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Joint Pain

Joint Pain

Joint Pain Relief

Move freely and live fully. Get back to doing what you love with our expert musculoskeletal injections – perfect for joint, ligament, muscle, and tendon injuries.

BENEFITS

  • Effective long-term pain relief
  • Restores strength and function
  • Improves quality of life
  • Proven safety and efficacy

Treatment Overview

Treatment Overview

Do you suffer from joint pain or stiffness that affects your daily activities? Are you tired of dealing with long waitlists for treatment? Look no further than Anti-Aging Medical and Laser Clinic.

We offer the latest and most advanced injection treatments in the field of sports medicine and rehabilitation, including Prolotherapy, Platelet-Rich Plasma (PRP), SportVis (Hyaluronic Acid (HA)), and Cingal (Hyaluronic Acid + Cortisone) injections. These treatments are administered with ultrasound guidance by our experienced and trained Sports Medicine Physician, Dr. Teri Fisher, to ensure precise and accurate delivery of the injectable solutions. Our treatments can effectively reduce joint pain and improve mobility in patients suffering from a variety of conditions.

If you are experiencing joint pain or discomfort, you may want to consider these treatment options to see if they are suitable for your needs.

Musculoskeletal injections are commonly used to treat joint, tendon, ligament, and muscle pain, and Dr. Fisher uses several different types of injections depending on the specific condition being treated. Hyaluronic acid injections are used to treat ligaments, tendons, and joints and involve injecting a gel-like substance directly into the area to lubricate, cushion, and promote healing. Platelet-rich plasma (PRP) injections use your own blood to deliver a concentrated dose of growth factors to the injured area, promoting healing. Prolotherapy involves the injection of a solution of dextrose to stimulate tissue repair and strengthen the injured area. Cortisone (in combination with hyaluronic acid) injections are used to reduce joint inflammation and pain, and are often used for conditions such as arthritis. While all of these injections can be effective for treating musculoskeletal pain, the specific type of injection used will depend on Dr. Fisher’s consultation and recommendations.

 

 

What to expect

What to expect

Planning Your Treatment

Patients are encouraged to self-refer (i.e. a referral from your family doctor is NOT required). However, you should be assessed initially by a GP and have a provisional diagnosis. Also, x-rays are required prior to the consultation with Dr. Fisher. The purpose of the consultation with Dr. Fisher is to determine if private therapeutic injections would be appropriate for you (not to diagnose the condition).

Once you have a provisional diagnosis and xrays, we will schedule a consultation with Dr. Fisher, where he will review your history, do a focused sports medicine physical exam, review your imaging, discuss your diagnosis, outline the pros and cons of the various injections, and recommend the most appropriate injection therapy based on your individual needs and preferences. Please be sure to bring any imaging reports that you have (e.g. x-rays, ultrasounds, MRI, MRA, CT scans) to the consultation. Depending on your specific situation, Dr. Fisher will either perform the ultrasound-guided injection at that time, or we will schedule a future appointment for the injection (and for subsequent injections, if necessary).

 

Before the Treatment

Depending on the specific injection therapy selected for you, Dr. Fisher may advise you to stop taking certain medications or supplements prior to the procedure (e.g.  such as blood thinners or anti-inflammatories). You should wear loose, comfortable clothing that allows easy access to the injection site, such as shorts for lower extremity concerns or a tank top or sports bra (for women) for upper extremity concerns.


During the Treatment

You will be placed in a comfortable position while the affected area is cleaned. Local anaesthetic will be provided if necessary. Dr. Fisher will then use the ultrasound machine to guide the needle to the correct location, ensuring accurate placement of the injection. The injection itself typically takes only a few minutes, after which the needle is removed and a small bandage is applied to the site.

All of our musculoskeletal injection techniques are done by Dr Fisher using ultrasound to guide to location of the injections. There are many advantages of using ultrasound to guide therapeutic injections:


Ultrasound Guided
  1. Increased Accuracy: Ultrasound allows Dr Fisher to have real-time visualization of the targeted area, which helps ensure accurate needle placement. This means that the injectable solution is more likely to be delivered precisely where it is needed, improving the effectiveness of the injection.

  2. Reduced Pain: When injections are given blindly, there is a risk of hitting nerves or other sensitive structures, which can cause pain. Ultrasound-guided injections can help reduce pain by allowing Dr. Fisher to avoid these sensitive areas.

  3. Improved Safety: Ultrasound-guided injections are generally considered safer than blind injections because Dr. Fisher can visualize the needle as it is inserted and ensure that it is placed in the correct location.

  4. Increased Patient Satisfaction: Patients who receive ultrasound-guided injections often report higher levels of satisfaction because the procedure is less painful and more effective.

After the Treatment

Dr. Fisher may advise you to rest the affected area and avoid strenuous activity for a certain period of time. You may also be advised to avoid certain medications for a specific length of time. Dr. Fisher will review your specific post-injection recommendations to ensure optimal results.

 


Recovery

Recovery from a therapeutic injection for musculoskeletal pain can vary depending on the type of injection and your individual response. In general, you may experience some mild discomfort or swelling at the injection site for a few days after the procedure. For some types of injections, such as hyaluronic acid or PRP, it may take several weeks and/or multiple injections to see the full benefits of the treatment. Prolotherapy typically involves a series of injections over several weeks or months, with gradual improvement in symptoms over time. 

How it works

How it works

Therapeutic injections for musculoskeletal pain work by delivering medication or other substances directly to the affected area, promoting healing and reducing inflammation and pain. Hyaluronic acid injections provide lubrication and cushioning to tendons, ligaments, and arthritic joints. Platelet-rich plasma (PRP) injections involve using your own blood to create a concentrated solution of growth factors and other healing substances, which are then injected into the affected area to promote tissue regeneration. Prolotherapy involves injecting a solution of dextrose to stimulate the growth of new tissue and strengthen ligaments and tendons. The specific mechanism of action for each type of injection may vary, but they all work by targeting the underlying cause of musculoskeletal pain to promote healing and improve function.

Maintenance

Maintenance

Recommended number of sessions and maintenance: 

Cingal (Hyaluronic Acid + Cortisone):
1 injection every 12-18 months, as needed

SportVis (Hyaluronic Acid):
2 injections, 1 week apart

PRP (Platelet-Rich Plasma):
1-3 injections, 2-4 weeks apart

Prolotherapy (Dextrose):
3-8 injections, 2-4 weeks apart

Pricing

Pricing

How much does this treatment cost?

The consultation fee is $550.

It’s important to note that before any treatment is given, Dr. Fisher conducts a thorough assessment of the patient’s condition to determine the most appropriate course of action. The cost for this assessment is $550. If you are interested in any of the treatments offered by Dr. Fisher, it is recommended to schedule a consultation and assessment to discuss your options and determine the best approach for your individual needs.

Cingal (Hyaluronic Acid + Cortisone):  $900 per treatment

SportVis (Hyaluronic Acid):  $1800 for 2 treatments

PRP (Platelet-Rich Plasma):  $1000 per treatment

Prolotherapy (Dextrose): $500 per treatment; $1900 for 4 treatments; $2700 for 6 treatments

Treatable Areas

Musculoskeletal (MSK) injections can be administered to alleviate pain and inflammation in the ligaments, tendons, and joints of various body parts such as the shoulder, elbow, wrist, hands, ankles, and feet. While a GP referral is not necessary, patients are expected to have undergone medical evaluation and diagnosis beforehand. 

Please note:  X-rays must be taken before consulting with Anti-Aging, and additional imaging tests such as ultrasound, MRI, or MRA may also required. We do NOT treat neck, back and hip conditions.

RESULTS

The results of musculoskeletal injections can vary depending on the individual patient and the specific condition being treated. In general, patients may experience a reduction in pain, swelling, and inflammation in the affected area. The injections can also improve mobility and range of motion in the joint or affected area, allowing patients to perform daily activities with less discomfort.

All treatments are administered by Dr. Teri Fisher, who is a highly skilled and experienced aesthetic and sports medicine physician. All MSK injections are conducted under ultrasound guidance, enabling precise targeting of the treatment area for increased injection accuracy and efficacy.

To learn more about Dr. Teri Fisher, click here.

Assessment Process

Steps to take if diagnosis or x-rays are not available


Please see your family doctor or make an appointment at Old Orchard Medical Clinic
 for an initial assessment/diagnosis and to get x-rays done. Please have your x-rays (and other imaging studies) done at one of the local hospitals or at one of the West Coast Medical Imaging locations. This will ensure that we will be able to access your x-rays online when you come to our clinic.

The closest West Coast Medical Imaging clinic to our clinic is the Arbutus location at:

2184 West Broadway, Unit #390
Vancouver, BC V6K 2E1
Phone: 604-731-2200

 

Requirements for patients with prior diagnosis and x-rays


If you possess prior imaging reports, kindly get in touch with us to book your personal musculoskeletal injection evaluation with Dr. Fisher. Please be sure to bring any imaging reports that you have (e.g. x-rays, ultrasounds, MRI, MRA, CT scans), particularly if they were not done at one of the locations listed above.

At the consultation, Dr. Fisher will review your history, do a focused sports medicine physical exam, review your imaging, discuss your diagnosis, outline the pros and cons of the various injections, and make a recommendation of the type of injections that would be the most appropriate for your condition.

Depending on your specific situation, Dr. Fisher will either go ahead and perform the ultrasound-guided injection at that time, or we will schedule a future appointment for the injection (and for subsequent injections, if necessary).

A follow-up appointment (included in the injection fee) will be scheduled approximately 2 weeks after your final injection.

Begin Intake Questionnaire

Frequently asked questions

Have Questions?
Call Us
(604) 261-9121
What prerequisites must be met prior to undergoing this treatment?
At Anti-Aging, patients are encouraged to self-refer, which means that a GP referral is not necessary. However, it’s important to note that patients should have already been assessed by a physician and have received a diagnosis before seeking treatment at Anti-Aging.

Additionally, before the consultation, patients are required to have X-rays taken, and in some cases, an ultrasound, MRI, or MRA may also be necessary. This is important for the medical team at Anti-Aging to get a clear understanding of the patient’s condition and to determine the most effective course of treatment.
Who is excluded from musculoskeletal injections?
Our clinic has established exclusion criteria to ensure the safety and effectiveness of our treatments. The following factors are taken into consideration when determining a patient’s eligibility for treatment:

– Pregnant or breastfeeding women due to safety concerns.
– Patients with active cancer are excluded due to potential risks and complications.
– Patients with neck, back, or hip pain and chronic pain syndromes.
– Patients who have undergone surgery to the affected area within one month before or after consultation as treatment may interfere with the recovery process.

It is important for patients to be aware of these criteria when seeking treatment and to disclose any relevant medical information to the medical team during the consultation.
To what extent do musculoskeletal injections (MSK) alleviate pain?
Dr. Fisher’s injections, including MSK injections, SportVis injections, Cingal injections, Prolotherapy injections, and PRP injections, are performed under ultrasound guidance. This means that the injection is precisely targeted to the area of the body that requires treatment, which can increase the accuracy and effectiveness of the injection.

Typically, individuals exhibit positive reactions to the treatment, witnessing a decrease in pain, swelling, and inflammation in the impacted region. Moreover, the injections may enhance joint movement and mobility, enabling patients to carry out everyday tasks with less discomfort. Dr. Fisher’s use of ultrasound guidance helps to ensure that the injections are safe and minimizes the risk of complications.
How many prolotherapy treatments are needed?
The number and frequency of treatment sessions depends on the diagnosis and severity of the pain and/or injury. The usual frequency of treatment sessions is every two to four weeks. The total number of treatments is usually between 3 and 8 treatment sessions.
How many PRP treatments do I need?
The number and frequency of PRP treatment sessions depends on the diagnosis and severity of the pain and/or injury. For maximum results, you may require an additional 1-2 injections after the initial procedure. Follow up PRP treatments can be done 2-4 weeks after the previous procedure.
How soon can I expect pain relief after PRP?
It is normal to experience soreness and tenderness in the injected area for a few days, and some swelling may persist for up to a week. However, over the course of two weeks, joint mobility and comfort should gradually improve.
What medications should I avoid before PRP and prolotherapy?
Anti-inflammatory medications can decrease the efficacy of these treatments. Therefore, do NOT use any steroidal or nonsteroidal anti-inflammatory drugs for 2 weeks prior to the treatment and for 2 weeks after your treatment.

Anti-inflammatory drugs to AVOID include:
– Steroidal anti-inflammatory drugs: e.g. cortisone and prednisone
– Nonsteroidal anti-inflammatory (NSAID) drugs: e.g. Advil/Motrin (ibuprofen)
– Aleve (naproxen)
– Aspirin (ASA)
– Celebrex (celecoxib)
– Voltaren (diclofenac), or any other NSAID.
– Other supplements with anti-inflammatory properties: e.g. boswellia, white willow, curcumin/turmeric, or Omega-3 fish oils.
What are contraindications for PRP?
There are a number of situations where PRP may not be appropriate (i.e. contraindications). These include the following: 

– Active infection at the injection site or in the body.
– Certain skin conditions, such as eczema or psoriasis.
– Allergy to any of the substances used in the prolotherapy treatment.
– Certain blood disorders, such as bleeding or clotting problems.
– Pregnancy or nursing.
– Pre-existing medical conditions (e.g. diabetes, heart disease) may pose a higher risk of complications.
What are the possible risks associated with PRP?
The possible risks or complications of PRP include:

– Minimal or no effect from the treatment.
– Local bruising and/or bleeding at the injection site. 
– Minor aching at the injection site.
– Immediate pain at the injection site and/or post-therapeutic pain flare, lasting up to 3-4 days or more. Occasionally this may be severe, however it usually lasts only 4–24 hours and is treated with Tylenol or other analgesia (NOT anti-inflammatories).
– Allergic reaction to any of the substances used during the procedure, such as the dressing, local anaesthetic or antiseptic.
– Dizziness or fainting.
– Infection. Infections take at least a day or two to manifest. If you develop fever, chills, redness or heat in the injected area after 48 hours, go to Urgent Care/ER urgently. 
Temporary or permanent muscle, nerve, or other tissue injury (extremely rare). 
What are contraindications for prolotherapy?
There are a number of situations where prolotherapy may not be appropriate (i.e. contraindications). These include the following: 

– Active infection at the injection site or in the body.
– Certain skin conditions, such as eczema or psoriasis.
– Allergy to any of the substances used in the prolotherapy treatment.
– Certain blood disorders, such as bleeding or clotting problems.
– Pregnancy or nursing.
– Pre-existing medical conditions (e.g. diabetes, heart disease) may pose a higher risk of complications.
What are the possible risks associated with prolotherapy?
The possible risks or complications of prolotherapy include:

– Minimal or no effect from the treatment.
– Local bruising and/or bleeding at the injection site. 
– Minor aching at the injection site.
– Immediate pain at the injection site and/or post-therapeutic pain flare, lasting up to 3-4 days or more. Occasionally this may be severe, however it usually lasts only 4–24 hours and is treated with Tylenol or other analgesia (NOT anti-inflammatories).
– Allergic reaction to any of the substances used during the procedure, such as the injection, dressing, local anesthetic or antiseptic.
– Dizziness or fainting.
– Infection. Infections take at least a day or two to manifest. If you develop fever, chills, redness or heat in the injected area after 48 hours, go to Urgent Care/ER urgently. 
Temporary or permanent muscle, nerve, or other tissue injury (extremely rare). 
Are there any restrictions after PRP and prolotherapy?
To ensure optimal recovery after the injection, it is recommended to follow these guidelines:

– Refrain from applying ice or heat to the injection site for the first three days.
– If you wish to take a hot shower or bath, limit the duration to less than 10 minutes.
– Do not use lotions, oils, or makeup on the injection site for six hours.
– It is advisable to abstain from smoking or drinking alcohol for at least three days after the procedure.

Rest for 3 days after injection but do not immobilize the treated joint. Gentle movement and stretching are important for healing ligaments and tendons. It’s always important to use pain as a guide for the appropriate level of activity. If you do experience pain, you may take analgesic medication that is not an anti-inflammatory, such as over-the-counter options like Tylenol.