Injection therapies for soft-tissue lesions

Local injection therapies, used in the management of a variety of musculoskeletal pain syndromes, include the local infiltration of substances such as corticosteroid, anaesthetic, sclerosants and botulinum toxin, as well as dry needling alone and neural blockade. In this chapter, a number of injection therapies for soft-tissue-mediated pain are described. The reasoning for their use, potential mechanisms of action and unwanted effects are discussed. The literature relating to their effects is critically reviewed. Practical suggestions for their utilisation in the management of soft-tissue conditions are given and proposals are made for future research in this important area.

Key words: botulinum, corticosteroid, injectate, injection, myofascial, nerve block, pain, soft tissue, tendon, ultrasound