Ultrasound in the Treatment of Soft Tissue Injuries

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.

 

What is ultrasound?

 

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-guided injections?

 

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 and treatment.

 

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.

 

Dr. 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.