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Non-Surgical Orthopedics – Asheville, NC

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Non-surgical orthopedics is one of the fastest-growing fields in all of medicine. It combines a wide variety of techniques and treatments to help patients overcome pain and injury without relying on powerful drugs or invasive surgery. If you’re ready for your back to stop hurting, or if your knee never seems to heal, Dr. Pinkston will do his best to help you finally enjoy the relief you deserve with the goal of avoiding any operations or lifetime prescriptions. You can learn more about everything he provides below, and to see what he could do for you, contact us today to schedule a FREE consultation to discuss non-surgical orthopedics in our Asheville, NC practice.

Why Choose Dr. James Pinkston for
Non-Surgical Orthopedic Treatments?

Diagnostic Musculoskeletal

Physician performing musculoskeletal ultrasound during non-surgical orthopedics visit

While traditional X-rays are extremely useful, they aren’t always the best tool when it comes to finding and identifying problems in a patient’s soft tissue. Musculoskeletal ultrasound allows Dr. Pinkston to look below the surface and see a patient’s muscles, tendons, ligaments, and other structures, so he can determine exactly what is causing someone’s pain. This leads to a more accurate diagnosis and effective treatment.


Patient receiving an ultrasound guided injection

Many of the treatments used by Dr. Pinkston come in the form of an injection, whether it’s fat or bone marrow derived biologic cell therapy, prolotherapy, or PRP therapy. Many doctors do their injections completely “blind,” as in they do not use imaging to tell exactly where the needle is going in the body. To make sure an injection goes precisely where it is planned and to avoid critical anatomy that could lead to complications, Dr. Pinkston utilizes ultrasound guidance. He’s able to see the needle once it’s under the skin and make sure whatever healing substance he’s using goes directly into the injured tissue, leading to better and more predictable outcomes.


Patient with back pain in need of neuromusculoskeletal injections for pain relief

Chronic pain and injuries often lead to inflammation, which is the root source of many musculoskeletal problems. Getting this inflammation under control and reducing it can be an extremely important step in a patient’s recovery. Localized injections of different therapeutic agents can help rapidly decrease pain and inflammation without many of the serious side effects that are associated with systemic medications. In many instances, these minimally invasive and cost-effective treatments can delay and even eliminate the need for surgical intervention. We offer a variety of neuromusculoskeletal injections including:

Physician placing corticosteroid injection in shoulder

Corticosteroid Injections

Corticosteroids are potent anti-inflammatory compounds that can provide immediate relief lasting weeks to months depending on the cause and severity of one’s discomfort. These should be used sparingly and are an option for those suffering with severe pain while working towards a more permanent solution.

Physician performing viscosupplementation treatment on patient's knee

Viscosupplementation Treatment

Viscosupplementation is a type of injection aimed at reducing joint pain. It contains a synthetic, viscous, or gel-like fluid that serves as a supplement to normal joint fluid. This non-surgical treatment can assist in temporary relief of discomfort from osteoarthritis in the knee, and may be helpful in the other joints such as the hip. Patients who have not had success with physical therapy or pain relievers to increase their mobility could be viable candidates for viscosupplementation treatments. These treatments can provide pain relief from 3 month up to a year or longer.

Physician placing trigger point injection in patient's back

Trigger Point/Tender Point Injections

Trigger point injections or tender point injections are performed by injecting a solution, which usually consists of lidocaine or another local anesthetic, directly into a muscle spasm or area of discomfort. This is done to break the pain cycle or to assist in muscle relaxation. Trigger points typically occur in a more restricted, regional pattern and can indicate myofascial pain syndrome. Tender points are areas of tenderness occurring in a more widespread manner, with similar characteristics similar to fibromyalgia. It is possible that the two conditions can exist in some patients with overlapping symptoms occurring.

Patient receiving botulinum toxin injection called Botox for facial pain

Botulinum Toxin Injections

Botulinum toxin is a neurotoxin produced by the bacteria clostridium botulinum, one example of this is Botox®. These injections can be used as a treatment for muscle spasms, such as facial twitching, and head/neck spasms, jaw pain, and migraines that do not respond to other measures. This injection will induce paralysis in the muscle(s) for approximately 3 months.

Animated spinal column with nerve block in place

Nerve Blocks

Also known as neural blockades, nerve blocks are designed to stop pain signals from reaching the brain. While these don’t help the body recover from an injury, they can deliver immediate pain relief, which can dramatically improve someone’s quality of life, while at the same time serving to help diagnose or more clearly define a problem area. They can be used to address pain felt in many areas of the body, and we have found them helpful in addressing many causes of discomfort. Dr. Pinkston is able to offer numerous types of nerve blocks so he can provide the ideal one for each patient and their specific issue.

Man with overlay of animated nerves and muscles after nerve hydrodissection

Nerve Hydrodissection

The nerves often have to travel through muscles and other connective tissue in order to reach their final destination, and if the nearby tissue becomes constricted, swollen, or inflamed, this can lead to something called nerve entrapment. A patient may experience pain, numbness, and a loss of strength because the nerve in a certain part of the body is literally being squeezed, so it cannot function properly. A common example of this is Carpal Tunnel Syndrome. Nerve hydrodissection relieves pressure from a distressed nerve by coating it in a thin layer of fluid, which establishes a much-needed cushion, freeing up the nerve while stopping the pain and other associated symptoms.

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