Photo Credit: by @CANPharmaWorld
Osteoarthritis (OA) is the most common form of arthritis, a condition whereby the joints are inflamed. OA can affect different joints such as hands, knees and hips, causing the cartilage to breakdown and wear away. When this happens, the joints lose the cushioning effects from the cartilage, bones rub against each other causing pain, stiffness and swelling. Risk factors for OA are advanced age, obesity, genetic factor, previous injury, occupation. For some unknown reasons, females are 2 to 3 times more likely to develop OA compared to men.
How to manage symptoms of osteoarthritis: lose weight (if overweight or obese) to reduce excessive strain on the joint. Physical activity, although painful at first, helps strengthen the muscles and relief stress on the joints. You may work with a physical therapist on appropriate exercises for your situation. Use assistive devices such as shoe inserts, splints, or braces to support the joint. Some people also find temporary relief in using hot and or cold packs.
Treatment options for OA: first line of treatment after the initial diagnosis of OA is topical non-steroidal inflammatory drugs (NSAID) such as Diclofenac gel. If sufficient pain relief is not achieved, then oral anti-inflammatory pain killers such as diclofenac, celecoxib, indomethacin may be prescribed by the doctor. However, these painkillers can be limited by side effects and interactions with other disease conditions. Topical capsaicin may also provide some relief. If non-drug measures, topical NSAIDS, and oral pain killers do not provide enough pain control, then injectable therapy or surgery may be an option.
What is the best injection for osteoarthritis of the knee? Injectable OA treatment may be in form of steroids or hyaluronan derivatives (Orthovisc, Monovisc, Synvisc, Durolane). Injectable steroid can be used to reduce pain and inflammation for up to 6 weeks post injection. These products are injected directly to the joint to improve mobility and relieve pain. Greater benefit may be observed in patients that have higher pain levels to start with and in patients who need to avoid oral pain killers due to side effects or interactions. You may be thinking how effective are hyaluronan injections for osteoarthritis? Hyaluronic acid injections can improve joint pain and functionality in OA. Meta analyses of various clinical trials show that hyaluronan derivative injections have better effect in reducing pain and stiffness compared to oral pain killers and steroid injection. In addition, the benefits from hyaluronan injection may last longer than that from steroid injections. So, the best option depends on situation and specific patient circumstances. In some cases, combination of steroid and hyaluronan derivatives may be needed in some people.
Hyaluronic acid Injection products: there are different types of hyaluronan derivative injections which differ by the way hyaluronic acid is stabilized in solution e.g. high molecular weight hyaluronan (Orthovisc), hyglan G-F20 (Synvisc), cross-linked sodium hyaluronate (Monovisc), cross-linked hyaluronic acid (Durolane). Durolane is a transparent gel which contains high levels of cross-linked hyaluronic acid and its usually a single shot treatment. Monovisc is prepared by crosslinking hyaluronan with a proprietary cross-linking agent and is also given as a single shot treatment. Synvisc is also a cross-linked sodium hyaluronate derivative but is given as a series of 3 weekly injections. Lastly orthovisc is non cross-linked purified hyaluronan derived from rooster combs. Orthovisc is also given in a series of 3-4 weekly injections. Your doctor will determine which of the products is best for your specific situation.
Do knee injections really work? Hyaluronan injections work by replacing the normal joint fluids which act as a lubricant and shock absorber for proper joint function. Benefits from hyaluronan derivatives injections may be as early as 4 weeks after the first injection and may last for up to 6 months. Relief from anti-inflammatory steroid knee injections appear sooner (few days) after injection but wears out after about 6 weeks.
How many knee injections can you have at once? One injection can be given into each joint
How often can you have knee injection? steroid knee injections should not be administered more than 3-4 times per year. Hyaluronan knee injection can be given at once or weekly for 3-5 consecutive weeks depending on the product.
Are knee injections painful? There may be a mild discomfort during the injection, but overall the injection is not painful. Long term side effects of steroid knee injection may include worsening of joint space and joint deterioration.
Can knee injections go wrong? Risks and complications of knee injections include infection, temporary sore joint, transient increase in blood sugar levels for diabetic patients, transient increase in blood pressure levels in patient with poorly controlled blood pressure. Post injection flare, pseudo sepsis. Talk to you doctor about the risks.
What Vitamins for OA? there is no specific vitamin or supplements that can cure OA, however you can take some supplements to support your bone and joint health in general. For example, taking calcium for stronger bones. Glucosamine and chondroitin can also help to maintain the cartilage and prevent further damage. Curcumin also known as turmeric may be beneficial in OA due to its anti-inflammatory effects.
Osteoarthritis pain is no joke, particularly among senior citizens. It may lead to significantly reduced mobility and anxiety for living an active lifestyle. Finding the best management techniques is important to relieve the pain and give you back some comfort in your knees. Talk to your doctor about any of your concerns about joint pain, stiffness or swelling. Your doctor will access your situation and provide proper recommendation for your specific circumstance.
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