Ultrasound-guided injections

Ultrasound lets us see the target tissue in real time — tendon, ligament, bursa, joint or nerve — and guide the needle with precision. This is not surgery. It is indicated only after a medical evaluation.

What it is

An ultrasound-guided injection is a minimally invasive procedure: a medication or therapeutic solution is placed at a specific anatomic point under live ultrasound.

In Dr. Ortiz’s practice it is part of MSK intervention and of regenerative protocols (prolotherapy, viscosupplementation, growth factors or other solutions, depending on the case).

The clinical goal is not “to give a shot”. It is to place the stimulus or the drug where the tissue needs it, with as little trauma as possible to nearby structures.

Why ultrasound

Without imaging, an injection is guided by surface landmarks. With ultrasound:

• The target tissue is identified (for example, an enthesis, a bursa or the joint recess).
• Vessels, nerves and planes that should not be punctured are avoided whenever possible.
• The treated point is documented and can be correlated with the clinical findings.

Training in MSK ultrasound of the upper and lower limbs (Sonoskills) is part of the background for this work.

When it may be considered

After history, examination and, when needed, imaging. Common examples in the consultation:

• Knee, shoulder or hip joint pain
• Tendinopathy, bursitis and plantar fasciitis
• Ligament injuries and instability
• Low back, neck or transitional pain with a mechanical component
• Radiculopathy or referred pain in selected patients
• Osteoarthritis and wear in which a regenerative or viscosupplementation protocol is considered

Each indication depends on the diagnosis, not on an isolated symptom.

How it is done

Local anesthetic is used to reduce discomfort. You may still feel pressure, contact or mild discomfort. Details are in the FAQ.

Related procedures

Ultrasound guidance is not a separate treatment: it is how other procedures in the practice are applied.

• Prolotherapy
• Viscosupplementation
• Knee pain
• Spine pain

Before and after

Before the procedure, let us know which medications you take (especially blood thinners), and whether you have a bleeding disorder or allergies.

Afterward, the most important thing is not to overload the joint: too much effort can irritate the treated area and slow recovery.

• Rest for the first 24–48 hours. Avoid demanding activities and repetitive movements.
• Stay active, but in moderation: light activities such as easy walking, as tolerated.
• Avoid overloading the area: lifting weights, strength training, running, jumping or impact, going up and down stairs too much, standing or squatting for long periods, high-impact sports, and twisting or sudden movements.
• Apply ice locally for 15–20 minutes, 2–3 times a day during the first 2–3 days.
• You can take acetaminophen (paracetamol) if you need it. Anti-inflammatories are not recommended unless a doctor indicates them.
• Drink enough water during the day.
• After the first few days, gentle stretching as your doctor indicates, and, if there is no pain, a stationary bike at an easy pace, swimming, and light mobility and balance exercises.

A mild inflammation or discomfort is normal. Every body is different and recovery times vary. If fever, redness, significant warmth or swelling appear, or severe pain that gets worse as the days go by, seek medical attention right away.

In short, in an infographic by Dr. Lizeth Ortiz:

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What this procedure does not promise

Results vary. Not everyone is a candidate. Guiding with ultrasound improves the precision of the procedure. It does not guarantee relief and does not always replace surgery, rehabilitation or management of the underlying condition. Expectations, risks and alternatives are reviewed in the consultation.

Frequently asked questions

See all questions