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Significant pain can develop when the cartilage in joints, which serves to cushion movement, wears away, causing bones to rub against each other. Steroids, commonly referred to as "cortisone," combined with an anesthetic solution injected directly into the joint, can provide significant pain relief and improvement in function. Cortisone injections to the joints can be repeated as frequently as every three months.

Joints treated with cortisone injections in the office include the knees, ankles, shoulders, elbows, wrists, and thumbs. It can also be effective in managing carpal tunnel syndrome, tennis elbow, golfer’s elbow, tendinitis and bursitis.

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Hyaluronic acid is a natural component of synovial fluid which acts as a lubricant for joints. Osteoarthritis develops when cartilage is worn away and with it less lubricating synovial fluid is produced. This leads to pain and decreased function of the joint.

Viscosupplementation, or "jelly injections" is a special injection treatment that works to restore the lubrication to the knee joint which improves pain and function. Brand names include Euflexxa, Synvisc, Supartz and Hyalgan.

The treatment course consists of a series of 3-5 weekly injections to the knees. Viscosupplementation injections can be repeated every 6-12 months.

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Prolotherapy is a pain management technique that can be particularly effective in cases where there are weak, injured or torn ligaments, tendons, meniscus or cartilage. These structures support the joints and spine. When not functioning properly due to injury or age-related wear and tear, pain develops.

Prolotherapy is a non-surgical technique to reconstruct the supporting structures of joints and the spine. It involves the injection of natural substances to the affected joint and supporting structures. This stimulates the body to repair the injured structures, thereby improving joint support and resulting in better joint function and less pain. The frequency of treatments varies from biweekly to monthly depending on the symptoms. A series of 2-6 treatments is typically needed depending on the medical condition.

Joints treated with prolotherapy in the office include the knees, ankles, shoulders, elbows, wrists, and thumbs. It can also be effective in managing chronic back pain, carpal tunnel syndrome, tennis elbow, golfer’s elbow, tendinitis and bursitis.

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Mesotherapy and biopuncture are both injection techniques used to manage pain. They involve injecting minute amounts of botanical substances, typically in the form of homeopathic solutions, and vitamins into the skin layer that is rich in blood vessels and nerves. These solutions stimulate the immune, nervous and circulatory systems to heal the injured areas, which ultimately improves pain and function.

Mesotherapy involves injecting the solutions superficially just under the skin along pain zones. The nappage technique, developed in France, involves gentle pricking of the skin with a very thin needle to stimulate healing of the injured areas.

Biopuncture is derived from the terms biological and acupuncture. It is similar to mesotherapy, except the solutions are typically injected into traditional acupuncture points where they stimulate the reflex responses of the immune and nervous systems to promote healing.

Treatments are initially given weekly for up to 6 weeks and the frequency is reduced as symptoms improve. Depending on the duration of symptoms, some patients may experience significant improvement within a few treatments, while others with more chronic injuries may respond optimally after longer treatment courses.

Mesotherapy and biopuncture can be effective in managing a variety of pain conditions, including chronic neck pain, whiplash, chronic back pain, sciatica, arthritis, muscle spasm, tendinitis, bursitis, tennis and golfer’s elbow, and fibromyalgia.

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Trigger points are areas of injured muscles that cause localized pain as well as referred pain to other muscles. Anesthetics and homeopathic solutions are injected into painful trigger points to improve healing and pain relief. Treatments are typically repeated weekly up to 6 times.

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