Injections inside the Joints in Arthritis: Why and How
Arthritis is one of the most common chronic diseases and, unfortunately, it's one of the most painful ones as well.
The first thing your doctor will try to do to provide relief from arthritis pain is non-pharmacological methods, including exercise and lifestyle changes such as losing weight and getting more sleep.
Unfortunately, suppose these don’t provide the relief you need. In that case, they’ll have to resort to pharmacological methods like injections inside the joints in arthritis, which might be both painful and stressful to patients.
What are injections?
Steroid injection in joint
Mainly, two types of injections are used in osteoarthritis of joints. The most common one is steroids, and another is viscosupplementation or synthetic synovial fluid.
Steroid injections are cheap and quickly effective. They reduce pain, and inflammation and also help the joints to move again. However, the action of steroids is for a short duration. Steroids also have many adverse effects on the body. These drugs are mainly used for quick relief from pain.
Viscosupplementation (Hyaluronic acid) is manufactured in the laboratory. These protein products are components of synovial fluid and act similar to synovial fluid. As you may know, synovial fluid is like grease in a bearing, which helps to reduce friction inside the joint. It can halt the progression of the disease but doesn’t have the ability to reverse cartilage damage. The principal advantage of Hyaluronic acid over steroids is fewer systemic side effects. On the other hand, Hyaluronic acid may cause an allergic reaction apart from it being expensive medicine and taking longer to act.
When should you inject?
Injections to the joint are the second line of the drug to treat arthritis. Your doctor might prescribe you injections when oral and topical pain medicines, physiotherapy, etc have failed to give any relief.
Consult your doctor or specialist before getting an injection to ensure that it's right for you. Another thing to know about joint injections is that they're not without side effects, so make sure to ask your doctor about those before going ahead with it. If you have medical conditions such as diabetes or heart disease, be sure to tell your doctor about these too.
Viscosupplementation injection in joint
Although there is an ongoing debate about whether Viscosupplementation injection has any advantage at all concerning the cost involved, many healthcare standard regulatory bodies approve its use. Readers are advised to look at the Cochrane library for more understanding and informed choice. ( Cochrane in CORR®: Viscosupplementation for the Treatment of Osteoarthritis of the Knee - PMC (nih.gov) )
How do you find injection sites?
Injecting medications into joints is a common practice for arthritis, which is a condition that causes your joints to be inflamed.
There are two types of injections commonly administered by doctors for arthritis patients: intra-articular and peri-articular.
Intra-articular refers to injection directly into a joint, whereas peri-articular injections are delivered around a joint capsule but not directly into it.
Most often, doctors will deliver medications through an intra-articular injection because it allows drugs to the affected part of your body without entering the bloodstream or having access to your organs.
The location of each patient's affected joints will determine where they should receive their injection.
For deep-seated joints, injections can be given using ultrasound guidance so that you know exactly where you're aiming.
Ultrasonography guided injection
Your doctor may also advise you on an X-ray before administering an injection to make sure that there aren't any other issues with your bones or joints.
After receiving an injection, it's normal to experience some pain and swelling at first. This usually goes away within a few days as long as you take the prescribed medication after receiving treatment.
It's important to note that while many people can manage their arthritis symptoms with medication alone, some patients require surgery instead.
Your doctor will discuss all available options with you if surgery becomes necessary. Although injecting medication into your joints can cause discomfort during treatment, it's important for managing symptoms associated with arthritis and improving the quality of life overall.
Benefits of injecting inside joints?
It is becoming a common practice to use injections of medicine directly into joints that are affected by rheumatoid arthritis.
There are two reasons for doing so. The first is that people feel that it can help stop some of their pain.
The second is because drugs injected directly into a joint may be absorbed more quickly than those given as pills or injections under the skin, although there has been little research done to show if either approach works better than another.
These treatments do have side effects, however, including bruising at injection sites, infection, and possibly damage to joint tissues.
Before starting any type of treatment with an injection or a new drug regimen, you should make sure you know what your options are and discuss them with your doctor in detail.
Disadvantages of injecting inside joints?
Infection inside the joint (Image courtesy Researchgate.net)
While injecting a drug directly into a joint may seem like an ideal way to medicate arthritis patients, there are some serious disadvantages to doing so.
Like any injection, there's always a risk that some foreign material could leak out of the injection site. If that happens, it could travel through nearby tissues or even the bloodstream to other parts of your body.
So, when it comes to arthritis, injections inside joints should be used sparingly—if at all. If you do decide to get one, make sure your doctor uses techniques designed specifically for joints (like trigger point injections) or very small needles and syringes.
This can reduce leakage from your joint. And ask about alternative treatments before agreeing to inject something into a joint.
For example, over-the-counter pain relievers might help just as well as an injected drug would. Or there might be another non-invasive treatment option that would work better than both drugs and injections.
One major complication of injection inside the joint is infection. More so in the case of multiple steroid injections, as it reduces the body’s immune system. Our skin harbors many organisms, many of which can cause serious infections once inoculated inside the body. Therefore, as a standard procedure before any injection doctor cleans the injection site with disinfectant, injection is kept and given in a sterile manner, thereby reducing the chance of infection.
New modality
PRP injection
Platelet-rich plasma is also nowadays being used in osteoarthritis. PRP is produced from patients’ own blood and therefore least immunogenic, but they are rich in growth factors that help to regenerate lost cartilage. As this is a new method that is only being used recently, more long-term follow-up is needed. However, PRP can revolutionize osteoarthritis management if can withstand the test of time.
N.B – The content provided is for information and education purposes only.
