4 Injections That Can Banish Joint Pain For Months
Article Published by: health.clevelandclinic.org
If you’re one of the 30 million adults in the United States who suffer with joint pain, you know the pain often is debilitating. It can keep you from staying active and even make daily chores seem impossible. What you might not know is that your doctor can treat you with more than pills or surgery.
Depending on the severity of your pain, injections can be another option for easing your joint pain and get you moving again, says physiatrist Michael Schaefer, MD.
“We use these injections to try to reduce inflammation and pain in your joints,” Dr. Schaefer says. “With these treatments, you often can experience fewer symptoms for several months.”
There are several injectable options to help treat knee pain, says sports and medical orthopaedist Jason Genin, DO.
“The injections range from corticosteroids, which have been around for decades, to newer orthobiologic injections like platelet-rich plasma (PRP) and placental tissue matrix (PTM),” he says.
Your physician will decide which one is best based on your individual needs, says sports and medical orthopaedist Dominic King, DO.
“Not every injection is right for every patient,” Dr. King says. “We take a lot of time to understand your specific issues and create an injectable plan that works with your entire knee care path.”
Use: This injection is the first line of defense against osteoarthritis symptoms and other joint pain in shoulders, knees and hips, Dr. Schaefer says. Corticosteroids can offer relief for two to three months, and reduce inflammatory cell activity in the joint.
Side effects: As with all injections, there’s a small chance of infection — about one in 1,000.
Cost: Most insurance covers the $100 cost of these injections. Your insurance provider may require that you try at least one corticosteroid injection first to see whether it works. If not, you may move on to a different therapy.
Use: Hyaluronic acid (HA) injections often are used when corticosteroid injections don’t work. But they usually are approved only for use in the knee.
In some instances, doctors consider an HA injection first if you don’t have obvious signs of inflammation. HA also is a better option if you have diabetes, as corticosteroids can raise blood sugar levels.
Also known as gel injections, HA injections are chemically similar to your natural joint fluid.
When you have osteoarthritis, joint fluid becomes watery. So, this injection helps to restore the fluid’s natural properties and works as a lubricant and a shock absorber.
“HA is a cushion or a buffer against inflammatory cells in the joint,” Dr. Schaefer says. “In some cases, it can stimulate the knee to start producing more natural HA.” Some physicians also believe that HA helps reduce pain by coating nerve endings within the joint.
One treatment, which may consist of between one and three injuections, usually offers symptom relief for four to five months, but sometimes up to one years. However, pain and stiffness will return. Most insurance companies only approve one HA injection every six months.
Side effects: There’s a 1-in-100 chance of an inflammatory reaction, Dr. Schaefer says. However, this reaction is less common with the newer HA injections.
Cost: HA injections cost more — about $300 to $750 per injection, but most insurance companies cover the cost for knee injections.
Platelet-rich plasma (PRP)
Use: Platelet-rich plasma (PRP) injections can treat osteoarthritis joint pain, and are being thoroughly researched to understand their effects, Dr. King says.
These injections use your own blood and platelets to promote healing. Platelets contain growth factors and proteins that aid healing in soft tissues. Research shows PRP injections can alter the immune response to help reduce inflammation, Dr. Schaefer says.
Side effects: Side effects include a very low risk of infection and pain at the injection site. You must stop oral anti-inflammatory medications for a short amount of time if you get a PRP injection, Dr. Genin says.
Cost: Insurance companies don’t generally cover PRP injections and you will pay between $500 and $1,000 per injection out-of-pocket.
Placental tissue matrix (PTM)
Use: Placental Tissue Matrix (PTM) injections can very profoundly decrease the pain related to osteoarthritis, Dr. King says.
These are injections of placental tissue, which is obtained after a healthy baby is delivered from a healthy mother. Research has discovered that there is a large number of growth factors in placental tissue that promote healing, Dr. Genin says.
Side effects: Side effects include a very low risk of infection and pain at the injection site. The placental tissue is “immune privileged,” which means the body would not have an adverse reaction to it.
Cost: Insurance companies don’t generally cover PTM injections; you will pay around $1,800 per injection out-of-pocket.
Many of these injections often are effective in reducing or stopping your joint pain, but it’s important to remember that they may not keep the pain from returning, Dr. Schaefer says. In fact, they’re most effective when used with other therapies.
“We consider surgical options and stronger medications only if other treatment options have failed,” he says. “But weight loss, physical therapy and bracing also go a long way toward relieving pain.”
ABOUT IFFIE OKORONKWO, M.D.
Iffie Okoronkwo, M.D. is a Spine and Sports Rehabilitation Medicine and Pain Management physician at Manhattan Spine and Sports Medicine (http://www.manhattanmd.com/), a private practice based in New York City with 40 years of experience providing the finest expert medical care and services to patients around the world.
Dr. Iffie is board certified in Physical Medicine and Rehabilitation and, as a physiatrist, utilizes ultrasound guided injections, fluoroscopy guided injections, PRP, regenerative medicine, and more to evaluate and treat a variety of conditions affecting muscles, joints, ligaments, and nerves.