Pain Management Exams

Please Note: We will be closed for the upcoming September long weekend. This includes Saturday August 31st to Monday September 2nd. We will reopen on Tuesday September 3rd for regular business hours.

Please select your exam from the below options to find out more about the procedure and the preparation required for your exam.

Steroid injections are commonly used for the treatment of joint and soft tissue disorders. Steroids have been shown to be helpful for easing pain and reducing high levels of inflammation. Steroid injections are often used in conjunction with local anesthetic. There are several different formulations of both steroid and anesthetic which may be used. Like all medication, an individual’s response to a steroid injection cannot be predicted. Most patients experience an improvement in their symptoms within a few days. For some, the beneficial effect will persist for several months.

*Please note pre-work up imaging may be required.

Pureform Procedure

Your Technologist will escort you to your exam room, position you on the bed (positioning is specific to each exam) Some individuals are susceptible to fainting during medical procedures, due to a temporary fall in blood pressure. Please inform the Radiologist or Sonographer prior to the procedure.

The Technologist will ask you a few questions and then introduce you to the Radiologist.

The Radiologist will clean the skin and inject a local anaesthetic, similar to the freezing you would get at your dentist.

After the location is confirmed either with x-ray or ultrasound guidance, the steroid will be injected using a small sterile needle.

After being checked post-injection, you are free to leave with no recovery time required.

Preparation

Take all prescribed medications as directed. If you are on anticoagulation drugs (Plavix, Coumadin, Warfarin) or if you are Diabetic and taking insulin, please let your booking coordinator know.

Please arrive 15 minutes prior to your appointment for there is paperwork to read over and a consent form to sign.

You may experience some discomfort following your exam. It is recommended that you have someone accompany you for your exam. However, it is mandatory for you to have a driver if you’re having a bilateral procedure.

Post Procedure

Avoidance of strenuous activities is generally advised for a few days especially if steroid is injected in the vicinity of a tendon or into a weight bearing joint. Deterioration of symptoms for about 48 hours after the injection is seen in 5-10% of patients.

Rest and simple painkillers usually help. It is recommended to work with a physiotherapist post procedure to aid recovery process.

This is a procedure where a Radiologist injects local anesthetic (numbing medication) and then uses a needle to gently poke holes into the abnormal tendon under ultrasound guidance. This procedure is intended to break down scar tissue, cause bleeding in the tendon, and invoke the body's natural healing process to start healing the damaged tendon. The Radiologist will use an ultrasound machine during the procedure in order to see the needle to ensure accuracy and safety. Some patients may experience mild side effects. There is a small risk of bleeding or hematoma. There is a small risk of infection. Mild swelling may occur after the procedure. These symptoms usually resolve spontaneously over a few days.

If you have any questions regarding this procedure, please speak with the Radiologist before beginning the procedure.

*Please note pre-work up imaging may be required.

Pureform Procedure

Your Technologist will escort you to your exam room and position you on the bed (positioning is specific to each exam).

The Technologist will ask you a few questions and then introduce you to the Radiologist.

The Radiologist will clean the skin and inject a local anesthetic (numbing medication) and then under ultrasound guidance, use a needle to gently poke holes into the abnormal tendon under ultrasound guidance.

Preparation

Take all prescribed medications as directed. If you are on anticoagulation drugs (Plavix, Coumadin, Warfarin) or if you are Diabetic and taking insulin, please let your booking coordinator know.

Please arrive 15 minutes prior to your appointment for there is paperwork to read over and a consent form to sign.

Please stop taking all anti-inflammatories 2 weeks prior to procedure date. (eg Advil, Motrin, Ibuprofen, Aleve, Naproxen, Celebrex,)

If this procedure is for Achilles Tenotomy, please bring the required walking boot. And use the walking boot for 2 weeks post procedure to reduce the risk of tendon rupture.

If this procedure is for Patellar Tenotomy, please bring the required hard knee brace. Please use the brace for 2 weeks post procedure to reduce risk of tendon rupture.

If you take insulin for diabetes, please let your booking coordinator know. You may have some juice and a small snack after taking your insulin.

You may experience some discomfort following your exam. It is recommended that you have someone accompany you for your exam. However, it is mandatory for you to have a driver for knee and ankle Tenotomy Treatments.

Post Procedure

After the numbing medication wears off (approx. 1-2 hours), the tissue that has been worked on will usually be quite sore. Although not typical, it can be so sore that some patients do not want to use that body part for some time. Sometimes a brace, splints, crutches, canes, or walkers can be used. Therefore, we recommend planning the procedure during a time that you will have at least a few days to recover.

Ice is generally recommended after the procedure. Anti-inflammatories such as Advil, Motrin, Ibuprofen, Aleve, Naproxen or Celebrex are DISCOURAGED for 2 weeks prior to the procedure, and 2 weeks following the procedure.

It is recommended to work with a physiotherapist post procedure to aid recovery process.

How long will the pain last after the procedure?

The acute “flare-up” of pain or increased pain usually lasts 3-7 days after the procedure but can rarely last for up to a month in some patients. There is a large amount of variability between patients and some patients hardly have ANY pain after the procedure. There are no restrictions given and patients are actually ENCOURAGED to use the treated body part as normally as possible.

In some cases, the Radiologist may recommend protecting the area in a brace or refraining from specific activities for up to 1-2 weeks post procedure, but there is usually no “down time” that would require patients to be off work or refrain from usual daily activities.