When physical therapy treatment is not providing enough pain relief we often resort to more invasive procedures. The following are the main categories of injections offered to combat degeneration in joints.
Steroid Injections act like the hormone cortisol, which reduces inflammation in the body. Besides possible pain relief, steroid injections can aide in diagnosis. For instance, if the pain is generated inside the joint, a complete relief of the symptoms initially should be expected. If there is no symptomatic relief, other causes of pain should be suspected. Results should last 4-6 weeks and can only be administered at least 3-4 months apart.
Gel injections mimic the fluid that a joint should naturally have. Hyaluronic acid gives the joint fluid its heavy and viscous, slippery quality. It acts as both a shock absorber and lubricant in your knee joint. An arthritic knee tends to have less protection against joint friction and impact. Viscosupplementation can lubricate and bind to the excessive inflammatory molecules produced within the joint thereby decreasing inflammation. It is recommended that for the best results a patient should receive three injections. Optimal results are expected 30 days following the initial injection and relief lasts 6-9 months.
Platelet rich plasma injections (PRP) injections aim to deliver a large amount of platelets to injured tissues to bolster the healing process. Platelets play a critical role in transporting the proteins that stimulate healing and suppress inflammation. The aim is to bolster the healing process. PRP injections are most effective when there isn’t significant joint damage. PRP injections are created by using a sample of your own blood. This is then centrifuged in a machine to separate the platelets and then reinjected into the joint capsule. Symptom relief tends to accumulate with each injection and on average lasts 9 months.
Stem cell injections are an exciting treatment that continues to evolve. The goal is to amplify the number of stem cells present at injury sites in order to enhance the body’s natural healing process. Besides having a regenerative potential, stem cells are powerful growth factors. Stem cell injections are created using a sample extracted from your body. Most commonly this sample is taken from bone marrow, but also blood, fat, or muscle can be used. You have to discontinue NSAIDs medications 2 weeks prior to injections. You should feel results within 4-6 weeks and results should last 6-9 months.
Given that no therapy is without risk, it is recommended that these therapies be used for symptomatic treatment not prevention of degeneration.