FAQ

Many patients have come to GRSM concerned that they had previously received an injection at a different facility that was very painful.  For this reason, at GRSM Injection Clinic, we take special care to make all injection procedures as comfortable as possible.   We explain the details of the injection in advance, so you can feel confident knowing what to expect during and after the procedure.  We use local analgesic (“freezing”) to numb the skin and tissue beneath the skin so that needle discomfort is minimized or eliminated.  In addition, because all injections at GRSM Injection Clinic are completed with ultrasound guidance, there is no “jabbing around” to find the correct locations that you are more likely to feel with the typical blind injections.

An injection involves using a needle to introduce a treatment into the patient’s body which is classified as an invasive procedure.  Anyone who is going to have an injection needs to be aware that every injection has inherent risks that include infection, bleeding, allergic reactions, etc. (for more information about possible complications of injections, click here).

At GRSM Injection clinic, we take exhaustive precautions to ensure the safety of all patients.  As a first step, we meet with you to conduct a thorough assessment to ensure an injection is an appropriate treatment for you.  This assessment includes a thorough review of your medical status to ensure that you don’t have medical conditions that could increase your risk of injection complications.  At the time of the injection appointment, similar to what is done in a hospital, we take very diligent precautions to minimize risk of infection.  This process includes very carefully disinfecting your skin and using sterile disposable gloves and needles.  All of the injection supplies at GRSM are sterile and disposable, and we even use sterile covers and sterile gel for the ultrasound probe.  For PRP and stem cell injections, we only handle one person’s blood and tissue at a time so there is never any risk of cross contamination between patients.

Figuring out if the person doing an injection is “qualified” can be difficult.  Most health care providers would agree that for an injection that is more complicated (such as an injection into a joint or into a tendon), you would typically want the injection to be done by a “medical doctor” or “physician”.   You need to be careful of the terminology “doctor” since chiropractors, naturopath and those holding academic doctorates can also be called “doctor”.  In addition, you want to find a medical doctor who has special training to do injections.  For example, sports medicine physicians, orthopedic surgeons and interventional radiologists have excellent experience in doing blind injections as part of their training.   Regarding the more accurate ultrasound-guided injections, the physician must have special training to be able to properly use the ultrasound equipment to help guide the needle accurately.  This training typically has to be achieved after a physician graduates from his or her program, and typically requires multiple hands-on ultrasound-guided injection courses by reputable programs.  In addition, you can ask about experience of the physician doing injections and ensuring that he or she has completed many injections in the past and has the appropriate skills to do your injection. 

Ultrasound-guided injections have been consistently shown in many research studies to be significantly more accurate than blind injections.  For example, intra-articular knee injections have traditionally been classified as being “easy” injections (i.e., easy to place the needle within the knee joint), but “blind” injections of the knee tend to miss the mark 20-30% of the time!  More difficult joints such as deeper hip and shoulder injections tend to have worse success rates when done blind (e.g., shoulder is only 64% accurate, hip is only 73% accurate, from AMSSM Position Statement 2015).  In comparison, ultrasound-guided injections are successful 95-100% of the time.  This accuracy is important to better ensure your comfort, safety and, most importantly, success of the treatment being injected.  For more information on ultrasound-guided injections, click here.

No, the grand majority of injections in Canada are done “blindly”.  Doing ultrasound-guided injections requires specialized training, technology and equipment so they are not as commonly done in the community.  See above for more information on training needed to do ultrasound-guided injections.

There are many different methods of producing PRP, and there are many different “protocols” for doing PRP injections, depending on your diagnosis and severity of condition.  For example, osteoarthritis will probably respond to a type of PRP that has low white blood cell content, whereas tendon injuries may more likely respond to PRP that has a higher white blood cell count.  Also, severe knee osteoarthritis will probably respond better to multiple PRP injections where as a tendonitis or mild osteoarthritis may respond well to only one PRP injection.  In addition, some PRP is a very concentrated formation, whereas other PRP is more dilute and contains fewer growth factors and healing hormones.  Another factor to consider is that the more accurate and effective ultrasound guided injections tend to be more expensive than the cheaper “blind” PRP injections because the ultrasound equipment, technology and training results in higher costs. 

At GRSM Injection Clinic, usually you are not “laid up” for long after an injection.  In fact, in most cases, you do not have much pain or discomfort after the injection and you can go about regular daily activities, but with some particular modifications to exercise and physical activities.    There are some occasional exceptions, however, this will be decided on an individual basis depending on your diagnosis and type of injection.  For example, for PRP injections, there is a slow healing effect that can take up to three months to take effect, so your physical activities may need to be modified to some degree until you start to improve.   Also, you will most likely benefit from doing particular rehab exercises during the healing process which can enhance your recovery.