3 Injections That Can Banish Joint Pain For Months
Two well-established injections and a third under investigation can provide months of relief from joint pain. Find out which one might work best for you.
If you’re one of the 30 million adults in the United States who suffer with joint pain, you know the pain often is debilitating. It can keep you from staying active and even make daily chores seem impossible. What you might not know is that your doctor can treat you with more than pills.
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There are two types of injections — and a third under investigation — that can alleviate your symptoms for months, says physiatrist Michael Schaefer, MD, Cleveland Clinic’s Director of Musculoskeletal Rehabilitation.
Depending on the severity of your joint pain or osteoarthritis, a corticosteroid or hyaluronic acid injection can help get you moving again, he says.
“We use these injections to reduce inflammation and pain in your joints,” he says. “With this treatment, you can often experience fewer symptoms for several months.”
Dr. Schaefer discusses how doctors use the injections so you’ll know the differences and can ask your doctor whether injections might help you.
Use: This injection is the first line of defense against osteoarthritis symptoms and other joint pain in shoulders, knees and hips, Dr. Schaefer says. Corticosteroids can offer relief for two to three months at a time. It reduces inflammatory cell activity in the joint.
Side effects: As with all injections, there’s a small chance of infection — about one in 1,000. See your doctor right away if you notice signs of infection, which include worsening pain, swelling, warmth and fever.
Cost: Most insurance covers the $100 cost of these injections. Your provider may require that you try at least one corticosteroid injection first to see whether it works. If not, you may move on to a different therapy.
Use: Hyaluronic acid (HA) injections often follow failed corticosteroid injections. But they are only approved for use in the knee.
In some instances, doctors consider an HA injection first if you don’t have obvious signs of inflammation. HA also is a better option if you have diabetes. Corticosteroids can raise blood sugar levels.
Also known as gel injections, HA injections are chemically similar to your natural joint fluid.
When you have osteoarthritis, joint fluid becomes watery. So, this injection works both as a lubricant and as a shock absorber. However, it doesn’t work well for bone-on-bone arthritis.
“HA is a cushion or a buffer against inflammatory cells in the joint,” Dr. Schaefer says. “In some cases, it can stimulate the knee to start producing more natural HA.”
Some physicians also believe that HA helps reduce pain by coating nerve endings within the joint.
One injection offers symptom relief for four to five months, but pain and stiffness will return. Most insurance companies only approve one HA injection every six months. A corticosteroid injection can tide you over if needed, he says.
Side effects: There’s a 1-in-100 chance of an inflammatory reaction, Dr. Schaefer says. Again, see your doctor right away if you see signs of infection.
Manufacturers make HA injections from rooster combs. If you have an allergy to chicken products, let your doctor know you’ll need a synthetic HA injection.
Cost: HA injections cost more — about $300 to $750 per injection. But most insurance companies cover the cost.
Use: Platelet-rich plasma (PRP) injections can treat osteoarthritis and joint pain, but are still under investigation, Dr. Schaefer says.
Though typically used to treat tendon injuries, these injections have grown in popularity over the past five years for treating muscles and joints. However, they are still experimental, with few studies confirming effectiveness in humans, he says.
These injections use your own blood and platelets to promote joint healing.
Platelets contain growth factors and proteins that aid healing in soft tissues. Research shows PRP injections can prompt an immune response to help reduce inflammation, Dr. Schaefer says.
Side effects: Side effects include a very low risk of infection and pain at the injection site. However, because PRP injections use your own blood, there’s no chance of an allergic or immunologic reaction. You must stop oral osteoarthritis medications if you get a PRP injection, Dr. Schaefer says.
Cost: Insurance companies don’t generally cover PRP injections, making them the most expensive option. You’ll pay between $500 and $1,000 per injection out-of-pocket.
These injections often are effective in stopping your joint pain. But it’s important to remember that they won’t keep the pain from returning, Dr. Schaefer says. In fact, they’re most effective when used with other therapies.
“We consider surgical options if the joint arthritis is severe enough when viewed on X-ray,” he says. “But, weight loss, physical therapy and bracing also go a long way toward relieving pain.”