Injection Therapy
Targeted injection treatments including cortisone steroid injections, hyaluronic acid joint therapy, and high volume injections for Achilles tendinopathy. All ultrasound-guided for maximum precision.
What is Injection Therapy?
Injection therapy delivers medication directly to the site of pain or inflammation, providing targeted relief when oral medications or other conservative treatments haven't been effective. At Lower Limb Clinic, we offer a comprehensive range of injection therapies for foot, ankle, and lower limb conditions.
All injections are performed using real-time ultrasound guidance, ensuring the medication reaches exactly the right location for maximum effectiveness and safety. This precision approach significantly improves outcomes compared to landmark-guided (blind) injections.
We offer three specialist injection types, each designed to target different conditions and stages of pathology:
Common Symptoms
- Persistent joint pain and stiffness
- Swelling and chronic inflammation
- Pain that limits daily activities or sport
- Mid-portion Achilles tendon thickening and pain
- Early to moderate osteoarthritis symptoms
- Burning or tingling sensations (neuromas)
- Pain not responding to other conservative treatments
- Joint stiffness and reduced range of motion
Common Causes
- Morton's neuroma
- Plantar fasciitis
- Ankle & foot osteoarthritis
- Mid-portion Achilles tendinopathy
- Bursitis (heel, ankle, or forefoot)
- Capsulitis (joint inflammation)
- Insertional tendinopathy
- Synovitis and joint effusion
Our Treatment Approach
We offer three distinct types of injection therapy, each selected based on your specific diagnosis, the stage of your condition, and your treatment goals:
💉 Corticosteroid (Cortisone) Injections
Corticosteroid injections are a powerful anti-inflammatory treatment used to rapidly reduce swelling, pain, and inflammation in joints, bursae, and soft tissues. They are one of the most widely used and evidence-based injection treatments in musculoskeletal medicine.
Commonly used for: plantar fasciitis, Morton's neuroma, bursitis (heel, ankle, forefoot), capsulitis, synovitis, and acute inflammatory joint conditions.
How it works: A corticosteroid (such as methylprednisolone or triamcinolone) is injected directly into the affected area under ultrasound guidance. The steroid suppresses the local inflammatory response, providing significant pain relief. This is often combined with a local anaesthetic for immediate comfort during the procedure.
What to expect: Relief typically begins within 3–7 days and can last from 6 weeks to several months. We generally limit corticosteroid injections to 2–3 per year in any one area to protect tissue integrity.
💧 Hyaluronic Acid Injections (Viscosupplementation)
Hyaluronic acid (HA) injections provide natural replenishment of joint lubrication for patients with early to moderate osteoarthritis. Hyaluronic acid is a naturally occurring substance found in healthy synovial (joint) fluid — it acts as both a lubricant and a shock absorber within the joint.
Commonly used for: early to moderate osteoarthritis of the ankle, midfoot, and first metatarsophalangeal (big toe) joint. Particularly suitable for patients who want to avoid or delay surgical intervention, or those who cannot tolerate repeated corticosteroid use.
How it works: The injection supplements the joint's depleted natural hyaluronic acid, restoring the viscosity and elasticity of the synovial fluid. This reduces friction between cartilage surfaces, decreases pain, and improves joint mobility. Unlike corticosteroids, HA injections work by restoring the joint's natural environment rather than simply suppressing inflammation.
What to expect: Benefits may take 2–4 weeks to develop fully and can last 6–12 months. A course of 1–3 injections may be recommended depending on the joint and severity. HA injections are well-tolerated with minimal side effects and can be repeated as needed.
🔬 High Volume Injections (HVI) for Mid-Portion Achilles Tendinopathy
High volume injection (HVI) therapy is a specialist treatment for chronic mid-portion Achilles tendinopathy — a condition characterised by tendon thickening, pain, and stiffness in the middle section of the Achilles tendon, typically 2–6cm above the heel bone.
How it works: Under real-time ultrasound guidance, a large volume of injectable fluid (typically a combination of normal saline, local anaesthetic, and a small amount of corticosteroid) is injected into the space between the Achilles tendon and the surrounding paratenon (Kager's fat pad). The high volume of fluid mechanically disrupts and strips away the abnormal neovascularisation (new blood vessel and nerve ingrowth) that develops in chronic tendinopathy — these abnormal vessels are strongly associated with pain.
The evidence: Research has shown that HVI can significantly reduce pain scores and improve function in patients with chronic mid-portion Achilles tendinopathy, particularly when combined with a structured eccentric loading rehabilitation programme. It is considered when conservative management (physiotherapy, shockwave therapy, load management) has plateaued.
What to expect: The procedure takes approximately 10–15 minutes. You may feel pressure as the volume is injected. Some patients notice immediate improvement, while others respond over the following 2–4 weeks. A structured rehabilitation programme is essential following the procedure to optimise outcomes.
What to Expect
Clinical Assessment
Thorough examination and diagnostic ultrasound to confirm the diagnosis, assess the stage of your condition, and determine the most appropriate injection type.
Treatment Selection
We'll explain which injection type is recommended for your condition — cortisone for acute inflammation, hyaluronic acid for osteoarthritis, or high volume injection for chronic Achilles tendinopathy.
Informed Consent
We'll explain the procedure, expected benefits, potential risks, and aftercare in detail. Written consent is obtained before proceeding.
Ultrasound-Guided Injection
The area is cleaned and the injection is administered under real-time ultrasound guidance. The procedure typically takes 5–15 minutes depending on the injection type.
Post-Injection Care
You'll rest briefly in the clinic. Detailed aftercare instructions are provided, including activity modifications for the first 24–72 hours and a rehabilitation plan where applicable.
Follow-Up Review
We'll review your response at 2–4 weeks. For hyaluronic acid, additional injections may be scheduled. For HVI, a structured rehab programme is prescribed.
"After months of Achilles pain that wouldn't shift, Paul recommended a high volume injection. The improvement was remarkable — within a few weeks I was back running. The ultrasound-guided approach gave me real confidence in the treatment."
James R.
Treated for: Mid-Portion Achilles Tendinopathy
Frequently Asked Questions
Common questions about Injection Therapy at Lower Limb Clinic.
Find Your Nearest Clinic
Get Injection Therapy at our clinic, conveniently located in East Belfast
Lisburn Road Clinic
385 Lisburn Road, BT9 7EP
Ormeau Road Clinic
373 Ormeau Road, BT7 3GP
Newcastle Clinic
1 Shimna Road, BT33 0AS
We serve patients from across Belfast and Northern Ireland including East Belfast, South Belfast, Lisburn, Bangor, Holywood, Newtownards, Dundonald, Carryduff, Hillsborough, and Comber.
Book Your Assessment
- 45-60 minute appointments
- No referral needed
- 600+ 5-star reviews
Treatment Benefits
- Targeted pain relief directly at the source
- Ultrasound guidance ensures precision and safety
- Three specialist injection types for different conditions
- Hyaluronic acid restores natural joint lubrication
- HVI addresses the root cause of chronic Achilles pain
- Can avoid or significantly delay surgical intervention
- Quick procedures (5–15 minutes)
- Minimal downtime — most patients walk out immediately
Related Services
Find Your Nearest Clinic
Get Injection Therapy at our clinic, conveniently located in East Belfast
Lisburn Road Clinic
385 Lisburn Road, BT9 7EP
Ormeau Road Clinic
373 Ormeau Road, BT7 3GP
Newcastle Clinic
1 Shimna Road, BT33 0AS
We serve patients from across Belfast and Northern Ireland including East Belfast, South Belfast, Lisburn, Bangor, Holywood, Newtownards, Dundonald, Carryduff, Hillsborough, and Comber.