut during the procedure, recovery is fast and scarring is minimized. The patient may need a day of bed rest after the procedure, as well as physical therapy. Most may return to normal activity within one to six weeks.

Prolotherapy Treatment for Chronic Knee Pain

Overview
This non-surgical procedure relieves chronic knee pain with an injection that promotes the natural healing of damaged joints and soft tissues.

Causes of Knee Pain
Problems of the knee, the most commonly injured joint in the body, often involve degeneration of the cartilage surface and sprains of the meniscus, ligaments and tendons. The limited blood supply and poor healing properties of these soft tissues make treatment necessary after injury.

Preparation
The knee is cleansed and sterilized. A local anesthetic is applied to numb the injection site.

Administering the Injection
A mixture of concentrated dextrose, composed of natural compounds and anesthetic, is injected into the damaged tissues. The physician may need to administer additional injections to other injured structures of the knee.

The Body Reacts
The injected solution promotes mild inflammation of the injured tissue. This tricks the body into responding as if a new injury has occurred. The body releases proteins called growth factors that promote a natural healing process.

Healing Begins
Once the inflammation resolves, cells called fibroblasts move in. The fibroblasts create collagen and use it to strengthen and rebuild any damaged ligaments and tendons. The strengthening and repair of these tissues results in improved joint stability and reduced pain.

Long-term Outcome
The patient will be able to go home the same day, and should avoid taking any anti-inflammatory pain medications (aspirin, ibuprofen and naproxen). Full recovery from inflammation usually occurs within one week of the procedure. Additional treatments may be required to ensure complete healing of the injured tissues.

Prolotherapy Treatment for Chronic Lower Back Pain

Overview
This non-surgical procedure relieves chronic lower back pain with an injection that promotes the natural healing of damaged joints and soft tissues of the spine.

Causes of Lower Back Pain
Problems in the lower spine are often associated with the damage or degeneration of tendons, ligaments and joint capsules. The limited blood supply and poor healing properties of these soft tissues make treatment necessary after injury.

Preparation
The back is cleansed and sterilized. A local anesthetic is used to numb the injection site.

Administering the Injection
A mixture of concentrated dextrose, composed of natural compounds and anesthetic, is injected into the damaged tissues. The physician may need to administer additional injections to other injured structures of the spine.

The Body Reacts
The injected solution promotes mild inflammation of the injured tissue. This tricks the body into responding as if a new injury has occurred. The body releases proteins called growth factors that promote a natural healing process.

Healing Begins
Once the inflammation resolves, cells called fibroblasts move in. The fibroblasts create collagen and use it to strengthen and rebuild the damaged ligaments and joint capsules. The strengthening and repair of these tissues results in improved joint stability and reduced pain.

End of Procedure and Aftercare
The patient will be able to go home the same day, and should avoid taking any anti-inflammatory pain medications (aspirin, ibuprofen and naproxen). Full recovery from inflammation usually occurs within one week of the procedure. Additional treatments may be required to ensure complete healing of the injured tissues.

PRP Injection for Chronic Back Pain

Overview
This non-surgical procedure relieves chronic back pain with an injection of the patient's own blood platelets. The concentrated platelets promote the natural healing of damaged joints and soft tissues of the spine.

Causes of Lower Back Pain
Problems in the lower spine are often associated with the damage or degeneration of tendons, ligaments and joint capsules. The limited blood supply and poor healing properties of these soft tissues make treatment necessary after injury.

Collecting the Platelets
The PRP process begins when a sample of blood is taken from the patient and is separated into its components - platelets and white blood cells, plasma, and red blood cells. A portion of the plasma is removed. The patient's concentrated platelets are mixed with the remaining plasma to form a concentrated solution. A syringe is filled with the solution.

Preparation
The back is cleansed and sterilized. A local anesthetic may be used to numb the injection site.

Administering the Injection
The needle is directed into the back and then guided to the target area. The platelet rich plasma is injected into and around the damaged tissues. The physician may need to administer additional injections to other injured structures of the spine. This will help to ensure complete tissue healing and maximize joint stability.

PRP Injection for Chronic Knee Pain

Overview
This non-surgical procedure relieves chronic knee pain with an injection of the patient’s own blood platelets. The concentrated platelets promote the natural healing of damaged ligaments, cartilage and tendons.

Causes of Knee Pain
Injuries of the knee, the most commonly injured joint in the body, often involve the surrounding soft tissues, ligaments, tendons and cartilage. Causes of knee pain include degeneration of the cartilage surface, and sprains or tears of the ligaments or tendons.

Collecting the Platelets
The PRP process begins when a sample of blood is taken from the patient and is separated into its components – platelets and white blood cells, plasma, and red blood cells. A portion of the plasma is removed. The patient’s concentrated platelets are mixed with the remaining plasma to form a concentrated solution. A syringe is filled with the solution.

Preparing the Knee
The knee is cleansed and sterilized. A local anesthetic may be applied to reduce pain at the injection site.

Administering the Injection
The needle is directed into the knee and then guided to the target area. The platelet rich plasma is injected into and around the damaged tissues. The physician may need to administer additional injections to other injured structures of the knee. This will help to ensure complete tissue healing and maximize joint stability.

The Body Reacts
The concentrated platelets release many growth factors that promote a natural immune response, mobilizing stem cells to the injured tissues. Macrophages – specialized white blood cells – rush in to remove damaged cells and prepare the tissue for healing.

The Healing Begins
Stem cells and other cells multiply, repair and rebuild the damaged tissue. This accelerated healing response reduces pain, promotes increased strength, and improves joint function.

Follow-up
The entire PRP treatment process takes about an hour – the patient will be able to go home the same day. Full recovery from the injection usually occurs within one week of the procedure. Many patients require three to four treatments before the injured tissues are completely healed and they return to a normal active lifestyle.

PRP Injection for Knee Arthritis

Overview
This non-surgical procedure relieves the pain of knee arthritis with an injection of the patient's own blood platelets. The concentrated platelets promote natural healing.

Collecting the Platelets
The PRP process begins when a sample of blood is taken from the patient and placed into a centrifuge, where it is spun rapidly. The spinning process separates it into its components: plasma, platelets and white blood cells, and red blood cells. The red blood cells are drained away, and then the patient's concentrated platelets, along with a portion of the plasma, are drawn into a syringe.

Preparing the Knee
The knee is cleansed and sterilized. A local anesthetic may be applied to reduce pain at the injection site.

Administering the Injection
The needle with the platelet rich plasma is directed into the knee and then guided to the target area. The platelet rich plasma is injected into and around the damaged tissues. Additional injections to other injured structures of the knee may be needed to ensure complete tissue healing and maximize joint stability.

The Body Reacts
The concentrated platelets release many growth factors that promote a natural immune response, mobilizing stem cells to the injured tissues. Macrophages - specialized white blood cells - rush in to remove damaged cells and prepare the tissue for healing.

The Healing Begins
Stem cells and other cells multiply, repair and rebuild the damaged tissue. This accelerated healing response reduces pain, promotes increased strength, and improves joint function.

Follow-up
The entire PRP treatment process takes about an hour - the patient will be able to go home the same day. Full recovery from the injection usually occurs within one week of the procedure. Many patients require three to four treatments before the injured tissues are completely healed and they return to a normal active lifestyle.

PRP Injection for Rotator Cuff Injury

Overview
This non-surgical procedure treats rotator cuff injury with an injection of the patient's own blood platelets. The concentrated platelets promote the natural healing of damaged ligaments, cartilage and tendons.

Collecting the Platelets
The PRP process begins when a sample of blood is taken from the patient and placed into a centrifuge, where it is spun rapidly. The spinning process separates it into its components: plasma, platelets and white blood cells, and red blood cells. The red blood cells are drained away, and then the patient's concentrated platelets, along with a portion of the plasma, are drawn into a syringe.

Preparing the Shoulder
The shoulder is cleansed and sterilized. A local anesthetic may be applied to reduce pain at the injection site.

Administering the Injection
The needle with the platelet rich plasma is directed into the shoulder and then guided to the target area. The platelet rich plasma is injected into and around the damaged tissues. Additional injections to other injured structures of the shoulder may be needed to ensure complete tissue healing and maximize joint stability.

The Body Reacts
The concentrated platelets release many growth factors that promote a natural immune response, mobilizing stem cells to the injured tissues. Macrophages - specialized white blood cells - rush in to remove damaged cells and prepare the tissue for healing.

The Healing Begins
Stem cells and other cells multiply, repair and rebuild the damaged tissue. This accelerated healing response reduces pain, promotes increased strength, and improves joint function.

Follow-up
The entire PRP treatment process takes about an hour - the patient will be able to go home the same day. Full recovery from the injection usually occurs within one week of the procedure. Many patients require three to four treatments before the injured tissues are completely healed and they return to a normal active lifestyle.

PRP Injection for Whiplash

Overview
This non-surgical procedure treats whiplash injury with an injection of the patient's own blood platelets. The concentrated platelets promote the natural healing of damaged ligaments, cartilage and tendons.

Collecting the Platelets
The PRP process begins when a sample of blood is taken from the patient and placed into a centrifuge, where it is spun rapidly. The spinning process separates it into its components: plasma, platelets and white blood cells, and red blood cells. The red blood cells are drained away, and then the patient's concentrated platelets, along with a portion of the plasma, are drawn into a syringe.

Preparing the Neck
The neck is cleansed and sterilized. A local anesthetic may be applied to reduce pain at the injection site.

Administering the Injection
The needle containing the platelet rich plasma is directed into the neck and precisely guided to the target area with the help of fluoroscopic x-ray visualization. The platelet rich plasma is injected into and around the damaged tissues. Additional injections to other injured structures of the neck may be needed to ensure complete tissue healing.

RACZ Caudal Neurolysis

Overview
This injection, generally performed as an outpatient procedure under local anesthesia, relieves low back and leg pain most often caused by scarring from a prior back surgery. The procedure is performed with the patient lying face down with a cushion placed under the stomach.

Anesthetic Injected
The physician locates the small opening at the base of the sacrum (called the sacral hiatus) and injects a local anesthetic that numbs the skin and all the tissue down to the surface of the sacral hiatus.

Needle Inserted
The physician then guides the needle through the anesthetized track and into the epidural space.

Contrast Solution Injected
A contrast solution is injected, allowing the physician to see the scarred and painful areas on an X-ray device called a fluoroscope.

Catheter Inserted
A small, flexible catheter is fed through the needle and positioned at the location of scarring.

Medication Injected
A steroid-anesthetics mix is injected through the catheter and around the scarring, bathing the painful area in medication and dissolving the scar tissue.

End of Procedure
The needle and catheter are removed. In some cases, it may be necessary to keep the catheter in place to allow for more injections over the next few days. It also may be necessary to repeat the procedure a few months later to reduce scar tissue further.

Sacroiliac Joint Steroid Injection

Overview
This injection procedure is performed to relieve pain caused by arthritis in the sacroiliac joint where the spine and hip bone meet. The steroid medication can reduce swelling and inflammation in the joint.

Sacroiliac Joint Located
The patient lies face down. A cushion is placed under the stomach for comfort and to arch the back. The physician uses touch and a fluoroscope to find the sacroiliac joint.

Anesthetic Injected
A local anesthetic numbs the skin and all the tissue down to the surface of the sacroiliac joint.

Needle Inserted
The physician advances a needle through the anesthetized track and into the sacroiliac joint.

Steroids Injected
A steroid-anesthetics mix is injected into the sacroiliac joint, bathing the painful area in medication.

End of Procedure
The needle is removed, and a small bandage is used to cover the tiny surface wound.

Sciatic Nerve Block

Overview
This procedure is an injection of anesthesia (or an anesthetic/steroid mixture) around the sciatic nerve. It can be used to block the pain of surgery on the knee, leg ankle or foot, or it can be used to manage the pain of chronic issues in the lower extremity.

Preparation
In preparation for the procedure, the patient is positioned to expose the buttock. The physician uses an ultrasound probe to determine the precise entry point for the needle. The tissue at the entry point is numbed with an injection of local anesthesia.

Needle Placement
The physician inserts a needle into the numbed tissue and carefully advances it down to the sciatic nerve. The physician uses the ultrasound to confirm the correct placement of the needle.

Injection
The physician injects the anesthetic (or anesthetic/steroid mixture) through the needle. The medication bathes the main trunk of the sciatic nerve, temporarily blocking sensation in the leg or relieving chronic pain and inflammation.

End of Procedure
When the injection is complete, the needle is carefully removed and a small bandage is placed over the injection site. The duration of the injection varies depending on the type of medication administered and the goal of the procedure.

Shoulder Joint Injection (therapeutic)

Overview
This outpatient injection procedure relieves pain in the shoulder and arm caused by arthritis, injury or disorder.

Preparation
In preparation for the procedure, the shoulder is cleansed and sanitized. Local anesthetic is administered to numb the tissue at the injection site. The physician may choose from multiple needle approaches, depending on which part of the shoulder requires treatment.

Needle Insertion
The physician carefully guides a needle into the shoulder joint. The physician may guide the needle with the help of an x-ray device called a fluoroscope. If so, the physician may inject contrast dye to confirm the needle's placement.

Pain Relief Injection
When the needle is in position, the physician injects a mixture of anesthetic and steroid medication. The medication will help reduce inflammation and relieve pain.

End of Procedure
When the injection is complete, the needle is slowly withdrawn. The injection site may be covered with a small bandage. For many patients, extended pain relief begins within two to three days of the injection. In some cases it may be necessary to repeat the procedure one or more times to receive the full benefit of the treatment.

Spinal Cord Stimulation

Overview
Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

Trial Implantation
The injection site is anesthetized. One or more insulated wire leads are inserted through an epidural needle or through a small incision into the space surrounding the spinal cord, called the epidural space.

Find the Right Location
Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. The patient gives feedback to help the physician determine where to place the stimulators to best block the patient's pain. The leads are connected to an external trial stimulator, which will be used for approximately one week to determine if SCS will help the patient.

Determine Effectiveness
If the patient and physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the leads are removed.

Permanent Implantation
The permanent implantation may be performed while the patient is under sedation or general anesthesia. First, one or more permanent leads are inserted through an epidural needle or a small incision into the predetermined location in the epidural space.

Generator Implantation
Next, a small incision is created, and the implantable pulse generator (IPG) battery is positioned beneath the skin. It is most often implanted in the buttocks or the abdomen. The leads are then connected to the IPG battery.

End of Procedure
The implant’s electrical pulses are programmed with an external wireless programmer. The patient can use the programmer to turn the system on or off, adjust the stimulation power level and switch between different programs.

Spinal Cord Stimulator Implant Trial Procedure

Overview
Spinal cord stimulation (also called SCS) uses electrical impulses to relieve chronic pain of the back, arms and legs. It is believed that electrical pulses prevent pain signals from being received by the brain. SCS candidates include people who suffer from neuropathic pain and for whom conservative treatments have failed.

Trial Implantation
The injection site is anesthetized. One or more insulated wire leads are inserted through an epidural needle or through a small incision into the space surrounding the spinal cord, called the epidural space.

Find the Right Location
Electrodes at the end of the lead produce electrical pulses that stimulate the nerves, blocking pain signals. The patient gives feedback to help the physician determine where to place the stimulators to best block the patient’s pain. The leads are connected to an external trial stimulator, which will be used for approximately one week to determine if SCS will help the patient.

Determine Effectiveness
If the patient and physician determine that the amount of pain relief is acceptable, the system may be permanently implanted. At the end of the trial implantation, the leads are removed.

Spinal Epidural for Hip and Lower Extremity

Overview
This procedure uses an injection of anesthesia to numb the hips and lower extremities in preparation for a medical procedure. The patient remains awake and alert, and still has the ability to offer feedback to the operating physician.

Preparation
The skin of the lower back is cleaned and sterilized, and the patient is positioned to expose the lower back. A small needle injects a local anesthetic, creating a numb pathway down to the spine.

Positioning the Needle
A larger needle is carefully inserted through the numb tissue and guided to the epidural space. The needle is not pushed through the dura, the sac that surrounds the nerve roots, but stops just outside this sac. If a catheter is needed, it is fed through the needle.

Injecting the Anesthesia
The anesthetic mixture is slowly injected, bathing the area. The pain-numbing sensation typically takes affect within 20 minutes.

End of Procedure
The needle is carefully removed. The affect will typically last for a few hours after the injection. If a catheter is used, it will remain in place in the spinal canal so that more anesthetic can be injected as needed. The catheter will be removed when the patient no longer requires anesthesia, and the injection site will be covered with a small bandage.

Subacromial Injection

Overview
During this procedure, a mixture of anesthesia and anti-inflammatory medication is injected into the space between the acromion and the head of the humerus. This injection can be used to treat a variety of painful conditions, including adhesive capsulitis, rotator cuff tendinosis, and impingement syndrome. The physician may choose an injection site on the front, side or rear of the shoulder.

Preparation
The patient is placed in a seated position, and the skin on the shoulder is cleaned and anesthetized.

The Injection
The physician carefully inserts a needle into the joint space and injects the medicated solution. The mixture bathes the joint space to reduce pain and inflammation in the joint.

End of Procedure and Aftercare
The needle is removed, and a small bandage is placed on the shoulder. The patient may be advised to avoid strenuous activity for the next few days.

Thoracic Epidural Steroid Injection

Overview
This outpatient procedure is an injection performed to relieve pain in the upper back.

Preparation
The patient sits or lies down to expose the back. The back is cleaned and sterilized, and a local anesthetic is administered to numb the tissue of the injection site down to the spinal column.

Inserting the Needle
The physician uses an x-ray device called a fluoroscope to guide a needle down to the vertebra that is causing the pain. The needle is carefully pushed into the epidural space, which is the area surrounding the spinal cord. A contrast solution is injected to confirm the needle's position.

Inserting the Medication
The physician injects a steroid-anesthetic mix into the epidural space, bathing the painful areas with soothing medication. The mixture will help reduce inflammation and reduce pain.

End of Procedure
The needle is removed, and the injection site may be covered with a small bandage. Extended pain relief usually begins within three to five days of the injection. In some cases it may be necessary to repeat the procedure as many as three times to get the full benefit of the medication. However, many patients get significant relief from only one or two injections.

Thoracic Transforaminal Epidural Steroid Injection

Overview
This injection procedure relieves pain in the upper back, ribs, and abdomen caused by a pinched nerve (or nerves) in the thoracic spine.

Preparation
The procedure is performed with the patient lying on the stomach. A region of skin and tissue of the back is numbed with an injection of local anesthetic.

Inserting the Needle
The physician uses an x-ray device called a fluoroscope to guide a needle to the painful area of the spine. The needle is inserted into the neural foramen space, the region through which spinal nerves travel.

Confirming the Needle Placement
Contrast dye is injected into the space to make sure the needle is properly positioned near the irritated nerve or nerves.

Injecting the Medication
A combination of an anesthetic and cortisone steroid solution is injected into the foramen space. The steroid is an anti-inflammatory medication that is absorbed by the inflamed nerves to decrease swelling and relieve pressure.

End of Procedure and After Care
The needle is removed and a small bandage is applied. Extended pain relief usually begins within two to three days of the injection. Some patients may need only one injection, but two or three injections may be needed to provide significant pain relief.

Trigger Point Injections

Overview
This outpatient procedure is designed to reduce or relieve the pain of trigger points. These small, tender knots can form in muscles or in the fascia (the soft, stretchy connective tissue that surrounds muscles and organs). The trigger point injection procedure takes only a few minutes to complete.

Preparation
In preparation for the procedure, the patient is positioned comfortably. The physician presses and pinches the skin to locate the trigger point. Once it has been identified, the physician cleanses the overlying skin. A topical anesthetic may be used to temporarily numb the skin.

Medication Injected
The physician carefully inserts a needle through the skin and into the trigger point. The physician injects an anesthetic mixture into the trigger point. This causes the trigger point to relax. If the trigger point does not relax completely after the first injection, the physician may adjust the needle's position and give additional injections.

End of Procedure
When the injection is complete, the physician removes the needle. A small bandage may be placed over the injection site. The patient may be encouraged to stretch and move the muscle after the injection.

Ultrasound-guided Injection for Knee Pain

Overview
This non-operative, outpatient procedure is designed to provide relief for patients with arthritis of the knee. The technique allows the physician to inject an inflammation-reducing steroid with maximum accuracy.

Preparation
In preparation for the procedure, the physician swabs the knee, injects a numbing medication and positions a hand-held ultrasound probe that will allow the physician to visualize the anatomy of the knee and accurately inject the medication.

Injecting the Medication
The physician inserts a needle into the knee and guides it to the problem area using ultrasound imagery. The medication is then injected into the joint.

End of Procedure
When the injection is complete, the needle is removed. The local anesthetic and steroid solution in the knee joint will reduce inflammation and pain. The injection can be repeated if necessary.

Ultrasound-guided Injection for Shoulder Pain

Overview
This non-operative, outpatient procedure is designed to provide relief for patients with pain in the shoulder from conditions such as osteoarthritis, rheumatoid arthritis and adhesive capsulitis. The technique allows the physician to inject an inflammation-reducing steroid with maximum accuracy.

Preparation
In preparation for the procedure, the physician swabs the shoulder, injects a numbing medication and positions a hand-held ultrasound probe that will allow the physician to visualize the anatomy of the shoulder and accurately inject the medication.

Injecting the Medication
The physician inserts a needle into the joint space and guides it to the problem area using ultrasound imagery. The medication is then injected into the joint.

End of Procedure
When the injection is complete, the needle is removed. The local anesthetic and steroid solution in the shoulder joint will reduce inflammation and pain. The injection can be repeated if necessary.

Vertebral Augmentation

Overview
This minimally-invasive, outpatient procedure is used to treat a compression fracture of the vertebra, an injury that commonly results from osteoporosis. This technique can restore the height of the vertebra and stabilize the fracture, providing rapid pain relief.

Preparation
After the patient has been positioned and anesthesia administered, the surgeon inserts a guide wire or needle through the skin of the back. Using fluoroscopic guidance, the surgeon pushes the wire down to the target vertebra. A dilator is pushed over the wire to create a working channel to the vertebra.

Stabilization
The surgeon pushes an instrument through the working channel and into the collapsed vertebra. The instrument is used to create a cavity in the body of the vertebra. The cavity is filled with bone cement which rapidly cures and thus stabilizes the bone.

End of Procedure
The instruments are removed, and the patient is monitored in a recovery room. In many cases, pain relief is immediate, and the patient can return home within a few hours of the procedure.

Vertebroplasty

Overview
This minimally-invasive treatment is used to repair spine fractures caused by osteoporosis or cancer. It stabilizes the spine, providing rapid back pain relief and helping prevent further weakening of the spine.

Bone Biopsied
After an area on the back is numbed, a tube is inserted through a small incision and positioned under x-ray guidance. One or two needles are inserted into the collapsed vertebra and used to collect diseased bone tissue for study.

Fracture Stabilized
The weakened area in the vertebra is filled with bone cement to stabilize the fracture. Once filled, the tube is removed. In some cases, the cement may be injected in both the left and right sides of the vertebra.

End of Procedure
An "internal cast" is now in place. The cast stabilizes the vertebral body and provides rapid mobility and pain relief.

Visco-supplementation for Arthritis of the Knee

Overview
This nonsurgical procedure is an injection of a gel-like medication into the knee joint to supplement or replace the thick synovial fluid that cushions the joint. This treatment can help reduce the pain of arthritis.

Preparation
In preparation for the procedure, the physician numbs the knee with an injection of local anesthetic.

The Injection
The physician carefully guides a needle through the numbed tissue and into the space within the knee joint. The physician may confirm the position of the needle with a fluoroscope, a special type of x-ray that shows moving images. Once the tip of the needle is positioned correctly, the physician injects the medication. This fluid will cushion and lubricate the knee joint.

End of Procedure and Aftercare
When the injection is complete, the physician removes the needle. The injection site is bandaged. The patient may not feel relief for a few weeks, and may need to return for additional injections.

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