Tell me more about manipulation under anaesthetic and injection under X-ray guidance

A common treatment for joint pain is to manipulate the painful joint under anaesthetic and use X-ray guidance to inject a dose of steroid and local anaesthetic into the affected area.

How does the operation work?

The patient is anaesthetised so that they are relaxed and any protective muscle spasm due to pain is ‘switched off’, allowing the painful joint to be examined and moved through its range. The degree of stiffness of the joint or its laxity can be documented and recorded with an X-ray of the joint in the ‘unstable’ position. For painful stiff joints an X-ray is useful to confirm the position of the injection of steroid and local anaesthetic into the joint. Certain joints are difficult to inject and may require different angles and several passes with the needle; a general anaesthetic minimises the discomfort for the patient.

How long will it take to recover?

Following this day case procedure you are normally allowed to bear weight as comfort permits. Due to the effects of the anaesthetic you should not drive for 24 hours. Some patients might experience an increase of pain after the procedure. This may start a few hours after the procedure and last for a few days. This increase in discomfort, should it occur, can be managed with ice and pain killers, such as paracetamol and/or ibuprofen and should gradually improve as the steroid takes effect.

What complications are possible following this operation?

Complications of this procedure include stiffness, swelling, bleeding into the joint (haemarthrosis), infection, discolouration of the skin and sometimes puckering of the skin at the site of the injection

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