What are Joint Injections?

Joint injections are a minimally invasive procedure that involves injecting medication directly into a joint to alleviate pain and inflammation. They are often used as a treatment option for various joint conditions when oral medications or physical therapy have not provided sufficient relief.

What kind of joint injections are there?

There are several types of joint injections, each with its unique mechanism of action and potential benefits. Let’s delve into the three most common ones: Corticosteroid, Hyaluronic Acid, and Platelet-Rich Plasma (PRP) injections.

Corticosteroid Injections

Corticosteroid injections work by reducing inflammation and pain in the joint. They contain powerful anti-inflammatory medications, such as cortisone, which help alleviate symptoms.

Commonly injected joints

They are commonly used for joints like the knee, shoulder, and hip, where conditions like osteoarthritis, rheumatoid arthritis, bursitis, tendinitis, or synovitis may be present.

Duration of effect and potential side effects

The duration of pain relief and reduced inflammation from corticosteroid injections varies among individuals. Discomfort may be felt at the injected area along with flushing of the face, which are temporary.

Hyaluronic Acid Injections

Hyaluronic Acid injections act as a lubricant and cushion for the joint, improving mobility and reducing pain.

Commonly injected joints

They are often used for joints which may be affected by osteoarthritis, such as the knee and shoulder. It may also be used to relieve pain in patients with the condition when other medications have not been effective.

Duration of effect and potential side effects

The effects of hyaluronic acid injections may vary depending on the patient but can last for several months. Side effects may include temporary pain, swelling, and redness at the injection site.

Platelet-Rich Plasma (PRP) Injections

PRP injections utilise the body’s own healing properties by injecting a concentration of the patient’s platelets into the affected joint.

Commonly injected joints

Commonly injected joints include the knee, elbow, and ankle which are affected by conditions such as osteoarthritis, tendon injuries, and ligament sprains.

Duration of effect and potential side effects

The effects of PRP Injections commonly last from 6 to 9 months, however it can differ depending on each person. You may experience bruising and pain at the area of injection which will go away on its own.

What are the conditions that joint injections treat?

Osteoarthritis

Osteoarthritis is a common degenerative joint disease. It primarily affects the cartilage, which is the smooth tissue that covers the ends of bones within a joint. Over time, the cartilage wears down, leading to pain, stiffness, and limited mobility in the affected joint.

The exact cause of osteoarthritis is still not fully understood, but it often occurs as a result of natural wear and tear on the joints due to ageing. However, certain risk factors can contribute to its development, such as obesity, joint injuries, repetitive stress on the joints, and genetic factors.

Rheumatoid arthritis

Rheumatoid arthritis is a chronic autoimmune disorder that primarily affects the joints. Unlike osteoarthritis, which is caused by wear and tear, this condition is characterised by the body’s immune system mistakenly attacking its own healthy joint tissues.

In rheumatoid arthritis, the immune system targets the synovium, which is the thin membrane that lines the joints. As a result, the synovium becomes inflamed and swollen, leading to joint pain, stiffness, and deformity. If left untreated, it can cause irreversible damage to the joints and other organs in the body.

Bursitis

Bursitis refers to the inflammation of the bursae, which are small, fluid-filled sacs located throughout the body near the joints. These bursae act as cushions between bones, tendons, and muscles, reducing friction and allowing smooth movement of the joints.

When the bursae become inflamed, usually due to repetitive motions, overuse, direct trauma, or infection, bursitis can occur. Common sites of bursitis include the shoulder, elbow, hip, knee, and heel. Symptoms of bursitis include pain, swelling, tenderness, and limited range of motion in the affected joint.

Tendinitis

Tendons are thick cords of tissue that connect muscles to bones. Tendinitis refers to the inflammation or irritation of a tendon, usually as a result of repetitive movements, overuse, or injury. It commonly affects tendons in the shoulders, elbows, wrists, knees, and heels.

Tendinitis can cause pain, tenderness, swelling, and difficulty moving the affected joint. Activities that involve repetitive motions or excessive force can contribute to the development of tendinitis, such as repetitive typing, lifting heavy objects, playing certain sports, or sudden changes in physical activity.

Synovitis

Synovitis refers to the inflammation of the synovial lining, a thin membrane that lines the inner surface of joints and produces synovial fluid, which lubricates the joints. It can occur as a result of joint injury, infection, autoimmune disorders (such as rheumatoid arthritis), or other inflammatory conditions.

When synovitis develops, the synovial lining becomes thickened and produces excess fluid, leading to joint swelling, pain, warmth, and limited mobility. In some cases, synovitis may also cause joint stiffness and deformity.

What are the benefits of joint injections?

Relieving pain and inflammation

Injections can relieve pain and reduce inflammation, leading to a greater degree of comfort for patients in their day-to-day lives. Joint injections may be recommended for conditions which do not respond to oral anti-inflammatory medication as well as for patients seeking long-term relief.

Improving joint function and mobility

Conditions which affect the joint are often accompanied by stiffness and limitations to mobility. These injections can improve joint lubrication, potentially reducing pain along with improving their quality of life.

Delaying the need for surgical intervention

Surgery may not be an option for some with conditions affecting the joint, and these injections can provide symptomatic relief.

How long do joint injections last?

The duration of relief from joint injections varies among individuals and depends on the type of injection and the severity of the condition. Corticosteroid injections may provide relief for weeks or months, while hyaluronic acid injections can last several months. PRP injections may require multiple sessions for optimal results.

Are joint injections safe?

Joint injections are generally considered safe. However, like any medical procedure, there are potential risks and side effects. These may include temporary pain at the injection site and possible allergic reactions. We strongly recommend discussing the risks and benefits with your healthcare provider before undergoing the procedure.

How effective are joint injections?

The effectiveness of joint injections can vary among individuals. Factors influencing the success of injections include the severity of the condition, the patient’s overall health, and the accuracy of the injection technique.

How long should I rest after a joint injection?

We suggest resting for a few days and avoid placing pressure on the joint. Your healthcare provider will have a detailed list of instructions on the downtime needed and specific activities to avoid. However, as a general guideline, here are some recommendations for rest and activities to avoid after joint injection.

Avoid Strenuous Activities or Exercises:

Refrain from engaging in strenuous physical activities or exercises that put excessive strain on the injected joint. This includes activities such as running, jumping, heavy lifting, or high-impact sports.

Avoid Excessive Heat or Cold:

Refrain from applying excessive heat or cold packs to the injected joint, as this can interfere with the effects of the injection. If you experience discomfort, please speak with your healthcare provider.

Follow Post-Injection Care Instructions:

Your healthcare provider will provide specific post-injection care instructions, including any additional restrictions or activities to avoid. It is crucial to follow these instructions to ensure optimal healing and minimise the risk of complications.

What is the procedure for a joint injection?

Step 1: Preparation for the procedure

You will start by having a consultation with your healthcare provider, who will evaluate your condition, and answer any questions or doubts that you might have. It will then be followed by a detailed examination of your medical history, including any medications you may be taking, allergies, previous joint treatments, and any bleeding disorders.

In some cases, you may need to undergo X-rays, MRI scans, or ultrasound to guide the injection and assess the joint’s condition. Finally, the procedure will be explained to you in full detail to ensure you understand the risks and benefits, along with obtaining your informed consent.

Step 2: Administration of the injection

Moving on to the administration of the injection, you’ll be positioned in a sitting or lying position, depending on the joint being injected. The skin over the injection will be cleaned and sterilised to minimise the risk of infection. However, local anaesthesia may also be administered to numb the surrounding area to reduce discomfort.

The needle will then be positioned within the joint, followed by the medication slowly injected into the joint space. The amount and type of medication used will depend on your specific condition and the treatment plan determined by your healthcare provider. After the treatment is completed, a bandage or dressing may be applied to the injection site to protect it and promote proper healing.

Step 3: Post-injection care and follow-up

Your healthcare provider will provide specific post-injection care instructions, including activities to avoid, any necessary pain management, and when to follow up for further evaluation or treatment. A follow-up appointment may also be scheduled to assess the effectiveness of the injection, monitor your progress, and discuss any additional treatment or management options.

Can joint injections be combined with other treatments?

Yes, joint injections can be combined with other treatments to enhance their effectiveness and provide comprehensive care for joint conditions. Here are some common treatments that can be combined with such injections.

Physical therapy and exercise

Physical therapists can design a tailored exercise program to complement the effects of the injection and promote optimal recovery. Engaging in appropriate physical therapy exercises can help strengthen the muscles around the joint, improve flexibility, and enhance overall joint stability.

Lifestyle modifications

Making healthy choices, such as maintaining a balanced diet, managing weight, and avoiding activities that strain the joints, can reduce stress on the injected joint and support the benefits of the injection. It is also recommended to use ergonomic devices to alleviate joint strain.

Surgical options

Joint injections can be used as a conservative treatment option to delay or even avoid the need for surgery. However, if surgical intervention becomes necessary, they can still be part of the overall treatment plan before or after the surgical procedure to manage pain and inflammation.