When are injections a treatment option?
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Apr 15, 2016
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Dr. Michael Raab explains how injections are used to treat arthritis.
When are injections a treatment option?
Patients often have questions regarding injections into a joint. And we’ll take the knee as an example. If we’ve already treated a patient with conservative measures such as anti-inflammatories, exercise, therapy, perhaps a brace, and the patient still has pain, we will typically offer an injection into the knee. Initially, we will offer an injection which is a combination of a steroid as well as a local anesthetic. Typically Depo-Medrol, Marcaine, and Lidocaine which is a steroid preparation and two types of anesthetics, one short-acting, one longer-acting. And this can give the patient either short amount of relief or a long-term amount of relief depending on how they respond. The goal of the cortisone injection is to interrupt the inflammatory cycle that’s within the knee creating the pain and swelling and discomfort. Every patient is different. Some people may have great relief with cortisone injection, some people may have very little relief. It really varies by the patient. Patients often ask how many can I have. And typically, we try to space them out at least two to three months apart. But once you’ve had three, four, or five injections in a particular joint and you still have pain, it’s probably not a great idea to continue doing what’s not helping. On the other hand, if you have great relief that lasts you for six to nine months from a cortisone injection, it would make sense to simply continue that approach until it’s no longer effective. The other type of injection that we often offer the patient is some of the newer gel injections, which is a high molecular weight gel that is a clear thick fluid that we can inject again into the knee to help cushion and smooth up the rough edges within the knee. It does not create new cartilage, it does not create a new joint, it simply smooths out and evens out and perhaps creates a bit of a thick cushion between the two worn out parts of the knee. So, those are some of the common injections that we will offer. The other patients – or other questions that the patients may ask is, “Will I gain weight?” And some people report that, many do not. It’s hard to say whether that truly leads to that or not. It’s more seen with oral steroids taking by mouth that can lead to weight gain. Typically an injection in a joint does not lead to prolonged weight gain.