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The very idea of going to the hospital used to cause chills down my spine as a child. Not much has changed since then. Hospitals were associated with pain and torture and tears. They were the places where merciless clinicians used needles to inflict pain, and so as a child, I did not like them so much. The narratives we grow up with tend to shape a lot of perspectives in our worlds. That is why it is not surprising that even after growing up, and even being trained on giving injections myself, I still have qualms about them.

However, we all know that injections are given from a good place. They are sometimes the only option to treat an ailment. Mostly, when one is recommended, it means that is the most effective way of delivering the necessary medication.

In pain management, sometimes the doctor will recommend an injection to deliver the medication required to reduce the symptoms. This usually happens in many musculoskeletal conditions like back pain, knee pain and ankle joint pain. Many patients, are often apprehensive of this procedure because:

· They do not understand the working mechanism of the medication (how)

· They do not understand how the procedure will be done (what/where)

· They are simply afraid of the procedure (fear)

· They do not understand the results of the injection. (after)

In line with this, it is therefore only fair to demystify some of these concerns. Let’s go back to the beginning: you come in to the doctor with unrelenting knee pain that has been present for more than six months. You have been on physiotherapy, a knee brace, topical gels, done multiple x-rays and maybe an MRI, all to no avail. Your doctor recommends an injection and immediately your mind goes blank.

Why is the doctor recommending an injection? Ans; pain is associated with active inflammatory process. This means that the body is producing chemicals in that region that bring about increased local temperatures, redness and mainly pain with aim of healing itself. The pain brings about limitation in function which is troubling. Therefore, the medication in the injection is aimed at reducing the active inflammation and consequently allow increase in function {walking well, jumping} for that knee.

How is the medication delivered? The doctor will draw some medication into a syringe and inject the area that needs relief. Through their study and training in anatomy (study of how body structures are arranged), they can use landmarks to safely locate the safe area to inject. . In cases where the structures are deeply located, the doctor may use an ultrasound machine (equipment that allows them to see inside the body) or fluoroscopy (use of imaging, specifically x-rays) and guide the needle to the required structure.

“My friend got an injection and the pain came back…. She gets the injections now too often. Are they not curative?” Ans: no, the injection is not curative. The injection acts as a pain relief but in most instances, this has to be accompanied with other therapies to ensure proper functioning of the joint. After an injection procedure, it is therefore recommended for one to do physical therapy and follow through with home exercises to get a curative effect.

After an injection, it is possible for one to be in pain for the first 48 hours (two days) as the medication spreads over the area. The recommended number of injections vary depending on the drug used and may not exceed three in the same area. That is why it is important for one to follow through with other adjunct management protocols like physical therapy. Other side effects may include a rise in blood sugar for diabetic patients, and weakness of an often-injected structure. Your doctor should disclose all the information necessary and guide through to make sure you understand before the procedure.

In conclusion, knowledge is power. It is our hope that this sheds a little light on that procedure and reduces your worry about it. We hope that it gives you ground to ask the proper questions and a background in understanding

how your pain is being managed.

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