There are many different types of injections that can provide anti inflammatory medication directly to the source of pain. At Supreme Medical Center we offer many of these joint injection to help our patients get the pain relief they are searching for.
Joint Injections for Arthritis Pain
The Arthritis Foundation shares information about specific joint injections that help to relieve arthritis pain.
What it is: A combination of a corticosteroid (or “steroid”), like cortisone, and a numbing agent is injected directly into the joint affected by arthritis. These shots are given in the doctor’s office and usually are covered by medical insurance.
Benefits and Risks: Injections provide safe and effective reduction of pain and inflammation. Relief typically lasts about a month. An extended-release formula called Zilretta to treat osteoarthritis (OA) pain in the knee provides three months of symptom relief.
Some people will have a temporary flare of pain in the injected joint, which should resolve in 48 hours. Repeated cortisone shots can cause the cartilage to deteriorate and weaken tendons and ligaments around the joint.
Who It’s Best For: Steroid injections are good for people with a very painful or inflamed joint who need fast, temporary relief.
Joints Treated: Ankle, elbow, hip, knee, shoulder, and small joints of the hands, feet, spine and wrists. Zilretta is for use in knees; it has not been tested for shoulders or hips and is not to be used in small joints, such as hands.
What it is: Hyaluronic acid (HA) is a natural lubricant that breaks down in joints affected by osteoarthritis. HA injections — also called viscosupplementation — help replace the lubricant lost to breakdown. Different brands have different dosing schedules, usually one injection per week for three or five weeks. These shots are given in the doctor’s office and are often covered by medical insurance, but pre-authorization may be required.
The most common side effects are pain, swelling, and stiffness in and around the joint.
Joints Treated: HA injections are approved by the FDA for use in knees only, but it’s commonly used off-label in shoulders and hips as well.
What it is: Prolotherapy involves a series of injections of an irritant (often a sugar solution) into joints, ligaments and tendons. The treatment is based on the theory that the injections stimulate local healing of injured tissues. A treatment program may involve 15 to 20 shots given monthly for three to four months.
Benefits and Risks: Prolotherapy has been around for 75 years, and several placebo-controlled studies show that it relieves pain and stiffness.
Who It’s Best For: For people with OA who have not gotten enough relief from physical therapy and losing weight, this may be an option.
Joints Treated: Nearly any joint affected by tendinitis or osteoarthritis can be treated. Best results were found in knee, low back and fingers.
Autologous Conditioned Serum
What it is: Autologous conditioned serum (ACS) is made from your own blood. First, your blood is drawn and it sits in a special container, usually overnight. The incubated blood has an increased concentration of anti-inflammatory molecules. You go back to the doctor’s office the next day and the conditioned serum is injected into your affected joint(s).
This procedure is done by specialists — usually an orthopaedic surgeon or sports medicine doctor — who offer the service. Depending on the protocol, it may be a one-time injection, or done once a week for three or five weeks, or even twice a week for three weeks.
Benefits and Risks: A 2015 study published in PLoS One showed that ACS combined with physical therapy reduced knee OA pain and improved function for two years. Side effects are extremely rare, but you may have some swelling and bruising at the injection site.
Who It’s Best For: ACS treatments are best for people with moderate arthritis; results are less predictable in people with extensive joint damage.
Joints treated: ACS is more commonly used for muscle, tendon and ligament damage than it is for arthritis.
What it is: Joint aspiration, or arthrocentesis, is a procedure in which a syringe is used to draw excess fluid from a joint to ease swelling and pressure. A local anesthesia may be injected first to numb the area, and in certain situations an ultrasound may be used at the same time to help guide the needle.
Your doctor might send a sample of the synovial fluid for testing to determine cause of the fluid buildup, such as the presence of infection or inflammation. Aspiration is most commonly done on knees, but it may be used in elbows, shoulders or other joints. The procedure may need to be repeated if fluid buildup recurs. The cost of this procedure is generally a few hundred dollars and covered by insurance.
Benefits and risks: Removing excess fluid typically eases joint pain and stiffness and improves flexibility. It also provides information needed to diagnose certain arthritis and infectious conditions, so your doctor can provide appropriate treatment.
Risks are rare, but if bacteria get into the joint — especially with cellulitis, a bacterial skin infection — a joint infection may result. Patients who have a bleeding disorder may experience some bleeding from the procedure, and those who are allergic to the anesthesia should not receive that class of drug.
Who it’s best for: Joint aspiration can provide pain and pressure relief for those experiencing joint swelling from synovial fluid buildup. For people who experience undiagnosed joint pain, arthrocentesis can be used to diagnose osteoarthritis, gout, rheumatoid arthritis and seronegative (meaning a negative test for rheumatoid factor in the blood) spondyloarthropathies such as ankylosing spondylitis, psoriatic arthritis and others.
Joints treated: Knees are the most common sites for aspiration, but the procedure may be used in any joint except axial joints (the vertebra and rib cage).
Supreme Medical Center in Houston
When it comes to getting better fast, the best thing you can do is schedule an appointment with your physician at the first sign of illness. At Supreme Medical Center our doctors work with you to treat your symptoms and get you back to feeling like yourself in no time.