Special Injections: Options for Pain Relief

Advanced, tailored procedures for complex cases

Some musculoskeletal conditions require more specific or targeted injections. These specialised techniques are often used when standard treatments haven’t worked, or when dealing with high-level athletes or complex pathologies.

All special injections are carried out using real-time ultrasound guidance for safety and precision.

Hydrodistension/ Hydrodilatation (Frozen Shoulder)

This involves injecting a controlled volume of fluid into the shoulder joint capsule to gently stretch it, reduce pain, and improve range of motion. Often combined with physiotherapy.

Rapid improvement in stiffness and pain
Often reduces need for surgical release

High-Volume Saline Injections (Tendinopathy)

Used for Achilles or patellar tendinopathy, this technique helps separate painful adhesions and decompresses tendons trapped between layers of tissue.

Targets chronic tendon pain
Enhances tendon glide and load tolerance

Prolotherapy (Joint Instability)

A regenerative technique using small injections of dextrose to stimulate ligament healing and improve joint stability, typically in areas such as the ankle or AC joint.

Useful for recurrent sprains or subtle instability
May help avoid surgical stabilisation

Adhesiolysis & Neurolysis

This technique uses targeted fluid pressure or specific injectates to break down scar tissue and release soft tissue adhesions or entrapments around nerves. It is especially helpful when pain or dysfunction persists despite rehab and standard injections.

Common examples include:

Recurrent calf muscle tears caused by deep scar tissue and tethering
Tibial or superficial peroneal nerve entrapment
Soft tissue-related groin pain, particularly where nerve or fascial irritation is contributing (e.g. ilioinguinal or obturator nerve involvement)
Post-surgical or post-injury adhesions causing restricted movement or pain

Benefits:

Restores nerve and muscle glide
Reduces pain and improves range of motion
May help avoid surgical decompression
Often used in complex, stubborn pain presentations

This technique is particularly useful in athletes or post-op patients where fascial tightness, fibrosis, or nerve irritation is contributing to groin or lower limb symptoms.

Nerve Blocks (e.g. Suprascapular Nerve Block)

Nerve blocks involve injecting a small amount of local anaesthetic (sometimes combined with steroid) around a nerve to reduce pain and inflammation. A common example is the suprascapular nerve block, often used for chronic shoulder pain due to rotator cuff tears or arthritis.

This type of injection can be particularly helpful for patients with severe joint pathology, such as:

Advanced shoulder osteoarthritis
Massive, irreparable rotator cuff tears

It is often considered when:

Surgery isn’t an option (e.g. due to other medical conditions or risk factors)
Physiotherapy, oral pain relief, and steroid injections haven’t worked