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Hyaluronic Acid Injections

Your body makes hyaluronic acid. It's a natural part of the fluid that lubricates and has been shown to improve shock absorption in your joints and it keeps them working smoothly.

When you have osteoarthritis (OA), the hyaluronic acid in the affected joint becomes thinner. Hyaluronic acid injections add to your body's natural supply. They can reduce joint pain and improve nutrition to the joint surfaces. When effective the benefit can last for many months sometimes more than 6 months and the benefit in some cases can last for up to a year.

Why are Hyaluronic Acid Injections offered to patients?

Health professionals can’t predict who will benefit from hyaluronic acid injections. But many doctors and qualified allied health professionals give hyaluronic acid injections to people with osteoarthritic joints who are active and want to continue to maintain an active lifestyle and whose symptoms have not responded to non-drug treatments such as exercise heat or ice, and who have not been getting better with painkillers such as Paracetamol, Ibuprofen, Naproxen or other non-steroidal anti-inflammatories.  

Hyaluronic acid injections are often tried by people who can't take painkillers. It is also useful in for those who don’t want or can't have invasive surgery.

How Effective Are Hyaluronic Acid Injections for Osteoarthritis?

Studies show that hyaluronic acid injections may work better than painkillers for some people with OA. Other studies have shown they also may work as well as corticosteroid knee injections.

Hyaluronic acid injections seem to work better for some people than others. From my extensive experience in using hyaluronic acid injections for osteoarthritis joint conditions patients who have pain induced by loadbearing or activity tend to respond more favourably than those who have very high levels of pain even during rest (i.e non-mechanical pain). In the second group steroid injections (if appropriate) are more likely to lead to pain reduction.

What happens during the injection?  

You will be placed in a comfortable position. The skin is cleaned with antiseptic. A needle is positioned into the affected area whilst the procedure is monitored by means of ultrasound guidance.  The hyaluronic acid is injected through the needle. A plaster will be placed over the site to keep it clean.  

 

Is the injection painful? 

The injection is not particularly painful although due to the higher volume injected and the gel like consistency it can be slightly more uncomfortable than a steroid injection. The clinician is thoroughly trained in this procedure. Sometimes there could be several days of pain following the procedure. 

 

 

Further information on hyaluronic acid injections

Before your appointment you will receive an information leaflet on hyaluronic acid injections. Please read this carefully. Also please fill out and return the questionnaire we will provide on your general health so that we can be sure this treatment is right for you.

Frequently Asked Questions

An ultrasound scan of the upper abdomen will provide information about the appearance of your liver, gallbladder, pancreas, kidneys and spleen.

This will help to diagnose or exclude a wide range of abdominal conditions normaly causing pain and discomfoirt in upper abdomen such as gallstones and kidneys stones .

No. Ultrasound is painless and safe. You will not feel any effect from it. There are no after effects.

No.

3D/4D scans are bonding/entertainment scans and have hardly any diagnostic value and that is why they are not offered in the NHS.

All the diagnosis takes place with 2D technology.

It is reccomended to regular check the testis for any lumps or for anything that doesnt feel right.

Testis is the ovoid structure within the scrotal sack. Within the scrotal sack there is also the head, tail and body of the epididiymis.

The epididymis is full of small tubules where the sperm matures. These tubules sometimes get block and expand resulting on what is called epididymal cyst.

Epididymal cysts are harmless and very common.

Sometimes the tubules leak and sperm escapes within the scrotal sack resulting in pain sometimes. This is called hydrocoele.

Infections are also common in the testis resulting on an inflammed epididymis that can can also feel like a lump. 

It is also possible for cancer to be developed inside the testis and it is therefore very important if you find any mumps to have them checked as sson as possible.

The basic formula to calculate your estimated delivery date is very simple and works great if your average cycle length is 28 days. Simply add 280 days (or 40 weeks) to the first day of your last period. If you know when conception happened then just add 266 days (or 38 weeks).
However, things can get complicated if your cycle length is not 28 days or if your luteal phase length is not 14 days. 

The most common early signs and symptoms of pregnancy might include: Missed period. If you're in your childbearing years and a week or more has passed without the start of an expected menstrual cycle, you might be pregnant. ... **Tender, swollen breasts. ... **Nausea with or without vomiting. ... **Increased urination. ... **Fatigue.

Steatosis or fatty liver as otherwise known, is a term that describes the buildup of fatty deposits in the liver. Having fat in your liver is normal, but if more than 5 to 10 percent is fat, then it's called fatty liver disease. Fatty liver is a reversible condition that can be resolved with diet and excersice.

Non-alcoholic fatty liver disease (NAFLD) is a very common disorder and refers to a group of conditions where there is accumulation of excess fat in the liver of people who drink little or no alcohol. The most common form of NAFLD is a non serious condition called fatty liver.

In general, if you have fatty liver, and in particular if you have NASH, you should:

•lose weight – safely. ...
•lower your triglycerides through diet, medication or both.
•avoid alcohol.
•control your diabetes, if you have it.
•eat a balanced, healthy diet.
•increase your physical activity.

Vaginal bleeding during pregnancy can happen any time from conception  to the end of pregnancy. Light bleeding, or spotting, during pregnancy is common, especially during the first trimester. Im most cases this is no cause for alarm.

Breakthrough bleeding usually referring to mid-cycle bleeding in users of combined oral contraceptives, as attributed to insufficient estrogens. 

Bleeding or spotting are very common throughout a pregnancy. Most of the women however continue with a healthy pregnancy. You might be more at risk of miscarrying if you have heavy and bright red bleeding and are passing clots. But some women even with these symptoms do go on to have a healthy pregnancy.

An ultrasound guided injection is a therapeutic intervention where a pharmaceutical agent is administered in the body. Ultrasound is being used to guide the injection at the correct place.

 

There is no preparation for this test. You can eat and drink as normal. 

The ultrasound scan will not hurt. When you have the injection you will feel a small needle prick but it should not be too painful.

The symptoms usually improve about three days after the injection but this varies from person to person.

The benefits of the ultrasound guided injection may last for a few weeks or even months. You may need more than one injection to settle the symptoms. 

Ultrasound-guided injection is a common procedure.

There are some complications or risks associated with the procedure: 

  • Pain - sometimes the steroid injection can make the pain or discomfort temporarily worse. This called a ‘Steroid flare’. This can be more painful for approximately 2-3 days after injection. You may take your regular painkillers to provide relief during this time.
  •  Discolouration - very rarely a white dot or patch on the skin can appear after the injection, this called ‘Depigmentation’. This is rarely permanent and may last for few months.
  •  Fat atrophy – thinning of the fat, which may result in a dent in the skin.
  •  Skin thinning or skin dimpling – occasionally the skin overlying the injection becomes thin over the course of some months. This is particularly noticeable when several injections are given close to the skin surface. This side effect rarely happens.
  •  Tendon rupture – this is rare but steroids may weaken the tendon so it is important to avoid any strenuous activity or exercises for 3-4 weeks.
  •  Infection – it is very rare to get an infection.  
  • Allergic reaction is extremely uncommon.
  •  In patients with diabetes, blood sugar can elevate temporarily.
  •  No effect – the injection may not have any benefit.

Sound travels in waves. Ultrasound is sound which travels at a higher frequency than we can hear.

Ultrasound examinations known as scans are done by building up pictures from the return of sound waves as they bounce back from any resistance they meet. The sound waves can be directed to and bounced back from the surfaces of various structures within the body to form pictures on a television screen.

The ultrasound waves are sent to and from the body by moving a hand-held sensor which is similar to a microphone over the surface of the skin of the area to be examined. Pictures, known as images are taken for doctors and senior radiographers look at them and diagnose your condition.

Ultrasound scans can be used to diagnose a variety of conditions. They are also used to guide the position of needles for injections. 

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