Common Questions

A referral is required for insured joint or tendon consultations and procedures. A referral is not required for privately paid PRP, hyaluronic acid, or prolotherapy when the patient understands the service is out of pocket. Private insurance reimbursement is not guaranteed. Current booking details are not yet available.

Usually not. The first visit is a consultation and assessment. If a procedure is appropriate, it is generally booked as a separate appointment so there is time for informed consent, preparation, and procedure-specific planning.

Selected shoulder, elbow, wrist, knee, hip, ankle, and foot concerns, as well as trigger finger, localized muscular trigger points, and acute sports injuries. Concussion is managed but is not a primary advertised service. Dr. Yang does not treat spinal conditions or chronic back pain.

He does not provide definitive fracture care. If a fracture is suspected during assessment of joint or sports-injury pain, he can provide appropriate initial management and arrange orthopedic referral when indicated. Emergency features require urgent or emergency care.

PRP, hyaluronic acid, prolotherapy, selected corticosteroid injections, trigger finger injections, and trigger-point injections, depending on the diagnosis and individual assessment.

No. Dr. Yang uses ultrasound guidance for most musculoskeletal procedures, especially when the target is deep, small, difficult to palpate, close to important nerves or blood vessels, or when fluid aspiration or exact needle placement matters.

Ultrasound allows the clinician to see the target, needle path, and nearby structures in real time. It does not “see pain” or prove that an injection is the correct treatment. Evidence and professional recommendations show that ultrasound often improves injection accuracy, but better accuracy does not consistently translate into better long-term pain or function. The size of any clinical benefit depends on the joint, target, diagnosis, injectate, and operator expertise.

Landmark-guided injection can therefore remain reasonable for selected straightforward targets. Dr. Yang may perform trigger-finger injections and occasional shoulder or knee injections without ultrasound when examination, anatomy, and the planned procedure make that appropriate. Sterile technique, correct diagnosis, informed consent, and clinician skill remain essential with either method.

Evidence: EULAR recommendations for intra-articular therapies.

These injections differ in what is injected, why it is used, and how certain the evidence is.

• PRP: Prepared from the patient’s own blood and contains concentrated platelets in plasma. PRP products are not standardized: platelet concentration, leukocyte content, processing, and the number of injections vary. Evidence is most developed for selected symptomatic knee osteoarthritis and some chronic tendinopathies, but results and guideline recommendations differ by diagnosis. It is not proven to regrow cartilage or reliably heal every tendon.
• Hyaluronic acid: A manufactured viscosupplement intended to alter the joint-fluid environment. It is used mainly for selected knee osteoarthritis and may provide temporary symptom relief for some patients, but it does not rebuild cartilage. Guidelines disagree and are cautious: AAOS does not recommend routine use for symptomatic knee osteoarthritis; the ACR/Arthritis Foundation conditionally recommends against it for knee osteoarthritis and strongly recommends against it for hip osteoarthritis, while recognizing that shared decision-making may still occur after other options have been considered.
• Prolotherapy: Usually hypertonic dextrose injected into or around selected joints, tendon or ligament attachments, or localized trigger points. Studies suggest possible benefit for some conditions, particularly knee osteoarthritis, but many trials are small or at high risk of bias, and evidence across tendon and ligament conditions remains inconsistent. It should not be described as proven tissue regeneration.

Bottom line: none is automatically the best option. Diagnosis, severity, rehabilitation, previous treatment, medical risks, cost, and patient goals matter. All can cause a temporary pain flare, bruising, bleeding, infection, or no meaningful improvement; specific risks differ by target and technique.

Evidence: AAOS knee osteoarthritis guideline, ACR/Arthritis Foundation osteoarthritis guideline, and systematic review of dextrose prolotherapy for knee osteoarthritis.

Yes. A temporary increase in soreness, stiffness, bruising, or swelling at the injection or blood-draw site is a recognized reaction after PRP. It commonly begins during the first day and settles over the next several days, but intensity and duration vary with the structure treated, injection volume and technique, the underlying condition, and PRP composition.

Studies of knee osteoarthritis report mostly mild, transient local reactions. Leukocyte-rich preparations may cause more post-injection pain and swelling than leukocyte-poor preparations. Follow the procedure-specific activity and medication instructions. Do not stop aspirin, an anticoagulant, or another prescribed medicine unless the prescribing clinician has advised it.

Contact the treating clinic promptly for severe or progressively worsening pain, fever or chills, spreading redness or warmth, drainage, marked swelling, new weakness or numbness, colour change, or other symptoms that seem out of proportion. These features are not assumed to be a routine PRP flare and may require urgent assessment.

Evidence: systematic review of adverse reactions after knee PRP. See also the website’s PRP aftercare sheet.

No. Corticosteroid injections can be useful when the diagnosis and treatment goal fit their strengths—for example, selected inflamed joints or bursae, adhesive capsulitis, trigger finger, carpal tunnel syndrome, or other conditions where short-term reduction of inflammation may help pain, sleep, movement, or participation in rehabilitation. They do not repair cartilage or reverse tendon degeneration.

Benefit is diagnosis-specific and often temporary. In tendinopathy, evidence commonly shows better short-term pain relief but little long-term benefit; for lateral elbow tendinopathy, some trials found worse intermediate- or long-term outcomes than no injection. Steroid should not be injected into tendon substance.

Risks include a temporary pain flare, skin lightening, local fat or tissue atrophy, transient elevation of blood glucose, bleeding, and infection. Tendon injury or rupture is uncommon but important, particularly around tendons. Dose, target, number and spacing of injections, diabetes, anticoagulant use, infection risk, and possible future surgery all affect the decision. Repeated injections are not automatically appropriate.

Bottom line: the choice should follow a diagnosis, discussion of alternatives and expected duration of benefit, and a rehabilitation plan when relevant.

Evidence: EULAR intra-articular therapy recommendations, systematic review of corticosteroid and other injections for tendinopathy, and AAOS knee osteoarthritis guideline.

Bring identification, your BC Services Card when relevant, a medication list, and available reports or imaging that have not already been forwarded. Clothing that allows the relevant body area to be examined is helpful.

No patient waitlist or appointment queue is open. You can request one email when independent-practice contact or booking information is confirmed. Do not submit symptoms or personal health information.