The pain of arthritis makes it tough for many people to get a good night’s sleep. Worse yet, tossing and turning at night can actually increase the perception of pain.
“There’s a reciprocal relationship between pain and poor sleep. The poorer people sleep, the more pain they tend to be in,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “If people with arthritis can improve the quality of their sleep, they can usually reduce their day-to-day pain.”
Your doctor can let you know if it would help you, based on your symptoms and other treatments you’ve tried. Though the shots have been available for more than a decade, studies on how effective they are have shown mixed results.
How They Work
Normally, a fluid called hyaluronan lubricates your joints. If you have osteoarthritis, your supply of hyaluronan has thinned.
The procedure is simple. Your doctor injects hyaluronic acid directly into the area around your knee joint. Most people get a shot a week for 3 to 5 weeks. The FDA has only approved this treatment for people with osteoarthritis of the knee, but some people get it in other joints as well.
There are different brands of hyaluronan. While they differ in some ways, none has been shown to work better or worse than another, says rheumatologist H. Ralph Schumacher Jr., MD, of the University of Pennsylvania Medical School and editor in chief of the Journal of Clinical Rheumatology.
Will This Treatment Help You?
Hyaluronic acid joint injections don’t work for everyone. The research is mixed on how well they work. They seem to work better for some people than for others. If you are older or have advanced osteoarthritis, you may be less likely to find relief from this treatment.
What to Consider
Usually, people only try hyaluronan when treatments like physical therapy, exercise, and injections with painkillers and steroids don’t provide enough help.
One advantage is that the side effects, such as swelling and discomfort on the area of your skin where you get the shot, are mild. Since the risks are small, your doctor may think that hyaluronan is worth a try, especially if your only other option is surgery.
Hyaluronan may also be a good choice if you have trouble with side effects of other treatments. For instance, some people can’t take common painkillers such as aspirin, ibuprofen, or naproxen because of the risk of gastrointestinal bleeding. And steroid injections, another common treatment for osteoarthritis, can harm your joints if overused.
Check with your insurance company before you start this treatment. Some cover the injections, but not all do. You’ll want to know ahead of time, since the shots are expensive.