From Our Experts  |  March 11, 2017  |  Russell (Rusty) C. Wilson, MD

Answers to Your Joint Pain Questions


Joint pain can affect people regardless of age or activity level. Dr. Rusty Wilson is a specialty trained musculoskeletal radiologist and the Co-Director of the Orthopedic and Sport Imaging section at Wake Radiology. Today, he’s addressing common questions related to joint pain and when you should talk with your doctor about how imaging can help your diagnosis and treatment.

What are some common causes of joint pain?

Joint pain can result from a number of different conditions. Some individuals may experience pain due to sports-related injuries, overuse and trauma. However, others may be a consequence of chronic conditions, including degenerative joint disease and osteoarthritis or inflammatory conditions, like rheumatoid arthritis.

What can be done for joint pain?

There are actually a lot of tools to treat joint pain. Some are simple like rest, ice and anti-inflammatory medications. Physical or occupational therapy may be prescribed for more acute pains while joint injections – where medication is delivered right to the center of the pain – can help ease protracted pain, such as arthritis. Patients should discuss their symptoms with their primary care doctor to development a care plan. That’s the doctor who can help decide and order a joint injection as part of their treatment.

How does image guidance improve the effectiveness of joint injection?

Without imaging guidance, injections are solely based on a doctor’s knowledge of anatomy. For some joints, such as the knee, this may be fine. However, for other joins that may be deeper, more narrow, smaller or degenerated, imaging guidance becomes very important.

With imaging guidance, we can accurately confirm that the injection is truly in the joint. Being able to “see inside” also helps the doctor easily adjust the course of the needle during the procedure so that it can be as swift and effective as possible. If a physician is just relying only on anatomy without imaging guidance, they’re ultimately relying on the sensation that we call “loss of resistance” when the needle enters the joint. Performing a joint injection this way often requires a larger needle. With imaging guidance, the reliance on that sensation is no longer necessary and we can use a smaller needle which is more comfortable for the patient.

What can the patient expect after the procedure?

We use a combination of medications so a patient often has immediate pain relief from the fast, but short acting, numbing medicine/anesthetic. When this wears off after several hours, the patient may experience mild soreness for a day or two. What the patient is then waiting to experience is the more substantial and longer acting pain relief achieved when the injected steroid “kicks in”, which typically takes about two – four days.

How often can you inject joints?

For certain injections, such as acute injuries or inflammatory conditions, a single, well-placed injection may do away with symptoms all together. For more chronic conditions, like arthritis, the disease is not being cured, only the symptoms are being treated and managed so injections are more focused on helping to relieve pain so the patient can enjoy a better quality of life. Typically, one injection helps with pain relief for three-four months. If needed, an individual could potentially receive 3-4 injections per year.

What other pain management procedures does Wake Radiology offer?

Wake Radiology has many ways to help with joint pain. Fluoroscopy, ultrasound and CT are all different kinds of imaging guidance that can be used for different procedures, including (but not limited to):

  • Arthritis
  • Bursitis
  • Tendon Sheath injection
  • Cyst drainage
  • Calcific tendinitis
  • Spine procedures

We recommend that all patients who are experiencing joint pain talk with their doctor to see if an image guided injection could help alleviate their symptoms. We perform joint injections at multiple offices throughout the Triangle so it’s likely we could assist a patient and their provider in achieving relief quickly. You can learn more about joint injections and our orthopedic and sports imaging services by visiting the orthopedic/sports section at

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