Osteoarthritis (OA) of the knee can cause pain and stiffness that can interfere with even the simplest day-to-day activities. For some, over-the-counter and prescription pain medications can provide enough relief, especially in early-stage OA. For others, it may be necessary to try other treatment options. If you have tried medications with little to no relief and aren’t ready for surgery, then injectable treatments for OA may do the trick and get you the relief you’re looking for.
The following information provides an overview of each of the different types of injectables for OA of the knee. Discuss these options with your doctor to see which one might be right for you.
Corticosteroid injections are the most commonly used injectables for OA of the knee. The injection often contains a combination of steroids as well as a local anesthetic. Some doctors may use two separate needles: one to inject the steroid and another to inject the anesthetic. The corticosteroids are injected directly into the knee joint for targeted relief from pain and inflammation. These injections occur anywhere from every few days to several months apart, depending on the patient.
Although these treatments are commonly used and known to provide relief with few side effects, most doctors will limit the number of injections a patient receives. Some evidence has suggested that repeated injections in the knee can break down cartilage. Some pain and redness is common at the injection site. This can be relieved by applying ice to the area. Redness and warmth on the face or chest is also fairly common after receiving a corticosteroid injection. Infection and bleeding are very rare complications. People with diabetes should be aware that corticosteroid injections may temporarily increase blood sugar levels.
Viscosupplementation (Hyaluronic Acid Injections)
Viscosupplementation isn’t as widely used as corticosteroid injections, but may be an option if other treatments have failed to provide relief. It involves injecting a gel-like substance called hyaluronic acid (HA) into the knee joint. HA is naturally found in the joint fluid and works as a lubricant to help joints move smoothly. It also acts as a cushion during walking. People with OA have less HA in the joints.
Your injection schedule will depend on which specific product is used. Some brands include Synvisc, Hyalgan, Euflexxa, and Orthovisc. Treatments can range from weekly injections to anywhere from three to five weeks. If your knee is swollen, a small amount of joint fluid may first need to be removed in order to make room for the HA.
Viscosupplementation doesn’t provide relief for everyone, and results vary from person to person. Common side effects are similar to those mentioned above for corticosteroid injections, with most people experiencing only some discomfort at the injection site. Again, infection and bleeding are rare complications. Unlike with corticosteroids, you’re required to avoid putting strain on the joint for the first 48 hours following treatment.
Arthrocentesis (Joint Fluid Aspiration)
Although it doesn’t necessarily involve injecting anything into the body, arthrocentesis does use a needle to help relieve pain associated with OA of the knee. A hollow needle is inserted into the joint to remove excess joint fluid. For many, some relief of pain and inflammation occurs almost immediately.
Along with the removal of excess fluid, arthrocentesis can also be used to diagnose knee problems. For people with OA, it can be used before a corticosteroid or HA injection. Those who are suffering from excess fluid in the knee will need to have this procedure before receiving other treatments for their knee pain.
The right injectable treatment for you will depend on the severity of your OA and symptoms. Your doctor will also consider other factors, such as other medical circumstances, when deciding which treatment option is best for you.