Traumeel & Zeel Injection Therapy – Foot & Ankle

What are Traumeel and Zeel?

Traumeel and Zeel are multi-component medicinal preparations containing a combination of ingredients in low concentrations.

Traumeel contains a combination of plant- and mineral-derived ingredients and is used in the management of inflammatory musculoskeletal conditions.

Zeel is a different multi-component preparation used in the management of osteoarthritis and degenerative joint conditions.

They may be used together where your podiatrist considers this an appropriate treatment option.

They do not contain corticosteroid.

How do Traumeel and Zeel work?

Traumeel and Zeel are intended to influence biological processes associated with inflammation, pain and musculoskeletal function.

Unlike corticosteroid injections, which primarily work through a potent suppression of inflammatory pathways, Traumeel and Zeel are proposed to have a broader modulatory effect on inflammatory processes.

The precise mechanisms and clinical effects continue to be studied.

The aim of treatment is to help:

• reduce pain and discomfort
• improve movement and function
• manage symptoms associated with inflammation or degenerative joint change; and
• make everyday activity and rehabilitation more comfortable.

They should not be considered treatments that have been proven to regenerate cartilage or reverse established osteoarthritis.

Why have Traumeel and Zeel been recommended?

Traumeel and Zeel may be considered for selected painful musculoskeletal conditions, particularly where a non-steroid injection option is preferred or considered appropriate.

Depending on your diagnosis, this may include selected:

• painful or degenerative joints
• osteoarthritis
• inflammatory musculoskeletal conditions
• persistent joint-related pain; and
• other foot and ankle conditions where your podiatrist considers treatment appropriate.

Not every painful foot or ankle condition is suitable for this type of injection.

Your podiatrist will have considered your diagnosis, clinical findings, previous treatment, medical history and individual circumstances before recommending treatment.

What does the research show?

Traumeel and Zeel have been investigated in clinical research for musculoskeletal pain.

A controlled clinical trial involving patients with painful knee osteoarthritis found that combined Traumeel and Zeel injections produced greater improvement in pain than saline injections during the study period.

However, the overall clinical research base is more limited than for some established conventional treatments, and there is less high-quality research specifically involving foot and ankle conditions.

For this reason, we do not use a single success rate or suggest that every patient or condition will respond in the same way.

Your podiatrist will explain why this treatment has been recommended in your particular circumstances and what improvement would realistically be expected.

Why do we use ultrasound guidance?

At The Podiatry Clinic, ultrasound guidance is normally used where appropriate for foot and ankle injections.

Ultrasound allows your podiatrist to visualise many of the relevant structures beneath the skin and guide the needle towards the intended treatment area.

This can be particularly useful when treating the relatively small joints and soft-tissue structures found within the foot and ankle.

The injection can therefore be planned according to your individual anatomy and diagnosis.

What happens during the procedure?

Before proceeding, your podiatrist will confirm the treatment area, review relevant medical information and discuss the procedure with you.

You will have an opportunity to ask questions before providing consent.

The skin is cleaned using an appropriate antiseptic solution.

Where appropriate, ultrasound is used to identify the treatment area and guide the procedure.

A sterile needle is then carefully introduced and the medication administered into or around the intended structure.

Depending on the condition being treated, Traumeel and Zeel may be used together.

A small dressing may be applied afterwards.

The injection itself normally takes a relatively short time, although your appointment allows time for assessment, preparation and appropriate aftercare advice.

What does the injection feel like?

You will feel the needle entering the skin and may experience:

• brief stinging
• pressure
• aching; or
• temporary discomfort

as the medication is administered.

If a joint is being injected, you may temporarily notice a feeling of pressure or fullness.

Most patients tolerate the procedure well.

How many treatments will I need?

The number and frequency of injections depend on:

• your diagnosis
• the structure being treated
• the severity and duration of your symptoms
• your response to treatment; and
• your overall treatment plan.

Your podiatrist will recommend an appropriate treatment schedule and review your response before deciding whether further treatment is appropriate.

Treatment is not continued automatically if you are not experiencing a worthwhile clinical benefit.

What results can I expect?

The aim of Traumeel and Zeel injection therapy is to provide a meaningful reduction in pain and improvement in function.

Some patients may experience useful symptom improvement, making walking, exercise and everyday activities more comfortable.

Response varies between individuals.

The amount and duration of improvement can depend on:

• the condition being treated
• the structure involved
• the severity of the underlying problem
• how long symptoms have been present
• other factors contributing to the condition; and
• your individual response.

Some patients may experience significant improvement, while others may experience a smaller response or little benefit.

Improvement cannot be guaranteed.

When should I expect improvement?

Response does not necessarily occur immediately following the injection.

Improvement may develop gradually following treatment.

Your podiatrist will review your response according to changes in:

• pain
• movement
• walking or activity
• function; and
• your ability to participate in rehabilitation.

For longstanding musculoskeletal and degenerative conditions, symptom improvement does not necessarily mean that the underlying condition has completely resolved.

What happens after the injection?

You will normally be able to walk following your appointment.

We generally recommend taking things relatively easy for the remainder of the day and avoiding unnecessary strenuous or high-impact activity immediately following an injection.

The treated area may temporarily feel:

• sore
• aching
• tender
• mildly swollen; or
• more sensitive than usual.

Minor bruising around the injection site can also occur.

Your podiatrist will provide specific advice according to the structure that has been treated.

Injection therapy works best as part of a treatment plan

Reducing pain can provide an opportunity to improve movement and address factors contributing to your condition.

Depending on your diagnosis, your treatment plan may therefore also include:

• strengthening or mobility exercises
• progressive rehabilitation
• activity modification
• footwear advice
• taping or bracing
• orthotics
• gait or pressure analysis
• weight management where relevant; and
• other treatments where appropriate.

Injection therapy should therefore be viewed as one component of your overall treatment plan where other interventions are also required.

What are the potential benefits?

Potential benefits of Traumeel and Zeel injection therapy include:

• a non-steroid injection option
• targeted treatment to the affected area
• potential reduction in pain and discomfort
• potential improvement in movement and function
• relatively short procedure
• little downtime for most patients
• ability to combine treatment with rehabilitation; and
• an additional non-surgical treatment option for selected musculoskeletal conditions.

What are the possible side effects and risks?

Traumeel and Zeel injections are generally well tolerated, but all injection procedures carry potential risks.

Temporary effects may include:

• discomfort during the injection
• soreness or aching afterwards
• mild swelling
• bruising
• temporary increase in symptoms; and
• tenderness around the injection site.

Less common risks associated with injection procedures include:

• bleeding or more significant bruising
• infection
• irritation or injury to a nearby nerve
• blood-vessel injury
• injury to surrounding tissues; and
• allergic or hypersensitivity reaction.

Traumeel and Zeel contain multiple ingredients, including plant-derived components. Allergic reactions are therefore possible, particularly in people with sensitivity to one or more of the ingredients.

Serious complications are uncommon when patients are appropriately assessed and injections are performed using appropriate clinical precautions.

Allergies and immune-system conditions

It is important to tell your podiatrist about all known allergies, including allergies to plants or herbal preparations.

Traumeel contains ingredients derived from plants within the daisy (Asteraceae) family, including ingredients such as Arnica, Calendula, Echinacea and others.

Treatment may not be appropriate if you have a known hypersensitivity to one of the ingredients.

Traumeel also contains Echinacea. Additional consideration may therefore be required for patients with certain immune-system disorders, autoimmune conditions, immunodeficiency or immunosuppression.

Your podiatrist will review your medical history before recommending treatment.

Is Traumeel and Zeel injection therapy suitable for everyone?

Treatment is not appropriate for every patient or every condition.

Your podiatrist will consider factors including:

• your diagnosis
• the structure being treated
• allergies or previous hypersensitivity reactions
• active infection or recent illness
• infection or skin problems around the injection site
• immune-system conditions
• anticoagulant or antiplatelet medication
• pregnancy or breastfeeding
• previous injections or procedures
• previous surgery
• your medications and medical history; and
• other factors that may affect treatment.

Please tell your podiatrist about any significant change in your health or medication before treatment.

What are the alternatives?

Your alternatives depend on your diagnosis.

These may include:

• rehabilitation and progressive loading
• activity modification
• footwear changes
• taping or bracing
• orthotics
• medication
• corticosteroid injection where clinically appropriate
• hyaluronic acid injection for appropriate joint conditions
• prolotherapy
• other injection therapies where appropriate
• focused or radial shockwave therapy
• Class IV laser therapy
• further imaging
• specialist assessment
• surgery for selected conditions; or
• choosing not to have the injection and continuing with conservative management.

Your podiatrist can explain which alternatives are relevant to your particular condition.

How much does Traumeel and Zeel Injection Therapy cost?

Traumeel / Zeel Injection Therapy – Foot & Ankle: £295

The fee includes the injection procedure and ultrasound guidance where clinically appropriate.

Your podiatrist will advise whether further treatment is appropriate according to your response.

When should I contact the clinic?

Some temporary soreness following an injection can be normal.

Please contact the clinic if you develop:

• severe or unexpectedly increasing pain
• significant swelling
• increasing redness or warmth
• discharge from the injection site
• persistent numbness or weakness
• an unexpected loss of function
• a significant rash or other suspected reaction; or
• anything else that concerns you following treatment.

Seek urgent medical advice

Infection following an injection is uncommon but requires prompt assessment.

Seek urgent medical advice if you develop severe or increasing pain associated with marked swelling, redness or heat, particularly if you also feel unwell or develop a fever.

Seek emergency medical assistance if you develop symptoms of a serious allergic reaction, such as difficulty breathing or significant swelling of the face, lips, tongue or throat.

Your next step

If you have already booked your treatment

Please attend your appointment as arranged.

Make sure we are aware of your current medication, allergies and any significant changes in your medical history.

If you have developed an infection, started antibiotics, become pregnant or there has been another important change in your health, please tell us before treatment.

Your podiatrist will review the treatment with you and answer any questions before you provide consent.

If Traumeel and Zeel injection therapy has been recommended but you have not yet booked

You can book your Traumeel / Zeel Injection Therapy – Foot & Ankle appointment when you are ready to proceed.

£295

Important information

This information sheet supports the discussion you have had with your podiatrist and is intended to help you make an informed decision about treatment. It does not replace individual clinical advice.

Traumeel and Zeel provide a non-steroid injection option that may be considered for selected painful, inflammatory or degenerative musculoskeletal conditions.

Clinical research provides some evidence supporting their use for musculoskeletal pain, particularly osteoarthritis, although the evidence base is more limited than for some established conventional treatments and research specifically involving foot and ankle conditions is limited.

Individual responses vary and improvement cannot be guaranteed.

Before treatment, your podiatrist will confirm that the treatment remains appropriate, discuss the relevant benefits, risks and alternatives with you, and provide an opportunity to ask questions before giving your consent.

The Podiatry Clinic