Interventional Injections such as Cortisone, Trigger Point, Prolotherapy, PRP, Botox, Ultrasound Guide, and Ketamine


At Pain Pathway one option is to inject cortisone into joints.  This technique can help relieve pain and inflammation in a specific area of your body. Common joints include:  ankle, elbow, hip, knee, shoulder, spine or wrist. Even the small joints in your hands or feet might benefit from cortisone shots.

Trigger Point Injections

Trigger point injection (TPI) is an option for treating painful areas for some patients. TPI is a procedure used to treat painful areas of muscle that contain knots of muscle that form when muscles do not relax (Trigger Points). Often, these knots can be felt under the skin on patients. Trigger points may irritate the nerves and cause referred pain, or pain that is felt in another part of the body.  By using Trigger Point Injections to relieve the origin of the pain the patient can successfully treat the entire area more effectively .


Prolotherapy can be used as a supplementary treatment for muscle and joint pain. The treatment is accomplished by repeating injections of an irritant sugar solution into the joint's interior or a supporting tendon or ligament. The treatment can trigger cellular responses and potentially remodelling of the pain pathways in the connective tissue of the joint, eventually leading to reduced pain. This process is meant to help repair any damaged soft tissue in your joint or muscle area, like nerves, blood vessels, and muscle tissue.

PRP (Platelet-Rich Plasma Injections)

What is platelet-rich plasma?
Platelet-rich plasma consists of just that, plasma and platelets. Plasma is the liquid portion of the blood and platelets are a type of blood cell that plays a crucial role in healing throughout the body. Platelets are known not only for their clotting abilities, but also for the growth factors that they contain which can help[ trigger cell reproduction and stimulate tissue regeneration or healing. Platelet-rich plasma is just plasma that has a higher than normal level of platelets in it.

Platelet-rich plasma is created by taking a sample of blood from a patient, placing it into a centrifuge device. This device will rapidly spin the sample of blood which will separate the other components of the blood from the platelets and concentrating them within the plasma.

What is a PRP injection?
Once the patient's platelet-rich plasma is created, the solution is injected into the target area. This is used to increase the concentration of the growth factors, which are bioprotiens or hormones, in that specific area in order to speed up the healing process. Many studies show that this increase of the growth factor in the platelet-rich plasma can stimulate or accelerate the healing process, shorten the time that an injury requires to heal as well as decrease the pain.

What are PRP injections used for?
They are used for a range of conditions including musculoskeletal pain and injuries as well as cosmetic procedure. At our clinic we only provide treatment for musculoskeletal pain and injuries.

Tendon, Ligament, Muscle and Joint Injuries
PRP injections can be used to treat a range of musculoskeletal injuries and conditions. For example, tendon injuries such as lateral epicondylitis (tennis elbow's), patellofemoral tendonitis (jumper's knee) or a meniscal tear can often take a long time to heal, or may never fully heal, so adding the PRP injection to the treatment regimen can help stimulate the healing process, decrease the patients pain and allow them to return to their activities sooner than without.

Post-Surgical Healing
PRP initially used to accelerate the healing process after a patient received jaw or plastic surgery. Today, post-surgical PRP injections include healing muscles, tendons and ligaments as many surgical procedures on these tissues require a tremendous amount of healing time.

Early studies have shown that PRP injection can be used to help treat osteoarthritis pain and stiffness. This is done by modulating the joint environment and reducing inflammation. The research on this topic is continuing to grow.

Botox for Migraines

If you have been diagnosed with migraine and get migraine headaches often, you may wonder if there's anything you can do to prevent them. OnabotulinumtoxinA, or Botox, was approved in 2010 for adults who get chronic migraines. That means you have both: A history of migraine headaches and Headaches (including tension-type) on most days (15 or more) of the month that last 4 hours a day or longer. Shots of Botox cut down the total number of days they had them or even other types of headaches. They also had more "crystal-clear" -- pain-free -- days each month, and they reported fewer days off work.

Ultrasound Guided Nerve Blocks

Therapeutic nerve blocks are used to treat painful conditions. Nerve blocks contain local anesthetic that can be used to block pain for specific periods of time to help diagnose, treat conditions while pain free or others reasons.


A hyaluronic acid specifically for tendons and ligaments. For tendon and ligament injuries, pain relief starts with SportVis.  It is an innovative soft tissue injury treatment that offers effective pain relief and return to activity.  It is most commonly used for chronic tennis elbow and acute ankle injuries however has other applications based on need.

Hyaluronic Acid

Hyaluronic acid is often used as an intraarticular injection, commonly known as viscosupplementation, to treat joint pain, particularly in osteoarthritis, by providing lubrication and cushioning to the affected joint.  By mimicking the naturally occurring hyaluronic acid found in joint fluid, these injections can improve mobility and reduce friction in the joint space, thereby alleviating pain and discomfort.  Although not a cure for joint conditions, hyaluronic acid injections can offer significant pain relief for several months at a time for patients who have not responded to other conservative treatments such as physical therapy or medication.