Injections for Knee Pain

The knee is notorious for injury. Because of how it is constructed, and the stress it endures, the knee joint can easily be twisted, injured or bruised. In most cases, with some preventive care, the problem will resolve itself. In some cases, however, the injury is severe enough to warrant medical care. People have the impression that doctors always want to perform surgery on injured knees, when this is usually far from the truth. Doctors will almost always exhaust all other options before surgery is attempted. One treatment for knee pain is the injection of various medications into the knee joint. This article will discuss those injections and their efficacy.

Function

• Injections for knee pain work in several different ways, depending on the type of injection. The most common type is a corticosteroid treatment. By injecting the medicine directly into the joint, the drug can immediately reduce swelling and inflammation, sometimes in as little as 24 hours. The injection is painful, and the knee must be rested for a day or two after the treatment, but in most cases a cortisone injection helps with pain in the knee. Another type of injection is that of hyaluronic acid. This is essentially a bio-lubricant that helps to keep the knee joint moving smoothly, which can be a huge pain relief in the case of degenerative arthritis.

Corticosteroid

• Most doctors will use a corticosteroid injection as a first try when they have determined that injections might be the best way to help with knee pain. A large syringe and bore needle, up to 18 gauge, is used in this procedure. The outside of the knee is injected with a numbing agent, as the knee must be perfectly still for the injection. The knee is grasped firmly and the needle inserted directly into the joint. The medicine is injected into the space between the kneecap and the leg bones. It is an unpleasant procedure, and can be quite painful. The medicine burns as it is injected. Despite the discomfort, the corticosteroid is usually quite successful in alleviating pain in the knee for up to six months. The steroid reduces painful inflammation, which helps the joint to function more normally. Easing stiffness also aids in pain relief.

Hyaluronic Acid

• This is a relatively new procedure that has had some excellent success in the past few years. Derived from the combs of chickens, hyaluronic acid serves as a kind of bio-lubricant. How it works is not precisely understood. But when injected into the knee joint once a week over a period of five weeks, the body absorbs and uses the hyaluronic acid as a makeshift barrier between the bones, allowing them to move smoothly over one another when before they would be grating, bone on bone. The procedure is very similar to the corticosteroid injection detailed above, and can be painful. In addition, the knee must be rested for 48 hours after the injections. But the benefits are very well worth the discomfort, and usually last for up to a year or more.

Misconceptions

• One thing that patients need to realize is that neither of these treatments are cures for knee problems. Whether the knee has been injured, is malformed, or is suffering from a disease, the injections simply treat the symptoms, not the root cause of the problem. In the case of hyaluronic acid injections, further degeneration caused by the arthritic grinding of bone on bone may be delayed, since the hyaluronic acid serves as a minimal barrier between the bones, but it will not be completely stopped. In the case of corticosteroid injections, the injury or disease remains--it is merely not as painful due to the reduction in swelling and stiffness.

Benefits

• The most obvious benefit of these injections is the cessation of pain, or at least the lessening of it. But there are other benefits as well. The main one is the delay of impending surgery. Orthopedic doctors will exhaust every option before putting a patient under the knife, and--in the case of knee injections--this is usually the last step before a surgical approach is tried. Another benefit in the case of hyaluronic acid is the long-term improvement for arthritis sufferers. In some cases, this may be a permanent solution to their problem.

• Dear Editor,

  I took your advice and just made a few minor adjustments to the language to indicate that in "most" cases, doctors try to avoid unnecessary surgeries. I have been lucky. I have had very good doctors. And although I ended up having 14 (!!!) surgeries on my left leg alone, I am the exception, not the rule. I have seen my doctors working with other patients like crazy trying to avoid cutting on those knees... once you cut on them, they have a tendency to end up cut again! ACK!