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For common side effects and complications as well as for private visit pricing please check the separate categories to the below FAQ.

  • Do I need a referral from my family doctor?
    We accept referrals but we are open to public without referral as well, including American patients. Patients can book their appointment online or call us for appointment without referral.
  • What substances do you inject?
    We most commonly inject cortisosteroids (often called "cortisone") or hyaluronic acid. We actually use a mix of lidocaine with methyprednisolone or lidocaine with triamcinolone (Kenalog). With our synthetic hyaluronic acid we tend to use lidocaine as well. For trigger point injections we use lidocaine or saline. For alternative and complementary medicine prolotherapy we use dextrose with lidocaine and biologicals plasma preparations as well.
  • Can a steroid or hyaluronic acid injection heal or repair my joint?
    Injections with corticosteroids ("cortisone") or hyaluronic acid are unfortunately not repairing or healing joints. They are used for symptomatic improvement only. These substances are calming down the joint inflammation and cushioning it to some extent, serving more as a pain killer injected directly to the site that hurts.
  • What is the difference between cortisone and hyaluronic acid?
    Corticosteroid ("cortisone") and hyaluronic acid injections work quite differently. Overall their efficacy is rather comparable. Hyaluronic acid works may sometimes work better than cortisone and steroids, or may work when cortisone not working. Hyaluronic acid tends to help pain for longer than cortisone - for approximately 6 months. Unlike corticosteroids, hyaluronic acid does not thin of ligaments and joint surfaces in the long run.
  • What are the chances your injections would work?
    There is no guarantee that injections will for everyone, nor that injections will work again to the same degree as previously. The chances that our injections will work for arthritis pain is typically around 75%. We assume significant noticeable improvement as our goal, not 100% improvement to being completely pain free. Factors affecting the chances for success include arthritis advancement (more advanced arthritis means less chances for success), presence of other injuries, functional status and age.
  • How long will the injection work for?
    We can generally say that on average steroid injections help pain for 2-3 months, while hyaluronic acid (viscossupplementation) we use tends to help pain for approximately 6 months.
  • How frequently can I repeat my injection?
    For cortisone injections we recommend to repeat not more frequently than in 3-4 months, for hyaluronic acid injections (viscosupplementation) we recommend to repeat when pain control effects wearing out at any time.
  • Do you perform ultrasound guided injections?
    Yes, we perform ultrasound guided injections which are OHIP covered if indicated. Ultrasound guided injections tend to be more precise and less painful.
  • Do you perform epidural injections and facet joint injections?
    We do not perform epidural injections, facet joint injections nor peripheral nerve blocks.
  • Is the clinic physician a specialist holding a FHO exemption?
    The joint injection clinic doctor is a family physician with special interest in the field of sports medicine. We hold a focused practice designation and referring FHO physicians will not be negated for outside use bonus
  • How painful are the injections?
    With proper technique joint injections are not painful. Injections tend to be slightly more unpleasant within palm of hand and sole foot but overall patients report discomfort around 1-2 out of 10, comparable to a routine venous blood draw in a laboratory.
  • What are the cortisone injections side effects?
    Most common complication is a steroid flare-up - subjective sensation of worsening of pain in first 2-3 days after injection. The intensity of discomfort is mild to moderate and goes away on its own. Patient may use over the counter anti-inflammatory medications and joint icing for discomfort. Risk for this complication is approximately 20-30%. Most serious complication is a severe joint infection called septic arthritis - which presents as severe pain, redness, warmth to joint with fever and requires urgent intervention or emergency room visit. Risk for septic arthritis with proper injection technique is extremely low, in the range of a fraction of a percent. Long term complication after multiple and repetitive steroid injections is thinning of ligaments and joint surfaces.
  • What are the hyaluronic acid injections side effects?
    Overall the hyaluronic acid we utilize is completely synthetic and poses no risk for biological reaction like some animal derived hyaluronic acid products. Most common complication is slight discomfort at time of procedure. Most serious complication is a severe joint infection called septic arthritis - which presents as severe pain, redness, warmth to joint with fever and requires urgent intervention or emergency room visit. Risk for septic arthritis with proper injection technique is extremely low.
  • What to do for pain or a side effect after injection?
    If you are experiencing more pain after injection but there is no fever, no redness or warmth to joint and the pain is not extreme - we recommend to use over the counter anti-inflammatories or acetaminophen, icing and rest. This is likely a steroid flare-up which resolves in 2-3 days followed by improvement. If you are experiencing extreme pain, joint warmth with new onset redness and fever we advise to go to emergency room since these can be signs of septic arthritis - a severe joint infection. If in doubt you can give us a call at 226-605-6060.
  • How do you prevent complications?
    To prevent joint infection we use sterile technique of injections. Before procedure the skin is prepped (sterilized) with a sequence antiseptic solutions. Afterwards only sterile needle has contact with the sterile skin at moment of injection. To minimize injection pain we use a good injection technique with appropriate landmarks which does not require any additional anesthesia.
  • What is the cost for patients from USA?
    We welcome patients from USA and we serve increasing amount of American patients since our competitive pricing and short distance from Detroit. Cost of each private consultation or each visit is 150 CAD. Cost of injection is an additional 50 CAD for each syringe with cortisone, and additional 500 CAD for each syringe of viscosupplementation. Cost of ultrasound guidance is 150 CAD for each joint injected in addition to visit fee and cost of substance injected.
  • Is the injection and visit covered by OHIP?
    For insured Canadians the visit and consultation is covered by OHIP and is free of charge. We charge a fee if our own medications use is requested to replenish our stores. For international or uninsured patients the cost of private visit is 150 dollars plus additional cost of medications (50 dollars for each syringe with cortisone, 500 dollars for each syringe with viscosupplementation). Biological injections costs 950 dollars.
  • Do I pay for anything at time of visit? What are your fees?
    Consultation for OHIP insured patients is free of charge. Corticosteroid mix fee can be applied if interested to have our cortisone used. Visits and consultation for OHIP non-insured patients is $150 each time in addition to the cost of substances injected.
  • I have additional coverage - do you accept my insurance plan?
    We have many patients who present with additional insurance coverage. At that time of visit we will charge patients our fees and give patients a receipt so they can arrange for reimbursement, it would be up to the patient to arrange for that. We can provide exact medications details if needed. We cannot guarantee the amount being reimbursed nor we help with insurance arrangements and communication.
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