Sports and Exercise Physicians specialize in the diagnosis and treatment of pain in bones, muscles and joints resulting from disease or injury. If you suffer from pain due to disease or injury, ask your family doctor or other health care provider to refer you to an SEM physician.
SEM injections can relieve pain due to fractures, sprains, tendonitis or bursitis. They may also help relieve pain from osteoarthritis of the shoulder, wrist, hip, knee or ankle, small joint arthritis in fingers and toes, and epicondylitis of the elbow – commonly known as tennis elbow. Essentially, if you have pain of movement in any joints or articulations, an SEM injection should in most cases provide relief.
SEM injectables are normally steroid medications. Depending on the patient’s condition and prescribed treatment plan, the physician may inject other agents such as hyaluronic acid or Platelet Enriched Plasma (PRP).
In most cases, the physician administers intra-articular injections, meaning the injection will be made to the joints. Injections can also be given into the muscles or other soft tissues depending on the physician’s diagnosis.
Though SEM injections are generally not painful, patients may experience some discomfort during treatment. We apply topical numbing agents in the injection area to reduce patient discomfort during treatment as much as possible.
Short-acting soluble steroid injections usually bring relief within a few hours. While longer-acting steroids normally take approximately two weeks to take effect, these injections usually ease symptoms for a longer period.
There are many variables to consider in predicting the duration of treatment benefits. Some longer-lasting, less-soluble SEM injectables can be effective for three months or longer, while other injectables can last up to two years. In some instances, patients may require only a single treatment and never require further injections.
There should be an interval of at least six weeks between injections, and we normally recommend no more than four injections to the same physical area within a span of 12 months.
Normally, SEM injections are quite successful. However, in some cases, it is possible that treatment will have little to no effect. The patient’s approach to self-care is often a determining factor in treatment outcomes. For example, an SEM injection for tennis elbow may have limited effect if the patient aggravates the problem by playing tennis against the physiotherapist or physician’s advice.
Making recommended changes to your lifestyle and sports routine, completing any prescribed rehabilitation exercises and seeing a physiotherapist greatly increase the likelihood of success for any SEM injection treatment.
Possible side effects vary with the injectable used in your treatment, and the physician will explain any possible side effects prior to injection. In the rare case of side effect, you may experience any of the following symptoms:
Immediately following treatment, you may notice a mild increase in joint pain at the site of the injection. This is rare but normal, and should abate within 48 hours. We recommend applying a cold compress to the affected area to reduce any post-treatment pain or discomfort.
Yes, you should still complete the exercises prescribed by your physiotherapist or the treating physician. You may also be encouraged to complete more intensive mobilisation exercises in the days after the treatment while the treated joint is less painful.
Yes, you can resume normal daily activities, including work. However, if your job involves heavy lifting, you should reduce your workload for several days following treatment.
We recommend you spend fifteen minutes relaxing in our waiting area after treatment to ensure you have no secondary effects. If you feel fine after fifteen minutes, you can safely operate your vehicle.
Yes. However, if you are taking any type of anticoagulant/blood-thinning medication, the physician will advise against any injection that may cause bleeding in the joint. It is imperative that you inform the physician of all medications you are taking prior to treatment, especially anti-coagulants.
No. Patients in need of such medications must consult their family physician, or attend a walk-in or pain clinic.
Yes. However, you must carefully monitor your blood sugar levels for forty-eight hours following a steroid injection. Sugar levels often rise and you may need more insulin than usual. The doctor will provide you with post-treatment advice and instructions.
Single steroid injections are not likely to affect fertility or pregnancy. However, if you are pregnant or attempting pregnancy, please inform the physician.
If an injection is given during breastfeeding, small amounts can pass into your breast milk. While this is unlikely to be harmful to your baby, you should still consult with the doctor before receiving a steroid injection. If you are concerned in any way, we advise against a steroid injection.
There is no specific reason to avoid moderate alcohol consumption in the days and weeks subsequent to an SEM injection.
A physician with training in Musculoskeletal medicine can perform SEM injections.