Health Services

MSP referral is required to access Health Services. Please have your Doctor place a referral if you wish to be seen by Physiatry or Sports Medicine.

Physiatry

Consultations

What is a Physiatrist?

Physiatrists are physical medicine and rehabilitation specialists with five years of residency training.  Physiatrists at Triumph Health specialize in non-operative musculoskeletal complaints and see patients with workplace, sports or motor vehicle accident-related injuries. Physiatrists are also experts in overuse tendinopathies, myofascial pain, and mild to moderate osteoarthritis.

What does a Physiatry consultation entail?

Patients undergoing a physiatry assessment are viewed in the context of the “whole” person. You will be asked about your medical history, medications, functional status and habits. A management plan is created considering both the physical and psychological aspects of a patient’s diagnosis.

How do Physiatrists help patients?

Physiatrists can make clinical diagnoses, order diagnostic tests and prescribe treatment. At the end of your initial consultation you will be provided with a summary of your diagnosis and next steps.

What treatments do Physiatrists offer?
    • Education
    • Exercise prescription
    • Medications
    • Bracing and device prescriptions
    • Injections

    Injections

    Cortisone

    What are cortisone injections for?

    Cortisone is an anti-inflammatory steroid medication that is primarily used to treat pain flares.

    How do cortisone injections work?

    Cortisone injections work by reducing local inflammation and the irritation of joints or tendons. Pain reduction is a secondary benefit.

    How much do cortisone injections cost?

    We charge between $45-80 for a steroid injection depending on the types of medications used. MSP allows Physicians to charge for prescription medications used during the provision of services and the fee includes the cost of ordering and stocking the medication on site.

    What are the possible side effects?

    The risk of an adverse event from a local cortisone injection is low. Your physician will review the risks and benefits as part of the consent process prior to receiving an injection.

    The most common side effects are 2-4 days of glucose intolerance (in people with diabetes), sleep disturbance the night after the injection or a transient pain flare 2-5 days after the injection.

    What should I expect after my injection?

    A cortisone injection is commonly combined with local anesthetic. This means the area will feel numb for 4 to 8 hours. After the “freezing” of the local anesthetic wears off, patients may experience a temporary increase in pain. It is reasonable to use over the counter pain relievers for 24 to 48 hours after the injection for local pain.

    Cortisone injections typically take up to 7 days to reduce pain levels by more than 30%.

    If, after 5 days, you are still experiencing worsening pain, a red, hot swollen joint or tissue and fever, seek medical attention by calling the clinic, making an appointment to be seen by your family physician or presenting yourself to the local emergency department for evaluation.

    You can begin a supervised or home exercise program one week after cortisone injection unless otherwise specified by your physician.

    Injections

    Trigger Point

    What are trigger point injections for?

     Trigger point injections are injections of local anesthetic (usually lidocaine 1%) into taut bands within muscle tissue.

    How do trigger point injections work?

    There are several theories regarding how trigger point injections work. The needle fenestration of the taut band in combination with local anesthetic reduces muscle tension and pain.

    How long do trigger point injections last?

     Length of benefit depends on patient and injury factors. Expected benefits will be reviewed at the time of the injection.

     

    How much do trigger point injections cost?

    The visit and injections are covered by MSP. There is no fee.

    What are the possible side effects?

    The most common side effects are local pain and mild bruising that typically last 24-48 hours. Heat and light activity after the injection are advised.

    What should I expect after my injection?

    Most patients report an increase in their range of motion and reduction in pain and stiffness. If pain worsens and remains constant past 48 hours, please contact us by email or phone to discuss other treatment options.

    Injections

    Prolotherapy

    What are prolotherapy injections for?

    Prolotherapy is used for tendon and ligament injuries. Common conditions treated with prolotherapy are Achilles tendinopathy, tennis elbow, patellar tendinopathy (Jumper’s knee), sports related groin injuries and sacroiliac ligament pain.

    How do prolotherapy injections work?

    Prolotherapy is a dextrose solution that causes local tissue irritation and results in remodelling and longer term pain relief than cortisone injections. Typically a series of 2-4 injections are performed approximately 4 to 6 weeks apart. Results are usually seen after 2-3 injections.

    How much do prolotherapy injections cost?

    There is a fee of $75.50 + GST for the medication and its administration using ultrasound guidance.

    What are the possible side effects?

    The most common side effect is increased pain of the target site for 5-7 days. Patients are advised relative rest for one week after the injection.

    What should I expect after my injection?

    Your Doctor will outline a rehab plan for you and your therapist following the injection that includes target exercises and gradual return to preferred activities. Prolotherapy can be safely used in combination with shockwave therapy.

    Injections

    Hyaluronic Acid

    What are hyaluronic acid injections for?

    Hyaluronic acid injections are used as part of pain management for patients with mild to moderate osteoarthritis.

    How do hyaluronic acid injections work?

    Hyaluronic acid is a joint lubricant product that is injected into the joint space using ultrasound guidance. Hyaluronic acid is found naturally in our joints and in arthritis, concentrations decline. Increasing hyaluronic acid concentrations with injectable high molecular weight products has been shown to improve pain and function for 6 months or more. It does not reverse osteoarthritis but may delay time to joint replacement.

    How much do hyaluronic acid injections cost?

    Hyaluronic acid injection can be purchased from your local pharmacy or at our clinic. The cost is $525 + GST and typically reimbursed by extended health benefits plans.

    What are the possible side effects?

    The most common side effect is a pain flare of the affected joint lasting 3-5 days. If the affected joint becomes red, hot, swollen and painful we advise patients to seek medical attention urgently.

    What should I expect after my injection?

    Typically pain in the affected joint improves within 7-14 days following a hyaluronic acid injection and lasts for 6-12 months depending on the nature and severity of underlying osteoarthritis. Patients can return to their preferred activities as tolerated. Hyaluronic acid injections are best used as part of a comprehensive non-operative plan including strengthening exercises, bracing and activity modification.

    Injections

    Platelet Rich Plasma (PRP)

    What are PRP injections for?

    PRP injections are used to treat tendon and joint pain that doesn’t respond to usual measures like rest, strengthening and activity modification. The greatest benefits have been reported for the treatment of chronic tennis elbow and mild to moderate knee osteoarthritis.

    How do PRP injections work?

    PRP results in supraphysiologic concentrations of platelets being injected using ultrasound guidance in and/or around the target tissue. PRP is made using a commercial kit and flow cytometry or light absorption by cells. A 60mL blood draw is taken from a vein in the antecubital fossa and processed. The final product is 3mL to 5mL. The appointment typically takes 45 minutes to an hour.

    How much do PRP injections cost?

    The cost of PRP is $825 + GST which includes the blood draw and commercial kit.

    What are the possible side effects?

    The most common side effect of PRP is local pain at the injection site which lasts up to 3-5 days. If the affected area becomes red, hot, swollen and painful we advise patients to seek medical attention urgently.

    What should I expect after my injection?

    After PRP injection, patients are advised a period of rest up to 2 weeks depending on the nature and severity of their injury. Your Doctor will outline a rehab plan for you and your therapist following the injection that includes target exercises and gradual return to preferred activities. PRP injections are best used as part of a comprehensive non-operative plan including strengthening exercises, bracing and activity modification.