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TO INJECT? OR NOT TO INJECT? THAT IS THE QUESTION

People ask me all the time if they should get an injection into their knee for their chronic pain. I tell them that there are many things to consider before signing on the dotted line and giving consent for an injection into your knee.

You go to your healthcare provider. You tell them that your knee hurts all the time. You tell them that you’re in agony just trying to climb the staris. have pain in your knee. It hurts to climb stairs. It aches and throbs all the time and will even wake you up at night because of the pain. Your healthcare provider tells you that you have osteoarthritis and they suggest getting an injection. A what??

Osteo – what?

Osteoarthritis (OA) which is sometimes called degenerative joint disease or degenerative arthritis, is the most common chronic condition of the joints, affecting approximately 27 million Americans. OA can affect any joint, but it occurs most often in knees, hips, lower back and neck, small joints of the fingers and the bases of the thumb and big toe.[1]

Back to the injections….

A steroid injection for you knee is usually recommended to reduce the swelling (or inflammation) in your knee. The swelling can cause OA in the knee to flare up.

There are two common types of injections you can get in your knee. One, is commonly called a “steroid” injection. The other is an injection that will help supplement the fluid in your knee to lubricate and cushion the joint. This can provide up to six months of pain relief if you suffer from osteoarthritis.

What happens when I get a steroid injection?

First the healthcare provider will numb the area where they are planning on giving the injection. There are two ways to numb the area. One way (and my favorite) is with “cold spray” (formally know as ethyl chloride). It is very cold when it goes on but it works very quickly!

The other way is to inject numbing medicine, such as lidocaine, into the area and waiting a minute or two for this to take effect.

Once the area is numb you’re ready for the injection. If you have a lot of fluid on your knee, your healthcare provider may remove some of the fluid first. If you don’t need to have fluid removed, you’ll get your pain-relieving injection usually just below your kneecap. This doesn’t hurt, but you do feel pressure when the needle is there.

You will start to feel relief almost immediately because there is a fast-acting steroid and a long-acting steroid in the mixture that was just injected. The fast-acting steroid usually lasts about 48 hours and then the long-acting steroid will start to work. Each person is different so each person will experience a different length of time for pain relief. For me, I usually get about 4 months of relief.

What happens when I get the lubricating injection?

Your healthcare provider will recommend the lubricating injection if you haven’t received enough pain relief from diet, exercise, and other treatments. If you’ve tried these options and they still haven’t worked, then you may be a candidate for the lubricating injection.

Getting this type of injection is much like getting the steroid injection. But instead of injecting steroids, your healthcare provider is injecting hyaluronan (pronounced hy-al-u-ROE-nan) that comes from chicken combs.[2] Hyaluronan is naturally found throughout the body especially in eyes, gums, joints, skin and hair follicles.

Your healthcare provider will numb the area either with cold spray or lidocaine and then they will inject the lubricant just under the kneecap. And just like steroid injections, everyone is different and will experience a different length of pain relief; however, for some patients, the relief can last up to six months.

Before getting any procedure done, be sure to go over the risks and benefits and side effects with your healthcare provider. Although I am a Nurse Practitioner, this information is for education only and should not be considered medical advice.

Until next time ~ Dr. JB Kirby

[1] www.arthritis.org

[2] www.synviscone.com

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