Joint Pain Treatments

Dr. Sheldon has extensive training and experience in ultrasound guided injections. Hyaluronic Acid, Platelet Rich Plasma and Cortisone may be injected into joints under ultrasound guidance to confirm accurate needle placement. It is not necessary to perform all joint injections under ultrasound guidance. Dr. Sheldon does ultrasound guided injections of hip joints, glenohumeral joints, ankle joints and under specific circumstances the knee joint.

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Dr. Sheldon has been performing Platelet Rich Plasma (PRP) injections since 2017. PRP is a natural therapy, from your own blood, used to treat joint pain from arthritis, labral tears and meniscus injuries. Platelets are cells in our blood that contain natural healing factors. When we injure ourselves, platelets go to the injury and secrete healing factors which repair damaged tissues and decrease pain. In the office, Platelet Rich Plasma can be obtained from your blood and injected into your joint to provide a large amount of platelets to naturally decrease pain and possibly repair damaged tissues.

Cortisone, Depo-medrol and Kenalog are medications that can be injected into joints or tendon sheaths to decrease pain and inflammation.  They are a type of steroid so you will hear Dr. Sheldon refer to these medications as Steroids. Steroids can be injected into a joint at the same time as Hyaluronic Acid to treat arthritis.

Hyaluronic acid (HA) is a medication that can be injected into arthritic joints to decrease pain and inflammation. Hyaluronic acid is a protein that is in all our joints and it naturally provides lubrication as well as shock absorbency. It has a thick consistency and is often referred to as The Gel Shot or The Lubricant. Hyaluronic Acid can be injected into a joint at the same time as Cortisone (Steroid, Kenalog, DepoMedrol) to treat arthritis.

Patients often experience relief of joint pain for 9-12 months after the injection.

 If you have extended health benefits Hyaluronic Acid may be covered by your insurance plan. 

Dr. Sheldon assesses patients with knee pain by reviewing their history, physical exam, x-rays and other available imaging. She may suggest a non-custom or custom brace for you to decrease pain and increase stability. Sandi, her nurse, is very knowledgeable in bracing and has had brace training in Toronto and Vancouver.

Often patients with knee arthritis have either medial (inside) or lateral (outside) narrowing causing more weight to be put through that side of the knee while walking. If after your assessment, Dr. Sheldon thinks your pain is from this narrowing she may recommend a non-custom or custom brace that applies tension to the side of your knee to open up the narrowing. The xray below shows an example of this narrowing. There is also more information regarding this narrowing on the education page.

Patellofemoral (PF) osteoarthritis affects the patella (kneecap) causing pain at the front of the knee around your kneecap. In the past, we haven't had an effective brace to treat patella arthritis. There is now a very effective brace developed and manufactured in Nova Scotia that can decrease anterior knee pain secondary to kneecap arthritis.

These braces are custom fit to your leg and are often covered by insurance benefits. You can purchase the brace at the clinic where we do the measurements, fitting and future adjustments needed for the bracing.

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