Non-surgical treatments for arthritis include injections into the painful joint. The two most common types of injections for arthritis are steroid injections and hyaluronics injections (viscosupplementation).
It is important to note that joint injections are intended to reduce pain symptoms from arthritis such that patients can participate in physical therapy exercise and everyday activities in order to stretch and strengthen the arthritic joint.
So what exactly are they and how can they help?
Therapeutic knee injections can reduce painful symptoms related to knee osteoarthritis. Injections are often used in conjunction with other nonsurgical treatments—such as physical therapy, bracing or medications.
Knee injections typically deliver medicine directly inside the knee joint capsule. Ultrasound may be used to help guide placement of an injection.
Cortisone injections work by treating the inflammation that can cause knee pain, swelling, and warmth. The effects of a cortisone injection can last from 3 weeks to 3 months, and occasionally longer.
People who want quick, temporary relief from knee arthritis pain may choose to have a cortisone injection. The temporary pain relief may allow a person to engage in physical therapy; attend to an important life event, such as a long-planned vacation; or postpone knee replacement surgery to a later, more convenient time.
Why Get a Cortisone Injection?
In general, patients receive cortisone injections for one of two reasons: to treat a condition or to provide information for an accurate diagnosis.
Cortisone to treat joint pain
A cortisone injection typically relieves inflammation and pain for between 6 weeks and 6 months. The pain may return after that time or it may not, depending on the person, the condition being treated, and follow-up care.
Temporary pain relief allows the patient to:
Treat an arthritic flare-up. For arthritic conditions such as a gout flare-up, a cortisone injection can relieve pain while the gout episode runs its course. The patient may also be prescribed oral medications and be advised to make dietary changes.
Participate in physical therapy. Pain relief from a cortisone injection gives the patient an opportunity to participate in physical therapy to improve the affected joint’s biomechanics. Ideally, by the time the effects of the cortisone wear off, the joint is healthier so pain is tolerable or even eliminated.
Rest the joint. A painfully inflamed joint needs to rest to recover. For example, patients with an inflamed bursa may need to adequately rest the affected joint in addition to participating in physical therapy.
Postpone surgery. In moderate to severe cases of arthritis, a joint replacement or another surgical treatment may be recommended. For patients who want to postpone or avoid surgery, cortisone injections may allow them to live with less pain.
Almost all types of arthritis are chronic, and a cortisone injection is just one part of a larger treatment plan.
Hyaluronic Acid Injections for Knee Arthritis
A hyaluronic acid injection delivers lubricating fluid into the knee joint. The goal is to temporarily lubricate the knee joint, thereby decreasing knee pain and inflammation, improving knee function, and perhaps even slowing the degeneration process.
Generally, hyaluronic acid injections are slower to take effect than cortisone injections; however, the positive effects may last longer.
These injections are sometimes called viscosupplementation injections.
How Viscosupplementation Works
During viscosupplementation a small amount of hyaluronic acid, often just 2 mL, is injected directly into a joint capsule.
A healthy knee joint has up to 4 mL of joint fluid within the joint capsule.1,2 Hyaluronic acid is a key component of the joint fluid. It gives the joint fluid its viscous, slippery quality, which does the following:
- Enables the bones’ cartilage-covered surfaces to glide against each other, thereby reducing joint friction
- Adds cushion to protect joints during impact (e.g. weight-bearing activity)
Joints affected by osteoarthritis typically have a lower concentration of hyaluronic acid in their joint fluid than healthy joints, and therefore less protection against joint friction and impact. Experts believe this further accelerates the joint degeneration process, setting in place a vicious cycle.
As its name implies, viscosupplementation artificially supplements the joint fluid’s natural viscosity. By injecting a man-made hyaluronan into the knee, doctors hope to temporarily lubricate the knee joint, thereby decreasing pain improving function and perhaps even slowing the degeneration process.
For more information on any of these treatments or to find out more contact our team today