New York State Medical Treatment Guidelines for
Therapeutic Injections in workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Injections: Therapeutic.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders.

The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Injections: Therapeutic

Anesthetic and/or anti-inflammatory drugs are injected therapeutically into the painful structure. The potential advantages of therapeutic injections are numerous. A therapeutic injection should, in theory, (a) lessen inflammation in a particular target location, (b) ease subsequent muscular spasm, (c) provide pain relief, and (d) promote therapy aimed at functional recovery.

Early and targeted use of diagnostic and therapeutic injections is necessary to establish a diagnosis and assist rehabilitation. Injections may be much less useful if they are overused or used outside of a closely controlled rehabilitation programme.

Contraindications: Local or systemic infections, clotting issues, drug allergies, and patient refusal are examples of general contraindications. Individual injections might be subject to certain contraindications.

  1. Soft Tissue Joint Injections

    Soft Tissue Joint Injections is recommended clinically appropriate in a subset of patients.

    Indications: Injections into soft tissues and joints can be used as analgesic or anti-inflammatory treatments. It is not advised to inject into the tendon.

    Frequency: not more often than twice or three times per year. One or two injections are typically sufficient.

    Time to produce effect: With local anaesthetics, immediately, or with corticosteroids, three days later.

    Optimum/maximum duration: only three injections at the same location each year, maximum


  2. Trigger Point Injections

    Trigger Point Injections is not recommended.


  3. Prolotherapy (also known as sclerotherapy)

    Prolotherapy (also known as sclerotherapy) is not recommended.


  4. Protein Rich Plasma (PRP)

    Protein Rich Plasma (PRP) is not recommended.


  5. Intra-Capsular Acid Salts – Viscosupplementation of Injections

    Intra-Capsular Acid Salts – Viscosupplementation of Injections: Therapeutic are recommended in clinically appropriate in a subset of patients.

    Indications: It is advised that these injections be taken into account as a therapeutic alternative in patients who have not responded to non-pharmacological and analgesic treatment, especially if non-steroidal antiinflammatory medication treatment is contraindicated or surgery is not a possibility.

    Viscosupplementation’s use in severe osteoarthritis and its effectiveness after six months are not well understood.

    Frequency: As directed by the product, one series of injections. Repeat use may be considered after six months if symptoms return if the first use is linked to improved function and reduced symptoms. The ideal time frame varies. The effectiveness after six months is unknown.

What our office can do if you have workers compensation injuries

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.


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Dr. Nakul Karkare

I am fellowship trained in joint replacement surgery, metabolic bone disorders, sports medicine and trauma. I specialize in total hip and knee replacements, and I have personally written most of the content on this page.

You can see my full CV at my profile page.