Using various cutting edge injection therapies and techniques, we provide non-surgical approaches and procedures to assist in the healing of certain musculoskeletal (MSK) ailments. Your body has the power to heal itself of many problems and we encourage this process conservatively and try to avoid surgical intervention.

We provide these services with advanced ultrasound technology to eliminate the guess work associated with traditional "blind" injections and therapy.  Dr. Miles was one of the first doctors in the state of Georgia credentialed in musculoskeletal ultrasound by the ARDMS and formally Registered in Musculoskeletal Sonography (RMSK.)  In addition to therapeutic interventions, MSK ultrasound offers certain diagnostic capabilities that cannot be seen with X-ray, CT, or MRI.

Dr. Miles was tutored by orthopedists and sports medicine physicians in the art and science of joint and tendon injections and has been performing these injections for over a decade. He is also experienced and trained in the newer procedures and techniques. Recent advances in musculoskeletal ultrasound imaging have made the procedures vastly more accurate and easy to provide in a comfortable office setting. This setting avoids exorbitant costs of surgery centers and operating suites.

Some of the injection therapies include: 

-  Anti-inflammatory Corticosteroids (aka cortisone injections, the most common injection we do) 

-  Platelet Rich Plasma (PRP, a form of prolotherapy but using your own concentrated growth factors for healing and repair) (read more about PRP)

-  Tendon Needle Fenestration (increases your own blood vessel growth and healing) (sometimes considered a form of Dry Needling)

-  Trigger Point Injections (injections of anesthetic into chronic, painful, tight bands of muscle tissue)

Each therapy is used for different types of healing, inflammation, or pain control. We use many of the same advanced procedures professional and other elite athletes seek out to optimize their healing rates and extend their careers.

Specific joints we inject include the: shoulder, elbow, wrist, hand, fingers, hip, knee, ankle, foot, toes, as well as the sacroiliac joint (SI joint.) At this time we are not injecting the spine.

Some of the various syndromes we treat include Rotator Cuff Syndromes, Lateral Epicondylitis (tennis elbow,) Medial Epicondylitis (golfer's elbow,) DeQuervain's tenosynovitis, Greater Trochanteric Bursitis, SI Joint Pain Syndrome, Piriformis Syndrome, Plantar Fasciitis, Carpal Tunnel Syndrome, and many various other Tendinitis and Bursitis and Arthritis conditions.

Some of the conditions we treat:

Tendinitis (tendonitis) and Tendinosis 
Exciting advances have been made in the conservative treatment of painful tendons. Both of these conditions have similar symptoms but vary in the pathophysiology seen, whether microscopically or with ultrasound or at surgery. The treatments can also be quite different. Tendinitis where there is actual inflammation present can respond very well to anti-inflammatory steroid injections. But tendinosis responds better to PRP, autologous blood, and tendon fenestration. The key with the success with all of these procedures is the patient's cooperation with rehab of the tendon. This can be with a well trained Physical Therapist or at home by a truly self motivated patient. 

Osteoarthritis
Osteoarthritis (OA) is a degenerative, "wear and tear" type of arthritis. Corticosteroid injections can help with pain but do not repair or slow the progression of the joint damage. Hyaluronic acid derivative injections also help with the pain and may act as a viscous lubricant for the joint. While PRP injections are not a traditional treatment for OA, there is some newer evidence that they help with pain and may delay further breakdown of the joint and its cartilage. For many OA joints this is an exciting area of research that shows promise for the future. Traditional prolotherapy is another treatment modality often effective and especially true for knee OA.

Muscle, ligament and tendon injuries 
Sprains and strains of these structures can lead to dysfunction and pain. Proper rest, rehabilitation, and sometimes certain injection therapies can help to heal the injured body. PRP has shown to increase healing rates and decrease healing times. Many professional athletes in basketball, football, baseball, tennis, and other sports have had PRP treatments and made the news with incredible healing times and rapid returns to their respective sports. 

Inflammatory Arthritis 
Types of inflammatory arthritis include Rheumatoid Arthritis, Gout, Psoriatic Arthritis, Lupus, Ankylosing Spondylitis, and others. The condition that causes the joints to flare needs to be controlled. But despite good treatment many patients will have joints periodically swell and become very painful. Occasional injections of corticosteroids are quite good at relieving the pain and inflammation associated with flares. These injections are usually easy to perform under ultrasound guidance.

Depending on the type of procedure you need we may be able to perform the procedure on the same day. We may instead have to set you up for a separate procedure time or have you complete further evaluation steps first.