1.   A 65 year old male presents with complaints of constant knee pain whether walking or not.  This patient had total bilateral knee replacement twice, once in 1998 and again in 2000.  He has had constant pain since before the replacements and after.  He has been on a pain medication regimen all of this time, which has not helped a great deal.  He walks with a cane and is in obvious pain.

Examination found considerable swelling of both knees and pain at specific spots around the knee cap on both knees.

The patient received injections into and around each knee.

The patient returned 4 days later, earlier than usual because he had to travel and would be away for the next 2 1/2 weeks.  His knees demonstrated a visual reduction in inflammation of both knees.  He stated that his pain was now off and on and no longer constant.  He stated that his pain intensity had dropped by 50% for the first time in years.

The patient was injected again in specific areas around both knees.

The patient returned 2 1/2 weeks later, coming into the office without a cane and walking quite normally.  He stated that he had ZERO pain and had been this way since a couple of days after the last set of injections.

The patient on followups since has had no further complaints of pain and is off all of his pain medications.

 

2.   A  76 year old female presents to this office with a history of constant right hip and  right knee pain that she has tolerated over the past 20 years, but which has finally gotten worse and has become debilitating.  She says that she feels better in the morning and that walking aggravates both areas.  She says that aspirin seems to help a little bit.

X-rays of the knees show a significant loss of the meniscus, the disc of the knee.  There is near bone on bone between the femur (thigh bone) and the tibia (leg bone).  X-rays of the hips shows significant degenerative joint disease (arthritis).

The patient received injections that day into painful areas of the right knee and into the joint capsule of the right hip.

The patient returned in one week and said that her right knee and right hip felt stronger, more stable, and less painful by about 50%.

The patient received injections into the distinctly less painful points of the right knee and into the joint capsule of the right hip.

The patient returned for follow up in one week and stated that her right knee was 80% improved and her right hip was 75% improved.

A follow up phone call two weeks later confirmed that all pain in both the right knee and the right hip had resolved completely.

 

3.   A 56 year old female presented to this office with right knee pain of 6 months duration that was keeping her from her regular dancing activity.  She stated that she had had knee sprains when she had played sports in high school and college, and that right knee discomfort has come and gone over the years, only becoming debilitating recently.

X-rays of the right knee showed arthritis of the knee joint and narrowing of the meniscus (knee disc).

The patient was injected at the painful points around the knee cap.

The patient returned in one week and stated that there was no more pain in her right knee, that it felt very stable, and that she had been able to dance over the previous weekend without any pain or instability.

Follow up by phone one month later confirmed that no pain in the right knee had returned and that the patient was dancing up a storm!

 

4.   A 69 year old female presented with a painful, burning right trigger thumb of several months duration.  She stated that many times during every day she would bend her thumb only to have it stay in that position, that the thumb was unable to straighten, and that she would have to gently coax it back into a straight position, all while experiencing pain before, during, and after the process.

The patient stated that she had had a cortisone injection to her right thumb 3 weeks prior to her visit at this office for the condition, and that the injection caused increased pain for 3 days afterwards before finally returning to the pre-injection pain levels.

Multiple pain points were found in the thumb and in the part of the hand below the thumb.  These areas were injected.

The patient returned in one week and stated that the burning of her thumb and hand was completely gone and that the only pain remained in her two thumb joints.  She said that she still had the trigger thumb, but that it wasn’t happening as frequently.  The patient was injected in the painful thumb joints.

The patient returned in one week and stated that the only pain that she had was in a specfic part of only one of the thumb joints and that it was significantly less. She says that the trigger thumb has only been getting stuck occasionally.

We opted to not inject again and to see if it would resolve with the momentum of the previous injections.

A follow up phone call several weeks later revealed that all pain and burning was completely gone, as was the trigger thumb issue.

 

5.   A 71 year old female presented to the office with a complaint of constant right shoulder pain that has been painful off and on for many years and that probably was started from sports injuries years ago.  She stated that lately she cannot sleep on it due to the pain, and that it hurts when raising her arm.

Examination revealed specific muscles of the rotator cuff to be painful and weak, and that the shoulder had limited mobility.

Injections were given to multiple areas around the right shoulder.

The patient returned in two weeks and stated that, starting the day after the injections, all pain had stopped and has not returned.  She stated that she had full movement of her right shoulder and that she was able to perform tasks related to raising her right arm without pain.  Examination confirmed those findings.