Ultrasound Guided Steroid Injection Service

The ultrasound guided injection service at ARC Physiotherapy, in partnership with Complete injections, has been specifically developed for patients to gain fast acting pain relief that targets the cause of your pain.


If you are struggling with basic daily tasks, leisure activities, looking after the kids, or sleeping and your pain is not improving an ultrasound guided steroid injection may be of use. 

What is an ultrasound guided injection?

An ultrasound guided injection is a highly accurate and effective method of delivering the pain-relieving product directly to where it is needed.  An ultrasound machine is used to visualise the injured tissue and a needle is then ‘guided’, in real time, to the target.

 There are a few different treatment options available, all of which have been proven to be effective at reducing pain.

 1.  Corticosteroid – a corticosteroid is a strong, fast-acting, anti-inflammatory medication which has been used for decades to effectively treat musculoskeletal pain. Corticosteroids are often mixed with a short-acting anaesthetic, ensuring a comfortable experience.

 2. Hyaluronic acid – hyaluronic acid replicates a joint’s natural lubrication and has been shown to provide significant pain relief and protect arthritic joints.  It can take a few weeks to start working and in some cases this medication can be mixed with the faster acting corticosteroid medication.  This treatment option can be used on a yearly basis to help preserve joints without causing any harm to the body and so can be extremely useful for active patients who wish to prolong activities and delay joint replacement surgery. Hyaluronic acid can also be mixed with a short acting anaesthetic, ensuring a comfortable experience.

 3. Platelet rich plasma (PRP) – PRP is a research-based treatment used primarily for tendon injuries.  PRP cells have been shown to be effective at kick starting the healing process and therefore speeding up recovery. For PRP to be effective a course of three injections is recommended.  This involves taking a small amount of blood from your arm and spinning out the PRP cells utilising a centrifuge. The extracted PRP is then injected back into you at the site of the injury.  Once again, PRP can also be mixed with a short acting anaesthetic, ensuring a comfortable experience. 

 Other techniques that can only be achieved under guidance include:

 1.    Aspiration or the removal of excess fluid from joints and cysts.  Research has shown aspiration under guidance yields 300% more aspirate than non-guided aspirations.  Often a corticosteroid is used after an aspiration.

 2.    Hydrodilatation – a hydrodilatation procedure is used for patients suffering from the pain and stiffness associated with frozen shoulder.  During this technique a large volume of sterile water mixed with corticosteroid and local anaesthetic is injected into the shoulder joint.  This stretches the joint with the aim of reducing pain and increasing function.  This can only be achieved under ultrasound guidance.    

 Although ultrasound guided injections are a rapid, evidence-based technique aimed directly at the source of your pain, they are not a stand-alone treatment. To ensure you treat the underlying condition it is essential that you undertake a course of physiotherapy after an injection.  Luke works closely with your ARC physiotherapist to ensure you get the best possible treatment.

About Luke Millward

Luke is a specialised, advanced practice physiotherapist and a musculoskeletal sonographer who specialises in diagnostic ultrasound imaging and ultrasound guided injection therapy. He is one of the few clinicians in the country to achieve a Post Graduate Diploma in interventional musculoskeletal ultrasound. He has extensive experience in musculoskeletal injection therapy and treats a wide variety of conditions both in the NHS and in the private sector.  

Luke uses his unique experience from the fields of physiotherapy and ultrasound imaging to assess and treat conditions affecting muscles, joints, nerves tendons and bursa (small anatomical washers) and runs a busy ultrasound diagnostic clinic, as a musculoskeletal sonographer, at Newham University Hospital.  

Furthermore, Luke is an Independent Prescriber and so is able to prescribe specific medications, without the need for a prescription from you G.P.  This truly unique combination allows patients to access a rapid diagnosis and highly accurate treatment without a referral from a doctor.  

Luke is a member of the Health and Care Professions Council (HCPC) and the Chartered Society of Physiotherapy (CSP) and is a member of the executive board of the Association of Chartered Physiotherapists in Orthopaedic Medicine and Injection Therapy (ACPOMIT).  Luke is also a tutor for the Sports Medicine Ultrasound Group (SMUG), the UKs leading musculoskeletal sonography company.  

If you feel you would benefit from a
diagnostic ultrasound scan or an ultrasound guided steroid injection please
feel free to contact Luke directly at: