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Should You Give Injectables a Shot for Osteoarthritis Pain?
Finding relief from knee pain can be a trying experience for the nearly 27 million Americans who live with osteoarthritis. Non-steroidal anti-inflammatory drugs (NSAIDs) help many, but these medications can have serious side effects, including ulcers and serious gastrointestinal bleeding. What?s more, supplements such as glucosamine and chondroitin, which were once hailed as miracles, have not always lived up to their claims in clinical studies.
Although joint replacement surgery is an option for many with advanced osteoarthritis (OA), new types of injections may help postpone the need for knee replacement surgery -- and help relieve pain in people who are not candidates for the surgery.
An Exercise Fix for Knee Osteoarthritis
Jerry Wade used to love bird-watching with his wife, an avid birder. "I'm not a birder myself, but I like being active and getting out there with her," he says. "Bird-watching puts you into natural areas and some rough terrain -- it's not an easy physical activity." But in the fall of 2005, the 66-year-old Columbia, Mo., resident, who had retired in 2000 from a career in community development, started noticing "pains and twinges" in his knees. A visit to his doctor in January 2006 brought...
Read the An Exercise Fix for Knee Osteoarthritis article > >
From steroids and hyaluronic acid to Botox (yes, the same Botox used by millions to paralyze their wrinkles) and stem cells, injectables do have a growing and important role in the multi-pronged approach to treating OA.
?Using injections to treat OA is becoming more mainstream,? says Jennifer L. Solomon, MD, an assistant attending physiatrist at the Hospital for Special Surgery and a clinical instructor at Weill Cornell Medical College, both in New York City. ?These are good options that can improve quality of life, especially for people who can?t undergo joint replacement.?
Osteoarthritis Treatments: Steroid Injections
Knees hurt? ?Steroid injections can decrease inflammation, which can cause joint cartilage breakdown and can be very effective at relieving OA pain,? says Edward Puzas, PhD, a professor of orthopedics at the University of Rochester at Rochester, NY.
But corticosteroid injections are certainly not a panacea for OA, says Elaine Husni, MD, MPH,the vice chair of rheumatology and the director of Arthritis and Musculoskeletal Center at the Cleveland Clinic in Ohio.
?Steroids are more of a one-time, last-resort treatment, and some people do get a lot of pain relief that lasts for months and months,? she says. Steroid injections can also be used with other treatments such as NSAIDs. ?Sometimes we use NSAIDs to get rid of stiffness and steroids for the pain,? Husni says.
Solomon agrees. ?If there is a lot of inflammation and acute irritation, steroid injections are the way to go,? she tells WebMD. ?If the pain is really more chronic, I still go with hyaluronic acid.?
Hyaluronic Acid Injections Can Help OA
Joint-lubricating injections of hyaluronan or hyaluronic acid also play a role in treating OA. Known as viscosupplementation, these injections basically replenish a substance found in normal joint fluid called hyaluronic acid. Several brands are available, including Euflexxa, Hyalgan, Orthovisc, Supartz, Synvisc, and Synvisc-One.
When injected directly into the knee, these OA treatments allow the cartilage surfaces of the bones to glide over each other more smoothly. They also act as a shock absorber to cushion your knee joint. Although these injections are only approved for the knee, some doctors use them for other arthritic joints, Solomon says.
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