Fees

Diagnostic ultrasound - charged as regular assessment fee

Steroid injection - £160

Hyaluronic Acid - £190

Diagnostic Ultrasound

Chris Myers and Dave Baker are clinical directors at Complete Physio and are highly specialised physiotherapists who have trained in the use of diagnostic ultrasound to help to diagnose muscle, tendon, ligament and joint problems. Diagnostic ultrasound technology has improved significantly over the past 15 years and is an effective imaging modality in sports medicine. Technological advancement means that ultrasound is now considered to be superior to MRI scans for visualising and diagnosing certain tendon, ligament and muscle complaints. These include the Achilles, patella and rotator cuff (shoulder) tendons and the tendons involved in tennis elbow and golfer’s elbow. Accurate diagnosis is key to implementing the most effective treatment regime for your recovery and diagnostic ultrasound can provide an effective adjunct in this process.

Please note we are unfortunately not able to provide CD discs of scans taken from our machines. Also, we recommend use of ultrasound provided in clinic as an accessible first line of assessment and will inform patients if a formal MRI scan or ultrasound preformed on high frequency machine and radiological setting is recommended.

Please note we do NOT scan:

  • lumps and bumps
  • the abdominal region
  • the spine
  • hernias

If you would like further information please email chris@complete-physio.co.uk or call 020 7482 3875.

Steriod Injection

Injection therapy is an extremely effective treatment as part of a physiotherapy programme for conditions such as frozen shoulder, tennis elbow or joint osteoarthritis or it can also be used as a stand alone treatment for conditions such as trigger finger or De Quervains Tenosynovitis (wrist tendon pain).

Steroid injections provide an effective anti-inflammatory and pain relieving treatment directly to the joint or soft tissues causing pain. Clinical specialist physiotherapists carry out the injections using ultrasound guidance to ensure the accuracy of the treatment. Normally, only one injection is required to gain sufficient pain relief and restore normal range of movement.

Local Steriod Injection Patient Information Leaflet can be found here:
Local Steriod Injection leaflet

If you would like further information please email dave@complete-physio.co.uk or call 020 7482 3875.

Hyaluronic Acid Injections

Hyaluronic acid injections are normally used for the treatment of osteoarthritis by reducing pain and improving the function of our joints. Research has shown hyaluronic acid injections reduce cartilage erosion and periarticular fibrosis and improve normal movement patterns, e.g. walking/running gait. Hyaluronic acid injections are licensed for use in any joint in the body (except the spine). Patients who are active particularly favor these injections as they work to nourish and lubricate joints mimicking the body’s natural synovial fluid, which generally becomes depleted and less viscous with age. From one course you can expect relief for 9-12 months. Ostenil (hyaluronic acid) is widely used in Sports Medicine, and is used by most UK premiership Football clubs, Rugby clubs, Cricket clubs and the British Olympic Association.

The injections can be used on a regular basis if required as they have no known side effects, and they are not known to be detrimental to the body’s tissues in any way. Because of its level of safety, hyaluronic acid is classed as a 'medical device' rather than a drug. For optimal affect, chronically swollen joints can be injected first with steroid to reduce inflammation and then injected with hyaluronic acid around 4 weeks later, reducing the need for repeated steroid injections. Complete Physio clinical specialist physiotherapists have worked with hyaluronic acid injections for many years and are thus able to give expert advice as to the usefulness for any particular patient presentation. All hyaluronic acid injections are delivered with image guidance to maximise their effectiveness.

For more information please contact Dave Baker (dave@complete-physio.co.uk) or Chris Myers (chris@complete-physio.co.uk) direct or call 0207 482 3875 and ask for them to call you back.

Ostenil Plus Patient Information Leaflet can be found here:
Hyaluronic Acid Injection leaflet

More information on hyluronic acid injections can be found here:
http://www.isakos.com/innovations/bobic2.aspx
http://www.shoulderdoc.co.uk/article.asp?article=83§ion=56
http://www.vivomed.co.uk/pdf/opcd.pdf

Here is a list of common complaints that can be effectively treated with injection therapy.

  • Shoulder
    • Impingement / bursitis – pain on flexion and abduction
    • Adhesive Capsulitis / frozen shoulder
    • Acromioclavicular joint sprain
  • Elbow
    • Tennis elbow (lateral epicondylitis pain)
    • Golfer's elbow (medial epicondylitis)
  • Hand and Wrist
    • Osteoarthritis of the joints of the hand
    • Trigger finger
    • Carpal Tunnel Syndrome
    • De Quervain's Tenosynovitis
  • Hip
    • Trochanteric bursitis - lateral hip pain
  • Knee
    • Osteoarthritis knee joint
  • Ankle and Foot
    • Ankle and subtalar joints
    • 1st MTPJ of big toe (big toe joint)
    • Plantar faciitis

PATIENT INFORMATION

Q: What is a corticosteroid?
A: A medicine which can relieve swelling, stiffness and pain by reducing inflammation.

Q: Is this the same drug that athletes and bodybuilders take?
A: No. The steroids we inject are completely different and are for medical use only.

Q: Why do I need a steroid injection?
A: Because it will help reduce your pain. You can then start rehabilitation sooner, have fewer treatment sessions and return to normal activities more quickly.

Q: Why don’t I just take anti-inflammatory pills?
A: You can, but the side effects of these are much more common and can cause stomach upsets and bleeding. These injections bypass the stomach.

Q: Are there any times I should not have an injection?
A: Yes, if you:

  • Have any infection on your skin or anywhere else in your body
  • Are allergic to local anaesthetic or steroid
  • Feel unwell
  • Are due to have surgery at the area soon
  • Are pregnant
  • Are under 18
  • Do not want the injection

Q: What are the possible side-effects?
A: These are very rare and your physiotherapist will discuss them with you:

  • Flushing of the face for a few hours
  • Small area of fat loss or a change in colour of the skin around the injection site
  • Slight vaginal bleeding
  • Diabetic patients may notice a temporary increase in blood sugar levels
  • If you are taking blood thinning drugs there may be some temporary bruising
  • Infection: if the area becomes hot, swollen and painful for more than 24 hours you should contact your physiotherapist or doctor immediately
  • You will be asked to wait for 30 minutes after the injection to ensure there is no allergic reaction to the drug

Q: How is the injection done?
A: The skin is cleaned with antiseptic. A needle is gently put into the affected part and the solution is injected through the needle. Shortly after, you will be examined again.

Q: Is the injection painful?
A: Not particularly, as your physiotherapist has had intensive training in the technique. Sometimes it can be sore for a few hours, but you will be told what to do about this.

Q: How fast does the injection work?
A: If local anaesthetic is also used the pain should be less within a few minutes, though it may return after about an hour, just as when you visit the dentist. The steroid usually starts to work within 24-48 hours but may take longer.

Q: How long does the effect last?
A: This varies from person to person and the condition being treated, but the steroid usually continues working for 3 to 6 weeks.

Q: How many injections can I have?
A: This depends on the part of the body involved and will be decided by your therapist and yourself. Usually one injection is sufficient, but if the pain is severe or has been there for a long time, you may need more.

Q: What should I do after the injection?
A: If the problem was caused by overuse, you will probably be told to rest the area for about a week; if it is a joint pain, you may start early gentle movement.

Q: When will I have to be seen again?
A: Usually your therapist will want to see you again about a week or ten days after the injection. You will then be given appropriate physiotherapy treatment and probably some exercises for you to do at home. You will also usually be reviewed a month after the injection to monitor the long term effect of the treatment.