Ultrasound in the Treatment of Soft
By Jake Veigel, MD
One of the areas in which sports
medicine physicians specialize is the treatment of injuries to soft tissues in
and around joints, including muscles, bursa, ligaments, cartilage, tendons, and
the sheaths that cover tendons. We often prescribe physical therapy to help
injured patients regain strength, range of motion, and flexibility and in some
instances we also recommend therapeutic injections of pain control agents.
These injections allow a patient to make greater gains in physical therapy as
they recover from their injuries.
How is ultrasound helpful in
treating sports-related injuries?
Physicians find ultrasound to be an
excellent tool for treating certain types of orthopedic conditions and sports
medicine injuries, particularly in the realm of injections for pain management.
These injections can be administered a couple of different ways. The most
common method is for the physician to insert the needle relying on his or her
experience and knowledge of human anatomy. The other method is to insert the
needle using ultrasound guidance combined with physician knowledge.
Ultrasound is a painless,
non-invasive form of imaging technology that uses sound waves to produce images
of structures inside the body. Unlike x-rays, fluoroscopy, or CT scanning,
ultrasound does not rely on radiation. One of the major benefits of ultrasound
scanning in the treatment of soft tissue injuries is that ultrasound produces a
clear image of those softer musculoskeletal structures that do not typically
show up well on x-rays.
What are the advantages of
Ultrasound enables the doctor to
see an image of the joint and to observe the needle while it is advancing. The
doctor can also see the medication spread as it enters the tissue. The
advantage of imaging guidance is that it improves the accuracy of the
injection, helping the doctor to avoid arteries, veins, or nerves. Hitting
nerves may cause nerve damage and hitting arteries or veins may cause serious,
potentially life-threatening complications.
What are some common conditions
that benefit from ultrasound-guided injections?
There are many conditions that
benefit. Pain treatment injections can be very helpful to patients with
shoulder disease and injury, for example. Among these are arthritis of the acromio-clavicular (A/C) joint (at the top of the shoulder
where the collarbone is joined to the shoulder blade); rotator cuff problems; and
problems in the glenohumeral joint, where the head of
the upper arm joins the shoulder blade. These are small joints and it is much
easier to find the exact location with ultrasound guidance. Moreover, each of
these problems can benefit significantly from accurately administered
injections. Ultrasound guided injections are also commonly used for treating
elbow problems and other difficult joint injections, including the hip.
Are there other advantages to
ultrasound in treating soft tissue problems?
Yes, we can use ultrasound guidance
when drawing fluid from swollen bursa or when aspirating a build-up of blood in
muscles and between tissue plains. Ultrasound imaging guides the physician
right to the pocket of fluid. By extracting fluid in these instances, we can
reduce swelling and promote healing. Sometimes, in these instances, the
physician can identify other existing pathology that can help with diagnosis
Ultrasound-guided injections have
superior accuracy. Patients typically experience less pain and have fewer
complications. Finally, with the benefit pain relief injections provide,
patients tend to recover from their injuries more quickly.
Veigel is board certified in family medicine with additional certification in
sports medicine. He serves on the medical staff of Cayuga Medical Center and is
in practice with Cayuga Sports Medicine and Athletic Performance, where he can
be reached at (607) 252-3580.