Injection Therapies

Injection therapies are used in podiatry for a variety of joint and soft tissue conditions. When clinically appropriate they can be used as part of a wider treatment plan to help relieve pain and inflammation. Injections can be performed under local anaesthetic and ultrasound guidance.

Hyaluronic acid

OSTENIL is a synthetic hyaluronic acid that is injected into the joint space to decrease the pain and stiffness within the affected joint. This is done by trying to restore the balance that has been upset between the breakdown and production of hyaluronic acid in synovial fluid.

Whilst this can decrease pain and help with movement, it does not reverse the damage to the cartilage.  Relief is temporary although can last for several months after a course of injections, which can be repeated.

There is a very low risk of reaction as it does not contain animal proteins and post injection soreness is also rare.  The more severe the arthritis the less chance of it being effective. These injections carry less risk than steroid injections.

Depending on the joint affected, it usually requires a course of injections on a weekly basis for 3 weeks, the effects can take a few days to be noticed or after a second injection.

Corticosteroid Injections

The injections are either a steroid on it’s own or with a local anaesthetic, sometimes a local anaesthetic is given separately as part of the treatment.

How it works:

The steroid injection itself is not a pain medication but rather an anti-inflammatory that works by preventing collagen production. The injection shuts down collagen-producing cells in the tendon or joint; this action suppresses inflammation, which is the redness and swelling caused by your body’s healing response to damage or injury, and calms nerves, which indirectly reduces pain.

How quickly will the injection work?

The effect of the steroid is usually seen within a few days, although it can take a few weeks before the full effect is seen. If an anaesthetic is used, any numbness lasts only a few hours and care must be taken.

How long will the beneficial effects last?

This varies depending on the condition. The effects may last between a few weeks to several months, it may even resolve the problem.

Possible side effects?

  • Side effects are rare but important to be aware of. Post injection flare-up of pain. This may last up to 48 hours. Painkillers such as paracetamol can be taken if needed.
  • Infection is rare but if you develop any of the following symptoms: swelling, redness, warmth around the injection site or are generally unwell then seek medical attention.
  • Anaphylactic shock is an extreme but very rare allergic reaction, it usually happens quickly, very shortly after the injection has been given, symptoms such as difficulty in swallowing or breathing, tightness in the chest, are possible signs of reaction.
  • Facial flushing can be present for 24 hours following injection and premenopausal females may experience breakthrough menstrual bleeding.
  • Fainting. A few people feel faint after their injection, this usually settles by lying down for a few minutes, please advise before an injection if you have a tendency to faint.
  • Reduced immunity may occur, as it is absorbed into the body it can reduce your immune system making you more susceptible to catching colds or flu and recovery could take longer
  • Central serous chorioretinopathy is a rare side effect causing blurred vision, should this happen contact GP or an ophthalmologist.
  • If you are breastfeeding it may cause milk production to stop for a short period of time.

Dermal Fillers

Curacorn® has been developed using a highly viscous formulation of Hyaluronic Acid (HA). HA is a naturally occurring substance, most often found in the joints, therefore it is biocompatible with very few side effects.

The filler is injected underneath a corn or callus which causes a response in the body that provokes the formation of collagen and draws fluid towards the area.  This creates a comfortable, natural cushion between the bone and the skin.

The ‘cushion’ underneath a lesion decreases the production of callus and corns, ultimately relieving the pain associated with them.  The high viscosity has proved not to disperse under the pressure of walking or the forces exerted on feet from footwear.

Who will Benefit?

  • Patients with acute or chronic corns on high weight-bearing areas or in-between toes
  • Patients with areas of pressure resulting from bony changes e.g. bunions, retracted toes
  • Patients with a thinning of the natural fatty padding in the ball of the foot expositing the joints to high pressure when walking
  • Pain in the heel caused by the loss of natural fatty pad
  • Patients with long standing, acute or chronic painful foot lesions
  • Patients who often wear high heels

Curacorn® has been developed using a highly viscous formulation of Hyaluronic Acid (HA). HA is a naturally occurring substance, most often found in the joints, therefore it is biocompatible with very few side effects.