Why Are They Needed?

The foot contains 28 bones and more than 30 joints.  Sometimes it is difficult for both the patient and Mr Gordon to work out where the pain is coming from.  Injections can help relieve pain.  Foot injections therefore serve 2 purposes:

• Diagnostic – To identity where the pain is coming from
• Therapeutic – To relieve pain

Where In The Hospital  Are They Performed?

Some injections are performed in clinic by Mr Gordon.  These are into joints easily accessible with accuracy, for example the ankle and toe joints.  Other joints are harder to identify, for example in the mid foot, so these are performed either under ultrasound guidance by an experienced consultant radiologist (X ray doctor), or in the operating theatre using an X-ray machine for accuracy.

What is the Procedure for Injections Performed in Theatre?

You will come into hospital and have the injection performed in the operating theatre.  You will be awake throughout the procedure, anaesthetic is sometimes used.  This means you will need to tolerate a small needle into the foot.  Most patients manage this well.  It takes approximately 2 minutes.  You will be changed into a gown and will lie on the operating table. Your foot will be cleaned and placed on the X-ray machine and the injection performed by Mr Gordon.

What Will Mr Gordon (using x-ray) or the Radiologist (using ultra sound) Inject?

A mixture of steroid and local anaesthetic will be injected into the joint.  If Mr Gordon performs the injection using x-ray, a die (Omnapaque) is first injected in order to ensure the injection is in the right place.  This die shows up on X-ray and maps out the joint (see x-ray picture). When performed under ultrasound, this die is not needed as the needle is directly visualised with the scanner.

What Happens After the Injection?

A plaster will be placed on the injection site and you will be taken back to the ward or waiting area.  A pain diary will be given to you for you to complete and bring with you to your next consultation with Mr Gordon.  You can go home straight away.

How Will I Feel After the Injection?

The local anaesthetic will produce a numb feeling in the local area for around 6 hours and your pain may disappear.  You may have an aching or swelling type sensation.  The numbness will wear off and your usual pain may return later in the day.  You may not notice a positive effect from the injection until up to a week.

What Will I Be Able To Do After the Injection?

You may drive straight after the injection and go back to work.  For manual workers, you may consider having the rest of the day off, but this is at you discretion, depending on how you feel.

Will I Experience Worsening Pain?

A small group of patients have increase in pain within 24 hours after an injection.  This then settles after 12-24 hours.  If you experience this, ice and elevate the leg and take some anti-inflammatories (if they are safe for you to take).

What Is the Pain Diary For?

This is for you to read and fill in and bring with you to your next appointment with Mr Gordon.  This helps document the success of the injection. It can be found here.

Pain Dairy Foot & Ankle Joint injections

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