If you are between 40 and 75, have knee arthritis, and a doctor has recommended an injection, you are almost certainly asking three practical questions: Should I choose a doctor who uses ultrasound? Is it worth paying more? Does it actually improve the result? These are excellent questions, and they deserve a straight answer rather than marketing. In this guide I will explain — as I would to a patient sitting across from me at PainClinix — what ultrasound guidance is, exactly why it can matter, where the evidence is strong, and where the evidence is genuinely mixed. My goal is that you finish reading understanding why guidance matters, not feeling that a clinic is advertising to you.
Ultrasound guidance reliably improves the accuracy of a knee injection — the needle, and the medicine, actually reach the intended target. Whether that changes your final outcome depends on the situation. It matters most for knees that are hard to inject (no swelling, obesity, prior surgery, deformity), for precise targets around the knee, and above all for expensive biologics such as PRP, where an inaccurate injection can waste the product. For a simple, swollen knee in experienced hands, a landmark (blind) injection is often accurate too, and there the outcome evidence is more mixed. The most important factors in your result are the right diagnosis, the right injection for your stage of arthritis, accurate delivery, and proper rehabilitation afterwards.
First, a Simple Idea: Delivery Decides the Result
Let me start with an analogy I use in clinic almost every week. Imagine you buy the finest fertiliser for a struggling plant. If you pour it onto the leaves or the surrounding soil instead of the roots, even the best fertiliser will disappoint you. The problem was never the product — it was the delivery.
A knee injection works the same way. Whatever we inject — a corticosteroid, hyaluronic acid, or platelet-rich plasma (PRP) — can only do its job if it is placed where it is meant to go. A medicine deposited into the fat pad, the muscle, or the soft tissue outside the joint capsule cannot act on the joint the way it was intended to. In plain terms: the value of any injection depends not just on what is injected, but on where it actually lands. Ultrasound guidance is, at its heart, a tool to make sure the medicine reaches the roots.
What Actually Happens During a Knee Injection?
The knee is not a simple hollow ball. It is a complex hinge wrapped in a capsule, lined by a delicate membrane called the synovium, cushioned by cartilage and two menisci, stabilised by ligaments, and padded in front by a soft cushion called the infrapatellar fat pad. When we inject "into the knee joint," we are aiming for the intra-articular space — the fluid-filled cavity inside the capsule where the medicine can bathe the joint surfaces.
In plain terms: think of the knee as a sealed room with several small doorways. The medicine needs to get inside the room. A needle that stops just short — in the wall, the padding, or the doorway — has technically been "injected into the knee," but the medicine is in the wrong place.
A blind (landmark-guided) injection relies on the physician feeling bony landmarks with their fingers and estimating the path of the needle. An experienced clinician does this well much of the time, especially when the knee is swollen and easy to feel. An ultrasound-guided injection adds a live picture: a handheld probe sends harmless sound waves into the tissue and shows, in real time, the layers of the knee and the needle itself as it advances.
What Is Ultrasound Guidance, and How Does It Work?
Ultrasound (sonography) is the same safe, radiation-free imaging used in pregnancy. A probe placed on the skin emits high-frequency sound waves that bounce off tissues and return to build a moving image on a screen. For injections, this gives the physician two powerful abilities:
- See the target before injecting — the joint space, the fluid, the cartilage, tendons and nearby blood vessels and nerves.
- Watch the needle in real time — the physician follows the needle tip all the way to the target and can confirm placement by watching the medicine spread exactly where it should.
In plain terms: a blind injection is like reversing a car using only your mirrors and memory; an ultrasound-guided injection is like reversing with a live rear camera. Both can be done well, but one lets you see precisely where you are going — and confirm you have arrived.
Ultrasound guidance lets the physician see the target, guide the needle in real time, and confirm the medicine has spread in the right place — without radiation. It converts an injection from an educated estimate into a directly observed procedure.
Does Ultrasound Actually Improve Accuracy? (What the Evidence Says)
This is where we should be careful to separate evidence from opinion. On accuracy, the evidence is consistent and strong.
A frequently cited study by Jackson and colleagues, published in The Journal of Bone & Joint Surgery, examined how often a blind knee injection actually reached the joint space in knees without obvious swelling. Using anatomical landmarks alone, accuracy depended heavily on the approach: roughly 71% via an anterolateral portal, 75% via an anteromedial portal, and 93% via a lateral mid-patellar portal. In other words, even in experienced hands and without imaging, a meaningful proportion of injections did not land where intended.
Reviews of ultrasound guidance, such as the one by Berkoff and colleagues in Clinical Interventions in Aging, concluded that ultrasound notably improves the accuracy of large-joint injections, including the knee, compared with landmark-only technique — commonly pushing accuracy into the high-90% range. This is the part of the story where the science is clear.
| Feature | Blind (landmark) injection | Ultrasound-guided injection |
|---|---|---|
| Needle path | Estimated by feel | Watched live on screen |
| Confirming placement | Not directly possible | Confirmed by seeing the spread |
| Accuracy (knee, no effusion) | Roughly 71–93% by approach | Commonly high-90% |
| Difficult knees (obese, no swelling, deformed) | Accuracy falls | Advantage is greatest |
| Procedural pain | Reference | Often lower (more direct path) |
| Radiation | None | None |
| Best value for | Simple, swollen knee | Biologics (PRP), precise or difficult targets |
Does Better Accuracy Improve the Outcome?
Here I want to be honest, because this is where patients are often over-promised. Better accuracy does not automatically mean a better result in every single case.
For some injections there is good supporting evidence. A randomized controlled study by Sibbitt and colleagues in The Journal of Rheumatology found that sonographic guidance reduced procedural pain (by around 43%), reduced pain two weeks later, and improved the proportion of patients who responded well. Berkoff's review similarly linked improved accuracy to better patient-reported outcomes and cost-effectiveness.
On the other hand, for a straightforward, swollen knee where an experienced clinician can reliably enter the joint by feel, several studies show little difference in the final outcome between blind and guided steroid injection. So the fair, expert summary is this:
Evidence (strong): ultrasound improves needle accuracy and reduces procedural pain. Evidence (mixed): whether guidance changes the final outcome depends on the joint and the injection — the benefit is clearest for difficult knees, precise targets, and costly biologics, and smaller for a simple, swollen knee with a cheap medication. Opinion (mine, stated as such): for PRP and for hard-to-inject knees, I believe guidance should be the default, because the downside of a missed injection is large and avoidable.
Can a Blind Injection Miss? How Often, and Why?
Yes, it can — and the "how often" is answered above (up to roughly one in four for some approaches in knees without swelling). The "why" is worth understanding, because it explains when guidance matters most:
- No swelling to guide the needle. A tense, swollen knee is easy to enter; a "dry" arthritic knee has very little space and is much harder to feel.
- Body habitus. In heavier knees, bony landmarks are harder to palpate, so estimates drift.
- Altered anatomy. Advanced arthritis, previous surgery, or deformity change the usual landmarks.
- The fat pad and folds. The needle can come to rest in the infrapatellar fat pad or a synovial fold rather than the true joint cavity.
What can go wrong when a needle is misplaced?
- The medicine lands in the wrong tissue — fat, muscle or soft tissue outside the joint — so it cannot act on the joint as intended.
- An expensive biologic (PRP) is wasted if it is not delivered to the target.
- More post-injection discomfort can occur when medication is deposited in soft tissue rather than the joint space.
- Rarely, sensitive structures nearby — cartilage surfaces, the meniscus, ligaments, nerves or vessels — are best avoided by seeing them; ultrasound helps the physician steer clear.
To be clear and not alarmist: serious injury from a standard knee injection is uncommon in trained hands. The everyday issue is not dramatic damage — it is misplacement, which quietly reduces how well the treatment works.
Is Ultrasound Useful for Each Injection Type? (PRP, Steroid, Hyaluronic Acid, Biologics)
Guidance is not equally important for every injection. Let me take them one at a time, because the answer genuinely differs.
1. PRP (Platelet-Rich Plasma) — guidance matters most
PRP is prepared from your own blood, concentrating the platelets that carry growth factors thought to influence healing and inflammation. Two facts make accuracy especially important for PRP: it is costly, and its effect depends on reaching the target. If a carefully prepared PRP dose is deposited outside the joint, you have paid for a premium product and delivered it to the wrong place — the fertiliser-on-the-leaves problem.
The evidence for PRP itself is encouraging but must be stated carefully. A meta-analysis of randomized trials by Belk and colleagues in The American Journal of Sports Medicine found that, for knee osteoarthritis, PRP tended to provide better pain and function scores than hyaluronic acid at 6–12 months in suitable patients. At the same time, major bodies such as the American Academy of Orthopaedic Surgeons (AAOS) rate the overall PRP evidence as "limited," largely because PRP preparations vary so much between clinics that studies are hard to compare. Emerging evidence also suggests the platelet dose and concentration influence results — which is exactly why how your PRP is prepared, and where it is delivered, both matter. (I discuss preparation quality in detail in our companion guide, Are All PRP Injections the Same?)
2. Corticosteroid (steroid) — guidance helps in difficult knees
A steroid injection reduces inflammation and often gives fast relief, which is genuinely useful for a painful flare. For a swollen, easily accessible knee, an experienced landmark injection is frequently accurate, so the added value of ultrasound is smaller. For a dry, stiff, or difficult knee, guidance improves the odds the steroid reaches the joint.
There is an important caution here that has nothing to do with guidance and everything to do with how often steroids are used. A 2-year randomized trial by McAlindon and colleagues in JAMA found that triamcinolone injected every three months was associated with greater cartilage loss and no better pain relief than saline. In plain terms: occasional, well-chosen steroid injections have a role, but repeated steroids as a long-term strategy for arthritis can do more harm than good. Accurate delivery does not change that principle.
3. Hyaluronic acid (viscosupplementation) — evidence is mixed, technique still counts
Hyaluronic acid aims to supplement the joint's natural lubricating fluid, with relief that tends to build gradually and can last longer for some patients. Guidelines differ on it: the American College of Rheumatology / Arthritis Foundation 2019 guideline issued a conditional recommendation against routine hyaluronic acid for knee osteoarthritis, while OARSI considered it conditionally appropriate for selected patients. Because hyaluronic acid is a viscous product that needs to sit inside the joint to work, accurate intra-articular placement is still important — a thick gel deposited in soft tissue is both wasted and more likely to hurt.
4. Cell-based and other biologics — accuracy is non-negotiable
For newer cell-based or concentrated biologic injections, the same logic as PRP applies, only more so: these are costly, precise treatments whose entire rationale depends on reaching the intended tissue. It is worth adding that the clinical evidence for many cell-based knee treatments is still early and uncertain, and I counsel patients honestly about that. When such a treatment is chosen, image-guided delivery is essential — but guidance cannot make an unproven product work.
| Injection | What it does | Typical relief | How much guidance helps |
|---|---|---|---|
| Corticosteroid | Reduces inflammation | Fast, usually short-term | Helps in difficult knees; less critical in a swollen knee |
| Hyaluronic acid | Supplements joint lubrication | Gradual, sometimes longer | Important — viscous gel must sit inside the joint |
| PRP | Uses your own concentrated platelets | Builds over weeks; can last months | Very important — costly biologic must reach the target |
| Cell-based biologics | Experimental regenerative approaches | Uncertain; still under study | Essential delivery; evidence for the product itself is limited |
Beyond Guidance: What Really Decides Your Result
Ultrasound is a tool, not a treatment. I would rather you understand the whole picture than fixate on one feature. In my experience, four things decide how well a knee injection works, and guidance is only one of them.
The right diagnosis
Is the pain truly from the joint surface (osteoarthritis), or from a tendon, ligament, bursa, or a referred source such as the hip or back? An injection into the knee will not help pain that is coming from elsewhere. This is why a careful assessment — and sometimes imaging — comes before any needle.
The right injection for your stage
Early to moderate arthritis behaves very differently from bone-on-bone, end-stage disease. Choosing steroid, hyaluronic acid or PRP — or recognising when injections are unlikely to help and a surgical opinion is wiser — depends on your stage. The same injection can help one patient and disappoint another simply because of how advanced the arthritis is.
Accurate delivery
Getting the medicine to the target — the part ultrasound protects, especially for biologics and difficult knees.
Rehabilitation afterwards
An injection calms the joint; strengthening, weight management and movement keep it calm. Injections that are paired with proper rehabilitation give more durable relief than injections given in isolation. At PainClinix we treat the injection as the start of a plan, not the whole plan.
Two people with "knee arthritis" can have very different outcomes from the "same" injection because the diagnosis, the stage of disease, the quality and dose of the product, the accuracy of delivery, and the rehabilitation all differ. A good result is a chain — and the chain is only as strong as its weakest link.
Common Myths About Knee Injections
Myths worth clearing up
- "An injection is an injection — the doctor doesn't matter." Diagnosis, product quality and accurate delivery vary widely, and so do results.
- "PRP always works better than everything." PRP is promising for suitable knee arthritis, but preparations vary and guideline bodies still rate the overall evidence as limited. It is not a cure for bone-on-bone arthritis.
- "Steroid injections are completely safe to repeat." Frequent steroids can worsen cartilage over time without improving pain, so they should be used selectively.
- "Ultrasound is just a gimmick to charge more." It genuinely improves accuracy; its value is highest for biologics and difficult knees, which is where we emphasise it.
- "If one injection didn't work, none will." Often the first injection was the wrong choice for the diagnosis or stage — not proof that the knee cannot be helped.
Your Practical Questions, Answered
These are the questions patients actually type into Google and ask me in clinic.
Does the ultrasound itself hurt?
No. The probe simply rests on the skin with a little gel — it is completely painless. In fact, guided injections tend to hurt less, because the needle takes a more direct path.
Can I see the needle on the screen?
Yes, and many patients find it reassuring to watch the needle reach the target and the medicine spread where it should. I am happy to talk you through the screen during the procedure.
Is PRP wasted if it is injected incorrectly?
Its benefit depends on reaching the target, so a misplaced dose does not act as intended. That is the single strongest practical reason to use guidance for PRP.
Why do clinics charge different prices for "the same" injection?
Because they are often not the same. Price can reflect the quality and dose of the product (this is especially true for PRP), whether the procedure is image-guided, who performs it, and whether assessment and rehabilitation are included. Cheaper is not always better value, and expensive is not automatically better either — what you are really paying for is an accurate diagnosis and a well-delivered, appropriate treatment.
How long does the procedure take?
The injection itself takes only a few minutes. Allow a little longer for the assessment, the ultrasound check, and aftercare advice. It is a day-care procedure — you walk in and walk out.
Will I need more than one?
It depends on the injection and your response. Some are single treatments; PRP is often given as a short course. We decide together, based on how your knee responds.
Safety, Comfort and Complications
Knee injections are among the safer procedures in musculoskeletal medicine when performed by a trained clinician. Local anaesthetic keeps the procedure comfortable, and most people describe it as brief pressure or a sting. Minor, temporary post-injection soreness or a short-lived flare can occur, particularly with hyaluronic acid or PRP. Serious complications such as infection are rare and are minimised by sterile technique. Ultrasound adds to safety by letting the physician see and avoid nearby vessels and nerves. As with any procedure, tell your physician about blood thinners, diabetes, allergies, or any active infection before the injection.
Red flags — when knee pain needs prompt medical review
- A hot, red, very swollen knee with fever — possible joint infection (needs urgent care).
- Knee pain after significant trauma, or an inability to bear weight or straighten the knee.
- Rapidly increasing swelling, severe rest pain, or the knee "giving way" repeatedly.
- Calf swelling, redness or breathlessness — seek urgent care to exclude a clot.
These are not situations for a routine injection first — they need assessment.
Doctor's advice
Do not choose your treatment by its name alone — choose it by its fit. Before any needle, ask for a clear diagnosis and an explanation of why this injection suits your stage of arthritis. If you are having a biologic such as PRP, ask that it be image-guided, so the treatment you have paid for actually reaches the joint. And whatever injection you have, pair it with rehabilitation — that is what turns short-term relief into lasting improvement.
How to Choose the Right Clinic for Knee Injections
Rather than telling you where to go, let me teach you what to ask. If you use these questions with any clinic — mine included — you will be able to tell an evidence-based practice from a hurried one. This is the most useful thing I can give you.
- "Will my injection be ultrasound-guided?" — Especially important for PRP and for a knee that is hard to inject.
- "Who will actually perform the procedure?" — You want a clinician trained and experienced in image-guided injections.
- "How was my diagnosis confirmed?" — The injection should follow a clear diagnosis, not precede it.
- "Which injection is appropriate for my condition and stage, and why?" — The reasoning should be specific to you.
- "What evidence supports this recommendation, and what are the alternatives?" — Including when an injection is not the answer.
- "For PRP — how is it prepared, and what platelet dose will I receive?" — Preparation quality genuinely affects results.
- "What is the rehabilitation plan afterwards?" — A good plan does not end when the needle comes out.
This is exactly how we work at PainClinix in Punjabi Bagh. As an interventional pain physician, I confirm the diagnosis first, perform knee injections under ultrasound guidance to international standards, match the injection — corticosteroid, hyaluronic acid or PRP — to your stage of arthritis rather than offering one option to everyone, and build a rehabilitation plan around it. Patients travel to us from across West Delhi and Delhi NCR precisely because the emphasis is on getting the whole chain right, not just the needle. None of this is a criticism of other clinicians — it is simply the standard I would want for my own family.
Osteoarthritis tends to progress, and a knee that is painful, weak and under-used loses muscle and mobility over time — which makes every later treatment harder. That does not mean rushing into injections; it means not ignoring the knee. An early, accurate assessment lets you use the least invasive effective option while it is most likely to help, and often delays or avoids surgery. Waiting rarely improves the situation.
Key takeaways
- Ultrasound guidance reliably improves accuracy — the medicine reaches the target. This part of the evidence is strong.
- Whether guidance changes the final outcome is context-dependent: biggest benefit for PRP, difficult knees and precise targets; smaller for a simple, swollen knee.
- Blind injections can miss — roughly 71–93% accurate by approach in knees without swelling, and less in obese or dry knees.
- For PRP, guidance matters most because a costly biologic must be delivered accurately to work.
- Repeated steroid injections can harm cartilage without improving pain — use them selectively.
- Your result depends on diagnosis, stage, product quality, accurate delivery and rehabilitation — not guidance alone.
- Guided injections are not more painful — often less.
Summary
So — does ultrasound guidance matter for knee injections? The honest answer is: yes, meaningfully, but not equally for everything. The evidence that guidance improves accuracy and lowers procedural pain is strong. The evidence that it changes the final outcome is context-dependent — clearest for PRP, difficult knees and precise targets, and more modest for a simple, swollen knee treated with an inexpensive medication. What matters just as much as guidance is the rest of the chain: an accurate diagnosis, the right injection for your stage of arthritis, a well-prepared product, accurate delivery, and proper rehabilitation. Choose your care by asking good questions, not by a single feature or the lowest price. Used wisely, a well-chosen, well-delivered knee injection can relieve pain, restore function, and help many people delay or avoid surgery.
Frequently Asked Questions
Does ultrasound guidance matter for knee injections?
Yes — it reliably improves accuracy. Its impact on the final outcome is greatest for PRP, difficult-to-inject knees and precise targets, and smaller for a simple, swollen knee with a cheap medication.
How does ultrasound guidance work?
A probe on the skin uses harmless sound waves to show the joint and the needle in real time, so the physician can steer to the target and confirm the medicine has spread correctly — without radiation.
How often does a blind knee injection miss the joint?
In knees without swelling, landmark accuracy has been reported at roughly 71% (anterolateral), 75% (anteromedial) and 93% (lateral mid-patellar), and it falls further in obese or dry knees.
Does accuracy really improve outcomes?
Sometimes. Guided injection reduces procedural pain and improves accuracy consistently; the effect on final outcome is clearest for biologics and difficult joints and more mixed for a simple, swollen knee.
Can a blind injection injure cartilage, meniscus or ligaments?
Serious injury is uncommon in trained hands. The usual problem is misplacement — the medicine landing outside the joint — which reduces effectiveness. Ultrasound helps avoid sensitive structures by seeing them.
Can expensive biologics like PRP be misplaced?
Yes. If PRP is not delivered to the target, its benefit is lost. Because PRP is costly and depends on accurate placement, guidance is strongly advisable.
Is ultrasound useful for a steroid injection?
It helps most in difficult knees. For a swollen, easily accessible knee, an experienced landmark injection is often accurate, so the added value is smaller.
Is ultrasound useful for hyaluronic acid?
Yes — hyaluronic acid is a viscous gel that must sit inside the joint to work, so accurate intra-articular placement is important.
Is ultrasound useful for cell-based biologics?
Accurate delivery is essential, but the evidence for many cell-based knee treatments is still early. Guidance cannot make an unproven product effective.
Does an ultrasound-guided injection hurt more?
No — it often hurts less, because the needle follows a more direct path. Local anaesthetic is used and the ultrasound probe itself is painless.
Can I watch the needle on the screen?
Yes. Many patients find it reassuring to see the needle reach the joint and the medicine spread in the right place.
Why do clinics charge different prices for knee injections?
Price often reflects product quality and dose (especially for PRP), whether the injection is image-guided, who performs it, and whether assessment and rehabilitation are included.
Is PRP better than steroid or hyaluronic acid for knee arthritis?
Meta-analysis suggests PRP can outperform hyaluronic acid at 6–12 months in suitable patients, but preparations vary and guideline bodies call the overall evidence limited. The best choice depends on your stage of arthritis.
Are repeated steroid injections safe?
Not as a long-term strategy. A 2-year trial found steroid every three months was linked to greater cartilage loss without better pain relief. Occasional, well-chosen steroid still has a role.
How long does a knee injection take?
The injection is a few minutes; allow a little longer for assessment, the ultrasound check and aftercare. It is a day-care procedure.
How long does relief last?
It varies: steroid relief is often short-term, hyaluronic acid can last longer, and PRP tends to build over weeks and can last months in responders. Rehabilitation prolongs the benefit.
Can knee injections help me avoid surgery?
For many people with early-to-moderate arthritis, appropriate injections plus rehabilitation reduce pain and delay or avoid surgery. For end-stage, bone-on-bone arthritis, a surgical opinion may be wiser.
Should I delay treatment for my knee?
Ignoring a painful knee usually leads to more muscle loss and stiffness, making later treatment harder. An early, accurate assessment lets you use the least invasive effective option.
Is ultrasound guidance safe?
Yes — ultrasound uses no radiation and adds safety by letting the physician avoid nearby vessels and nerves.
Who should perform my knee injection?
Ideally a clinician trained and experienced in image-guided musculoskeletal injections, who confirms the diagnosis, chooses the right injection for your stage, and plans rehabilitation.
Where can I get an ultrasound-guided knee injection in Delhi?
At PainClinix, Punjabi Bagh, interventional pain physician Dr. Titiksha Goyal performs ultrasound-guided PRP, steroid and hyaluronic acid knee injections for patients across West Delhi and Delhi NCR.
References
- Jackson DW, Evans NA, Thomas BM. Accuracy of needle placement into the intra-articular space of the knee. J Bone Joint Surg Am. 2002;84(9):1522–1527. PubMed
- Sibbitt WL Jr, Peisajovich A, Michael AA, et al. Does sonographic needle guidance affect the clinical outcome of intraarticular injections? J Rheumatol. 2009;36(9):1892–1902. PubMed
- Berkoff DJ, Miller LE, Block JE. Clinical utility of ultrasound guidance for intra-articular knee injections: a review. Clin Interv Aging. 2012;7:89–95. PubMed
- McAlindon TE, LaValley MP, Harvey WF, et al. Effect of intra-articular triamcinolone vs saline on knee cartilage volume and pain in patients with knee osteoarthritis: a randomized clinical trial. JAMA. 2017;317(19):1967–1975. PubMed
- Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578–1589. Osteoarthritis and Cartilage
- Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Rheumatol. 2020;72(2):220–233. PubMed
- Belk JW, Kraeutler MJ, Houck DA, Goodrich JA, Dragoo JL, McCarty EC. Platelet-rich plasma versus hyaluronic acid for knee osteoarthritis: a systematic review and meta-analysis of randomized controlled trials. Am J Sports Med. 2021;49(1):249–260. PubMed
- American Academy of Orthopaedic Surgeons. Management of osteoarthritis of the knee (non-arthroplasty), 3rd edition — clinical practice guideline. AAOS; 2021. AAOS
Medical disclaimer
This article is for general education and does not replace a personal medical consultation. Decisions about knee injections should be made after individual assessment, including diagnosis and, where appropriate, imaging. Treatment responses vary between patients. Please consult a qualified pain physician or orthopaedic specialist before making decisions about your care.