Ultrasound-guided Injection Therapies

9 min episode
Ultrasound-guided joint injections are a safe, non-invasive approach to treating pain, inflammation and impaired mobility. We spoke to Dr Alex Del Duca to learn more about this emerging technology.

Ultrasound is frequently used to identify injuries or abnormalities; it is also used when performing injections into the knee, shoulder, and hip. Today we are talking to the Editor, Dr Philip Rouchotas, and contributor Dr Alex Del Duca about his recent article in the Journal concerning ultrasound-guided injection therapies for pain management.

In this program, Dr DeLuca describes what these procedures entail, what the advantages are, and where they can be applied.

The Canadian Journal of Naturopathic Medicine is available online as a peer-reviewed publication for naturopathic doctors.

Read the latest issue here

Key Take-Aways

What are ultrasound-guided injections for pain management?
Ultrasound-guided joint injections are a safe, non-invasive approach to treating pain, inflammation, and impaired mobility that can be performed in the doctor's office.

Examples include using injectable hyaluronic acid for osteoarthritis. Corticosteroids are sometimes warranted when patients are going through physiotherapy, for example, where they hit a roadblock and they need additional relief.

Sometimes regenerative tissue strengthening injections are used as well, like platelet-rich plasma.

Where can these practices be used?
Not all jurisdictions allow these procedures to be performed, or even the use of ultrasound in clinics. It is Dr Del Duca’s position that more health professionals ought to be using ultrasound and more jurisdictions should support the use of injection therapy as an alternative to pain interventions.

Therefore, the purpose of this article is to look at the landscape of injection therapy for naturopathic physicians across North America.

Advantages of ultrasound-guided injections
Performing a traditional landmark-guided injection is essentially an educated guess. You follow a procedure and hope you achieve a good result.

However, with the advancement of this technology, ultrasound machines have become smaller and more portable. This has allowed treating clinicians to be able to use real-time, point-of-care ultrasound, to assist in the diagnosis and treatment of their patients with ultrasound-guided injections.

This not only leads to better results but requires smaller doses.

Improved success rate
Ultrasound-guided injections are not only safer than landmark-guided injections but also improve the odds of a successful outcome. For example, landmark-guided procedures will fail approximately one in five times. With ultrasound-guided injections, there is about a one in 20 chance that it will fail to make it into the joint.

Jurisdictions that allow ultrasound-guided injections
The article identifies and tabulates the jurisdictions that allow the use of intramuscular injections and the use of ultrasound, as well as describing what kind of training is needed to facilitate these procedures.

The overall goal is to form a framework for North American practitioners to enable the advancement of this practice.

Key Quote

“All of these injections have a time and place in pathology. It really depends on the patient's history, the subacute nature, the chronic nature of the injury, and really what treatments they've had in the past and what they've done before.” Dr Alex DeLuca


The opinions expressed in this Nutramedica program are those of the guests and contributors. They do not necessarily reflect the opinions of Nutritional Fundamentals For Health Inc.

This video is intended for licensed or registered health professionals and students of health professions only. These statements have not been evaluated by the Food and Drug Administration. Information contained in these programs is not intended to diagnose, treat, cure, or prevent any disease.