Intra-articular injections are often used to provide emergency treatment for joint diseases. In many cases, intra-articular injection can actually alleviate the patient's condition. But at the same time, injections into the joint for arthrosis are done much more often than is actually necessary. It is about this incorrect, in my opinion, trend that I would like to talk in more detail.
Most often, corticosteroid hormone preparations are injected into the joint: Kenalog, Diprospan, Hydrocortisone, Flosterone, Celeston, Metypred, Depomedrol .
Corticosteroids are good because they quickly and effectively suppress pain and inflammation associated with synovitis (swelling and swelling of the joint). It is the speed with which the therapeutic effect is achieved that is the reason why corticosteroid injections have gained particular popularity among doctors. But this led to the fact that intra-articular injections of hormones began to be carried out even without a real need. For example, I have more than once encountered the fact that hormones were injected into a patient’s joint for prophylactic purposes in order to prevent the further development of arthrosis.
However, the problem is that it is arthrosis itself that corticosteroids do not and cannot treat. This means they cannot prevent the development of arthrosis! Corticosteroids do not improve the condition of articular cartilage, strengthen bone tissue, or restore normal blood circulation. All they can do is reduce the body’s inflammatory response to this or that damage in the joint cavity. Therefore, it is pointless to use intra-articular injections of hormonal drugs as an independent method of treatment: they should be used only in the complex therapy of arthrosis.
For example, a patient was diagnosed with arthrosis of the knee joint of the second stage, complicated by synovitis, that is, swelling of the joint due to the accumulation of pathological fluid in it. The accumulation of fluid (synovitis) makes it difficult to carry out medical procedures: manual therapy, gymnastics, physiotherapy. In such a situation, the doctor performs an intra-articular injection of a hormonal drug to eliminate synovitis, and a week later begins other active treatment measures - this is the right approach.
Now let's imagine a different situation. The patient also has stage 2 gonarthrosis, but without fluid accumulation and joint swelling. Is it necessary to inject corticosteroids into the joint in this case? Certainly not. No inflammation - no “point of impact” for corticosteroid hormones.
But even if intra-articular injection of corticosteroids is really necessary, a number of rules must be followed. Firstly, it is undesirable to make such injections into the same joint more often than once every 2 weeks. The fact is that the administered medicine will not “work” in full force immediately and the doctor will be able to finally assess the effect of the procedure only after 10-14 days.
You should also know that usually the first injection of corticosteroids brings more relief than subsequent ones. And if the first intra-articular injection of a drug does not produce results, it is unlikely that the second or third injection of the same drug in the same place will. If the first intra-articular injection is ineffective, you need to either change the drug, or, if changing the drug does not help, choose the injection site more accurately.
If after this the injection of a corticosteroid into the joint does not give the desired result, it is better to abandon the very idea of treating this joint with hormonal drugs. Moreover, it is generally extremely undesirable to inject hormones into the same joint more than 4-5 times, otherwise the likelihood of side effects increases significantly.
Unfortunately, in practice we have to deal with excessive “singleness” of doctors who inject corticosteroid drugs into the same joint over and over again, without achieving at least a minimal effect with the first three injections.
Two similar cases struck me more than others. One of the patients received “only” ten injections of Kenalog, and the procedure was carried out daily, even without the required ten-day break necessary to evaluate the results of the injection. And the second patient was injected with hormones, observing an interval (though only 3-5 days), but during the course of treatment the poor fellow received 20 injections of corticosteroids into the same knee joint!
It would seem that the doctor “went too far” a little - no big deal. Could there be any harm from such treatment? It turns out it can! Firstly, with each injection, the joint, albeit slightly, is injured by the needle. Secondly, with intra-articular injection there is always some risk of infection in the joint. Thirdly, frequent injections of hormones provoke disruption of the structure of the joint ligaments and surrounding muscles, causing relative “looseness” of the joint.
And most importantly, frequent injections of corticosteroids worsen the condition of those patients whose joint damage is combined with diabetes mellitus, high blood pressure, obesity, renal failure, gastric or intestinal ulcers, tuberculosis, purulent infections and mental illness. Even when administered exclusively into the joint cavity, corticosteroids have an effect on the entire body and can aggravate the course of these diseases.
It is somewhat more useful to inject chondroprotectors ( alflutop, chondrolone or homeopathic Target T ) into the knee joint affected by arthrosis. These drugs are used in courses over 2-3 years. During a course of treatment, from 5 to 15 injections of chondroprotectors are carried out in one joint; on average, 2-3 such courses are carried out per year.
The advantage of these drugs is their ability to affect the cause of the disease: they improve the condition of cartilage tissue and normalize metabolism in the joint. That is, unlike corticosteroids, chondroprotectors not only eliminate the symptoms of the disease, but also treat arthrosis. The question arises: why is intra-articular administration of chondroprotectors less commonly used by doctors?
The thing is that these drugs help only 50-70% of patients, and it is impossible to predict in advance whether their use will have an effect or not. In addition, quite a lot of injections into the joint are required, which, as we said, increases the risk of needle injury to the joint and increases the risk of complications.
In addition, the effect of these drugs, unlike hormones, develops slowly, and, therefore, chondroprotectors make less of an impression on the patient.
This circumstance is of no small importance in the context of the commercialization of medicine: nowadays, patients are often forced to pay money for treatment.
And they believe that the money is well spent only if they get quick results from the treatment. Therefore, not every patient will agree to undergo two or three annual courses of 5-10 intra-articular injections of chondroprotectors, given the relatively high cost of such injections with no guarantee of recovery.
Ostenil , which appeared about 5 years ago, act much more reliably, and most importantly, faster than chondroprotectors .
Ostenil - a 1% solution of sodium hyapuronate - is also called a “liquid prosthesis” or “liquid implant”. Injected into a diseased joint, it gradually restores the characteristics of synovial fluid, the natural “lubricant” of the joint, to normal. Ostenil also forms a protective film on damaged cartilage, protecting its tissue from further destruction and improving the sliding of contacting cartilage surfaces.
In addition, ostenil penetrates deep into the cartilage, improving its firmness and elasticity. Thanks to ostenil, cartilage that has dried out and become thinner due to arthrosis restores its shock-absorbing properties. As a result of weakening the mechanical overload, pain in the diseased joint decreases and its mobility increases.
It is most advisable to inject ostenil into the supporting joints, which primarily suffer from arthrosis - the knee, hip, and shoulder joints. To treat these joints, standard pre-filled sterile 2 ml syringes containing 20 mg of active substance are used.
For the treatment of small joints of the extremities (ankle, elbow, wrist and joints of the fingers or toes), as well as arthrosis of the jaw joint (!), Ostenil mini : an economical syringe of a smaller volume, 1 ml, containing 10 mg of the active substance.
Typically, for the treatment of arthrosis, 3 to 5 injections of Ostenil are performed in large joints (in each affected joint) and 1-3 injections of mini Ostenil in small joints. Injections are given at intervals of 5 to 10 days. A similar course is carried out 1-2 times a year: for arthrosis of the first stage for two years; for arthrosis of the second stage - for 2-3 years; for arthrosis of the third stage - for 3-4 years.
At the same time, ostenil introduced correctly into the joint cavity has practically no side effects.
Unfortunately, hyaluronic acid preparations are not cheap. But their use made it possible to literally “put back on their feet” many patients who previously, before the advent of these drugs, would have definitely had to undergo surgery. What is especially important, given the cost of joint surgery, the use of Ostenil even for several years, in any case and in every sense, costs the patient less than a joint replacement surgery.
This is important to know! Hyaluronic acid preparations are instantly destroyed in a joint in which there are obvious signs of inflammation. Therefore, they are practically useless to administer to a patient with active arthritis. But they are useful to use in stable remission of arthritis for the treatment of secondary arthrosis.
With arthrosis, you also need to pay attention to similar points. For example, if a patient’s joint is “bursting” from the accumulation of excess, pathological fluid, it makes sense to first “extinguish” the symptoms of synovitis (inflammation) and remove excess pathological fluid by means of a preliminary intra-articular injection of hormones or taking non-steroidal anti-inflammatory drugs. And only then inject ostenil into the joint, freed from inflammatory elements.
Arthrosis of the knee joint (gonarthrosis) is a chronic disease associated with deformation and destruction of cartilage tissue, accompanied by very severe pain. One of the effective methods of treatment is medication. Therefore, doctors often prescribe injections to their patients for arthrosis of the knee joint, drugs for which we will consider in this article.
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This diagnosis is very often given to older people who complain of periodic knee pain - “arthrosis of the knee joint”. We will try to explain what it is to those who believe that pain is caused by the deposition of salts in the joints. The cause of the disease is a violation of blood circulation in the vessels of the bones of the limb, which causes a change in the structure of the cartilage tissue: it begins to exfoliate, becomes thinner, and may even disappear completely.
Many people face this problem after 40 years of age, and arthrosis can be unilateral or bilateral. If the disease is not treated in any way, complete destruction of the cartilage and deformation of the bones of the knee joint occurs. The result may be complete immobilization of the patient.
The first “bell” of arthrosis is a not very pleasant sensation of some stiffness in the knee; often after tension or physical activity, pain and crunching appear when bending it. I also experience severe pain in the morning after sleep or during the day after sitting for a long time. In this case, it becomes necessary to walk a little or perform simple physical exercises, and then the pain subsides. Exacerbation of gonarthrosis can also occur with hypothermia.
Such primary, but still barely noticeable signs are sometimes observed for several years, sometimes arising under unfavorable circumstances. But then it becomes more and more painful for the patient to walk, and joint deformation begins to occur.
The main cause of gonarthrosis is most often the age-related process of wear and changes in the joints. This pathological process is influenced by many factors:
Treatment of this disease is possible with the help of medications, physiotherapy and special exercises. Methods are selected depending on the degree of disease and deformation of cartilage tissue.
It is not difficult to completely restore JOINTS! The most important thing is to rub this into the sore spot 2-3 times a day.
The disease usually develops gradually, so it makes sense to consult a doctor as early as possible if you suspect problems in the knee joint.
The disease has 3 degrees of severity:
1st degree - pain and crunching in the knees appear, mainly after sleep (“starting pain”), but with no load they subside.
2 — pain with arthrosis of the knee joint intensifies, problems with limited movement begin, and lameness appears; inside the joint begins to deform, osteophytes (spikes and growths on the joint tissue) appear, fluid may accumulate in the knee, as a result, we have synovitis of the joint (inflammatory process of the inner membrane).
3 - severe arthrosis, when pain is present even at rest, bone deformation in the knee area is very noticeable, and there is no joint space.
Osteoarthritis of the knee joint, the symptoms and treatment of which are discussed in this article, can be observed not only in older people, but also in younger people - athletes, people who have suffered leg injuries or have varicose veins, as well as those who are genetically predisposed to it disease.
The main methods of treating arthrosis at stages 1 and 2 are:
There are also proprietary methods for the complex treatment of arthrosis of the knee joint, developed by famous doctors, for example Bubnovsky and Evdokimenko. They include treatment with medications, physiotherapeutic procedures, ointments, light physical activity, and special diets.
The biggest problem for a patient with gonarthrosis is to reduce pain in the joint, which prevents the ability to move normally. Knee pain can be relieved with the help of painkillers (tablets or powders), but injections into the knee joint for arthrosis are more effective. The drugs used in this case are prescribed by the attending physician based on the general treatment regimen for the joint and the severity of the patient’s condition. Injections into the knee joint are one of the methods of complex treatment of the disease and are used in parallel with other methods.
There are 3 types of injection medications:
A knee joint block for arthrosis is prescribed by a doctor for severe pain when conventional analgesics do not help. Blockade by injection has a local effect and reduces pain and inflammation.
Corticosteroids are potent anti-inflammatory drugs, they are used in the form of tablets (Prednisolone, etc.) and injections to reduce inflammation in any area. When corticosteroids are injected directly into the knee joint, local anesthesia occurs and the mobility of the joint itself improves.
The most commonly used drugs are Triamcinolone acetonide, Methylprednisolone acetate, etc. Sometimes in severe situations, the doctor may prescribe 2 types of corticosteroids for a more effective and long-lasting effect on the joint. Often intra-articular injections are used in combination with local analgesics.
Hyaluronic acid is a substance that is a component of the synovial fluid in the joint, which gives it the necessary viscosity. It acts as a lubricant and reduces the impact of injuries and impacts.
Hyaluronic acid injections into the knee joint are prescribed to people who suffer from knee pain that interferes with normal life, and to those who have not responded to corticosteroid injections and other treatments prescribed by a doctor.
The most common drugs with hyaluronic acid are “Ostenil”, “Sinokrom”, “Fermatron”, etc. The drug is injected directly into the knee joint to replace intra-articular fluid. The course of treatment consists of 3-5 injections and can be repeated six months later.
There are some likely side effects from these injections:
What are the most effective injections into the knee joint for arthrosis? Chondroprotective drugs are a whole group of potent drugs that relieve pain and have a positive effect on the cartilage tissue of the knee joint, helping to restore and strengthen it. Their effectiveness in the treatment of gonarthrosis is due to the content of substances in them that help restore cartilage tissue - glucosamine and chondroitin sulfate.
Glucosamine is an indispensable component in the synthesis of cartilage tissue, has a protective effect, reduces damage, relieves swelling and acts as an anti-inflammatory agent. In practice, its effectiveness can only be felt when used in combination with another substance.
Chondroitin - affects the phosphorus-calcium metabolic process in cartilage tissue, increasing its elasticity, affects regenerative processes in joints and does not counteract the decrease in calcium in bones and cartilage.
Chondoprotectors are usually prescribed in the initial stages of gonarthrosis in the form of tablets, powders or injections. The course of treatment with injections is 10-20 injections, which have a direct local effect on the diseased joint. Then treatment should continue with tablets of the same group of drugs.
The dosage of the injection for arthrosis of the knee joint is determined by the attending physician.
Chondroprotectors often used for injection:
"Adgelon" is a drug belonging to the group of chondroprotectors, the action of which is aimed at healing joint tissue. It is prescribed for the treatment of arthrosis, injuries and inflammatory processes in the joints. The drug can be taken either orally or by injection. Intra-articular injections with Adgelon are used to treat lesions of large joints (knees and hips).
The active ingredient is a glycoprotein substance, which is obtained from cattle serum. Its effectiveness is aimed at stimulating the growth of young cartilage cells, which allows the damaged joint to be filled with new cells.
Its important advantage is the absence of side effects, which is due to its natural origin. The drug has virtually no toxic effect on the human body even with prolonged use.
When the medicine is injected into the diseased joint, the latter begins to experience increased production of its own glycoproteins and collagen, which are necessary for the normal functioning of the knee joint. Almost after two injections, pain noticeably decreases.
How to inject Adgelon correctly? The instructions for use recommend injections 2 times a week (under the supervision of a doctor), a single dose is 2 ml (1 ampoule), the course duration is 5-10 weeks.
On the recommendation of a doctor, in severe cases, it is possible to use Adgelon and antibiotics or corticosteroids together, but it is necessary to take a break of 2-3 hours between injections.
Contraindications to the use of Adgelon are:
During treatment with chondroprotectors in the form of injections, it is necessary to comply with a number of requirements and recommendations of specialists:
What is the purpose of a drug blockade when injections are given into the knee joint for arthrosis? The drugs are injected directly into the cavity of the knee joint, and their active ingredients reduce the effect of negative factors that cause severe pain.
The procedure is performed in two ways:
Such manipulations can only be performed by a good professional - a doctor with experience in such work; sometimes an ultrasound diagnostic device is used when administering the medicine.
The qualifications and skills of the doctor who gives injections into the knee joint (for arthrosis) are very important. Reviews of patients who have used this method of treatment vary greatly: some complain of severe pain during injections, others tolerate them completely calmly and painlessly.
Injections are prescribed by the attending physician for the following purposes:
The most important rule for a patient suffering from arthrosis of the knee joint is to prevent the situation from worsening, to use all existing methods and medications (we have already described what procedures and medications are prescribed for arthrosis of the knee joint). Because advanced, stage 3 arthrosis can no longer be treated with medications and other methods - in this case, surgery is needed. Equally important is correct diagnosis and timely consultation with a doctor.
The joints of the human body are distinguished by an identical structure - the space between the articular surfaces is lined with cartilage tissue, the entire structure is located in the synovial bursa containing synovial fluid that nourishes the articular apparatus. In case of joint deformities leading to the destruction of cartilage tissue, intra-articular injections are prescribed to speed up its regeneration in order to prevent surgical treatment.
Most often, signs of arthrosis develop in the knee and hip joints. In the initial stages of the disease, the symptoms can be treated with tablets and ointments; with the progressive course of the disease, excruciating pain with inflammation is relieved using novocaine blockade. Painkilling injections with novocaine are given intramuscularly no more than three times a month, combined with therapy with B vitamins.
It is recommended to carry out injections directly into the hip and knee joints in courses of 4-5 injections with two-week breaks. Treatment is designed to improve the biomechanics and nutrition of the damaged joint by prescribing the following types of injections:
Important: intra-articular injections require special care, especially with hormonal agents that require qualified administration. Due to their pronounced immunosuppressive effect, they are recommended to be administered in short courses.
What is administered intramuscularly:
Important: when prescribing any drugs for injection into the knee or hip joint, one should take into account their side effects, and also do not forget about contraindications. Osteoarthritis usually affects people of advanced age who have a number of concomitant diseases.
What are intra-articular injections used for:
Acid injections for severe joint pain are among modern methods of treating arthrosis. The procedure is expensive, but effective, since the acid is similar in composition to synovial fluid, it is called a liquid implant.
Dystrophic lesions of joint cartilage are treated with intra-articular acid injections. Over the course of two weeks, four injections are given in the sore spot. To increase the effect, hyaluron is taken orally, including physiotherapy. This is an alternative to surgery, a reliable way to restore cartilage tissue of diseased joints in a short time, especially with secondary arthrosis.
The hyaluron that gets into the joint capsule replaces the spent synovial fluid, covering the cartilage affected by arthrosis with a film. Hyaluronic acid saves it from friction, prevents destruction, restores firmness and elasticity. Acid is the safest and most effective remedy, although it is very expensive.
Arthrosis is a chronic disease that manifests itself as the gradual destruction of intra-articular cartilage. As a rule, the disease manifests itself in older people as a result of the natural aging process of body tissues, but recently this disease has been increasingly diagnosed in men and women over forty years of age.
The causes of secondary arthrosis can be traumatic lesions (bruises, dislocations, fractures), too high loads in athletes and workers whose field of activity involves heavy physical labor. In addition, the prerequisites for the development of the disease can be created by other factors, such as autoimmune diseases, previous infectious and inflammatory processes, genetic predisposition, diseases of the endocrine system, processes of metabolic disorders and others.
Treatment of arthrosis can be medicinal and surgical. Surgical treatment involves joint replacement - endoprosthetics.
The main goal of drug therapy for arthrosis is to stop further destruction of cartilage tissue and preserve joint function.
In terms of the severity of the analgesic effect, the strongest are: “Ibuprofen”, “Diclofenac sodium” (“Voltaren”). NSAIDs do not cause euphoria, drowsiness, addiction, or drug dependence, but their long-term use has a detrimental effect on the gastric mucosa. Therefore, Diclofenac (injections) is prescribed to relieve acute pain. The price of five ampoules per package is about two hundred rubles. Application: intramuscularly for two to five days, and then transfer to the tablet form of taking the drug (if necessary).
It is also possible to use “Ketonal” - injections intramuscularly or intravenously, as well as injection forms of “Flamax”, “Artrosilene”. When administered intravenously, the intervals between procedures should be at least 8 hours.
Therefore, from GCS, doctors prescribe intra-articular drugs “Diprospan”, “Kenalog”, “Hydrocortisone” in the form of injections, which reduces the likelihood that undesirable consequences will occur to a minimum.
Chondroprotectors are drugs and preparations that promote the formation of completely new structural elements of cartilage tissue. They regenerate it and prevent further destruction.
Alflutop (SC Biotehnos, SA; Romania) is considered the most effective remedy. The basis of the drug is an extract from four species of marine organisms. The fat-free concentrate is cleared of foreign impurities and proteins. The main effect of the drug is aimed at regulating metabolic processes in cartilage tissues.
Drugs such as Chondroxide, Chondrolone, Structum, and Dona have a similar effect. Application: intramuscularly, deeply, 1 ml every day for three weeks.
When large joints are involved in the process, one or two milliliters are administered intra-articularly into each diseased joint once every three to four days (the total number is five to six injections), and then intramuscular injections are carried out for twenty days. The course must be repeated after six months.
The approximate price in pharmacies is 3,300 rubles per package.
Rumalon (ZAO Bryntsalov A, Russia) is recognized as another effective drug. It contains extracts of the brain and tracheal cartilage of calves.
Application: only for deep intramuscular injections. For adults, the dose is 1 ml three times a week or 2 ml twice a week. The positive effects of this therapy become noticeable after just a couple of weeks of treatment. The full course of treatment includes 25 injections of 1 ml each or 15, but 2 ml each (over 6–8 weeks). Courses of injections should be repeated twice a year at least or up to four times a year in case of a complicated course of the disease over several years.
The approximate price in pharmacies is from 1100 rubles per package.
Intra-articular injections into the knee joint for arthrosis, preparations based on hyaluronate affect the diseased organ in three directions:
Also effective are drugs containing chondroitin and glucosamine.
There are many reasons for the development of arthrosis of the knees, but they all lead to aching pain and discomfort that haunts the patient. To prevent serious consequences, it is necessary to inject a special gel for arthrosis. Injections relieve pain, eliminate inflammation and fight degenerative lesions. The swelling goes away quite quickly and the structure of the cartilage improves.
Unlike ointments and tablets, you can count on quick results without side effects on other organs. Doctors prescribe different injections to patients for treatment of arthrosis, the reviews of which are very different.
Injections for arthrosis have a number of advantages. They act almost instantly, removing pain and swelling. Active substances activate the supply of nutrients to the affected area, stimulate blood circulation and strengthen the surrounding muscles. Leg mobility is restored quite quickly.
The most common corticosteroid injections into the knees are Hydrocortisone, Celeston, Kenalog and Diprospan. They relieve pain and inflammation in a matter of minutes. Unfortunately, these drugs do not cure diseases or restore damaged cartilage tissue. Additionally, they create microtraumas and increase the likelihood of infection.
Gel in the knee joint in a preparation containing hyaluronic acid is an artificial substitute for synovial fluid. A thin film is created on the surface of the joint, lubricating and protecting the cartilage from friction and mechanical damage.
Hyaluronic acid, which is part of the medicine, creates nourishing and moisturizing effects, protecting against drying out. Cartilaginous tissue acquires firmness and elasticity, and the limb regains normal mobility. You can take injections with hyaluronic acid for a long time, since the substance has no side effects.
The main products with this acid are Crespin, Ostenil and Fermatron. When a special gel gets inside, it acts as a natural synovial fluid, triggering regenerative processes.
The most popular gel for the knee joint from Germany is Crespin, the instructions for use of which are very simple. Typically three or four injections are given over the course of a year. The positive result is especially noticeable in the first and second stages of the disease, and in the third stage, the gel with hyaluronic acid creates a temporary effect.
Crespin gel reviews are mostly positive, since it is enough to give one injection every few months. Patients note this feature as an important advantage, since this procedure is not pleasant. The result lasts long enough, so you don’t have to use additional ointments or take pills. The price for Crespin gel is not the lowest, but it is compensated by the long-lasting effect.
Doctors usually prescribe the administration of chondroprotectors after the inflammatory process has resolved. They nourish cartilage tissue and speed up recovery. Injections of chondroprotectors in the treatment of arthrosis have a targeted effect, unlike taking pills, and the entire course usually includes 5-10 procedures. The most popular are:
They contain chondroitin and sometimes glucosamine (depending on the manufacturer), which are similar in composition to natural cartilage tissue. The active components stimulate the healing of damaged tissues, but a positive result does not occur immediately, but after a long course.
There are gels for intramuscular administration. They are selected taking into account the course of the disease, the age of the patient and the degree of damage. They come in different types, which we will consider below.
Non-steroidal anti-inflammatory drugs in the form of injections are needed to relieve inflammation in the cartilage of the knees. They also remove soreness and swelling. The main advantages include quick results.
Among the disadvantages are the harmful effects on the digestive organs. The injections provoke ulcers on the walls of the stomach and disrupt the functioning of the gallbladder and liver. Typically, NSAIDs are prescribed for joints in advanced forms of arthrosis and only in short courses. After them, the patient must take a vitamin complex with B vitamins. The best medications from this group are Ibuprofen, Piroxicam and Diclofenac.
Analgesic gels for knee joints are needed to relieve pain that worries the patient. Sometimes the pain syndrome is so severe that a normal lifestyle is impossible without an injection. Note that such remedies do not restore damaged cartilage, but only relieve symptoms. Usually Baclofen and Mydocalm are used, which are injected in a weekly course.
When the knee joint is significantly damaged, the doctor may prescribe a special steroid gel for arthrosis for intramuscular injections. The most popular is Ambene, the effectiveness of which has been confirmed by many specialists and ordinary people who have undergone treatment. The product relieves pain, reduces inflammation and promotes regeneration. Doctors prescribe steroid drugs in extreme cases, as they contribute to the weaning of cartilage tissue from the ability to create new cells.
Injections of vitamin complexes, including B1, B6 and B12, play an important role in the treatment of knees. The best of them are considered to be Copligam B, Combilipen, Milgamma and Neurorubin. Vitamins help relieve pain and reduce the conduction of nerve impulses that irritate the affected joint.
Sometimes doctors prescribe subcutaneous administration of novocaine to patients. This need arises in case of acute pain accompanying destructive processes in the knee. Blockades are introduced into the affected area, surrounding muscles and tendons no more than three times a month.
There are many reviews on the Internet about injections for arthrosis, left by people who are undergoing or have undergone treatment for the disease. Most people note that it is necessary to start treatment as early as possible in order to limit it to chondroprotectors or medications with hyaluronic acid, which do not have serious side effects.
Crespin gel in the knee joint gives excellent results, reviews of which are mostly positive. It is injected to prevent the development of the disease and speedy restoration of cartilage tissue.
Also, former and current patients are advised not to forget about vitamin preparations, which eliminate the adverse side effects of basic medications, especially steroids and corticosteroids.
For various diseases of the musculoskeletal system, joint injections may be prescribed. Do not be afraid of this procedure; today it is the most effective way to treat arthritis, arthrosis and rheumatoid diseases.
Treatment of arthritis and arthrosis in the acute phase is impossible, so the first thing to do in this case is to relieve pain and inflammation. Tablets can help if your arthritis or arthrosis has only recently begun to develop, but in serious stages of joint disease, a blockade is necessary - an injection of an anti-inflammatory painkiller into the joint. There are three categories of drugs:
Despite the good performance of the latter type of medicine, hormonal drugs are still more often used in medical practice. This is largely due to insufficient study of new drugs. Injections for joint pain can be given directly into the joint gap, or intramuscularly. We will look at both types of injections.
Injections for arthritis of the knee joint, or any other junction of large bones that bear a large load, are not performed often. If we are talking about an anti-inflammatory drug, the doctor makes an injection into the intra-articular space once every 10 days. This is enough to relieve pain and gradually cope with inflammation. Here are the drugs that are used most often:
The main advantage of these remedies is that they relieve pain and make it possible to treat the very cause of the disease.
Sometimes therapy is supplemented with injections with an antibacterial component - in cases where foreign microorganisms begin to multiply in the synovial fluid of the joint. The course of treatment with these drugs should not exceed 1-2 months due to the large number of contraindications and side effects. This is especially true for hormonal medications.
Here are the names of joint injections performed intramuscularly:
These anti-inflammatory injections for joints do not act locally, but on the entire body as a whole, so their effectiveness can be considered relatively low, but in the initial stages of the disease these medications are completely justified. During therapy, it should be taken into account that they are usually not prescribed to patients with a sensitive digestive tract and gastric and duodenal ulcers.
Injections for arthrosis of the knee joint, if the inflammatory process has already been stopped, are aimed at protecting the joint from further destruction. The patient may be prescribed chondroprotectors or hyaluronic acid injections. The most effective chondroprotectors:
Depending on the patient’s needs, injections can be performed once every 5-7 days, or several times a month. The course of treatment can last up to six months, but upon completion, stable remission is likely.
Hyaluronic acid is an analogue of synovial fluid, which nourishes cartilage tissue and increases the shock absorption of joints, so 1-2 injections per year are enough for the patient to feel normal. Injections into the joint for arthrosis today are the only way to slow down the progression of the disease and maintain mobility.
The great ancient Greek scientist and philosopher Aristotle said: “Movement is life.” But, unfortunately, not all people can fully enjoy it. Every tenth person on the planet experiences pain after physical activity, cracking in the joints and internal stiffness of movement, which significantly worsens the quality of life. This is how the first signs of arthrosis appear. The article discusses when it is necessary to give injections into the knee joint for arthrosis, and the medications necessary for these procedures.
Arthrosis is a chronic disease that manifests itself as the gradual destruction of intra-articular cartilage. As a rule, the disease manifests itself in older people as a result of the natural aging process of body tissues, but recently this disease has been increasingly diagnosed in men and women over forty years of age.
This is due to the fact that the physical activity of the population has decreased significantly: sedentary work, the use of public transport and personal cars, unbalanced abundant nutrition - as a result, excess weight, which increases the load on the joints. As a treatment, doctors offer injections into the knee joint. For arthrosis, drugs are administered mainly inside the joint.
All joints in the human body have an almost identical structure - two or more articular surfaces lined with cartilage tissue, enclosed in a synovial bursa containing synovial fluid. Hyaline cartilage has a smooth and elastic structure, which reduces friction during movement. The joint is nourished through synovial fluid, since it does not have its own blood vessels.
It is this property that makes cartilage vulnerable. Due to a failure of metabolic processes or too much articular load, hyaline cartilage can undergo degenerative changes, and in the absence or insufficient nutritional supply, its restoration and regeneration occurs extremely slowly. The thinning of the layer of hyaline cartilage leads to increased friction in the joint during movements, which leads to accelerated destruction of cartilage and contributes to the development of inflammatory processes. In people, this process manifests itself as pain, stiffness, and limited mobility. At this stage, injections into the knee joint can come to the rescue. Reviews from specialists and patients about these procedures indicate their effectiveness.
At the final step of this pathological process, the cartilage is destroyed and rough connective tissue grows in its place. As a result of such changes, the joint is deformed and can no longer perform its functions. To prevent this from happening, chondroprotectors are used. Their price is low and allows them to be used quite widely.
Unfortunately, they act only in the initial stages of destruction of cartilage tissue and may not produce the expected effect in the case of an advanced process. In addition, such drugs must be taken for a long time, for three to six months, and in some individual cases up to one and a half years, because cartilage tissue regenerates extremely slowly. The duration of the course, the regimen of administration, what injections into the knee joint and in what dosages to give - all this is determined and prescribed by the doctor to each patient individually, based on the initial condition and observing changes during treatment.
Treatment of arthrosis can be medicinal and surgical. Surgical treatment involves joint replacement - endoprosthetics.
The main goal of drug therapy for arthrosis is to stop further destruction of cartilage tissue and preserve joint function.
For treatment to give good results, it must be aimed at relieving inflammation, pain and restoring cartilage tissue. For this use:
Medicines of this type relieve inflammation, swelling, and have an antipyretic and analgesic effect.
In terms of the severity of the analgesic effect, the strongest are: “Ibuprofen”, “Diclofenac sodium” (“Voltaren”). NSAIDs do not cause euphoria, drowsiness, addiction, or drug dependence, but their long-term use has a detrimental effect on the gastric mucosa. Therefore, Diclofenac (injections) is prescribed to relieve acute pain. The price of five ampoules per package is about two hundred rubles. Application: intramuscularly for two to five days, and then transfer to the tablet form of taking the drug (if necessary).
It is also possible to use “Ketonal” - injections intramuscularly or intravenously, as well as injection forms of “Flamax”, “Artrosilene”. When administered intravenously, the intervals between procedures should be at least 8 hours.
The price becomes less important if the pain overcomes, and ointments or creams are no longer effective. When arthrosis reaches the acute stage, it becomes advisable to take hormonal corticosteroids. These drugs help to quickly and effectively suppress the inflammatory process, but with prolonged use they lead to joint destruction and often cause adverse reactions.
Therefore, from GCS, doctors prescribe intra-articular drugs “Diprospan”, “Kenalog”, “Hydrocortisone” in the form of injections, which reduces the likelihood that undesirable consequences will occur to a minimum.
Chondroprotectors are drugs and preparations that promote the formation of completely new structural elements of cartilage tissue. They regenerate it and prevent further destruction.
Chondroprotectors include two key components: glucosamine and chondroitin sulfate. It is these substances that are required for the formation of synovial fluid, and the human body normally produces them itself.
Currently, pharmaceutical companies produce chondroitin and glucosamine preparations in the following forms:
There are three generations of chondroprotectors:
The classification of chondroprotectors is based on various methods of administration:
Alflutop (SC Biotehnos, SA; Romania) is considered the most effective remedy. The basis of the drug is an extract from four species of marine organisms. The fat-free concentrate is cleared of foreign impurities and proteins. The main effect of the drug is aimed at regulating metabolic processes in cartilage tissues.
Drugs such as Chondroxide, Chondrolone, Structum, and Dona have a similar effect. Application: intramuscularly, deeply, 1 ml every day for three weeks.
When large joints are involved in the process, one or two milliliters are administered intra-articularly into each diseased joint once every three to four days (the total number is five to six injections), and then intramuscular injections are carried out for twenty days. The course must be repeated after six months.
The products can be supplied in packages of ten one-millimeter ampoules or five two-ml ampoules.
Rumalon (ZAO Bryntsalov A, Russia) is recognized as another effective drug. It contains extracts of the brain and tracheal cartilage of calves.
Application: only for deep intramuscular injections. For adults, the dose is 1 ml three times a week or 2 ml twice a week. The positive effects of this therapy become noticeable after just a couple of weeks of treatment. The full course of treatment includes 25 injections of 1 ml each or 15, but 2 ml each (over 6-8 weeks). Courses of injections should be repeated twice a year at least or up to four times a year in case of a complicated course of the disease over several years.
Available in packs of ten ampoules containing one milliliter of the finished solution.
The following are classic and widely used:
Combined medications:
The most common hyaluronic acid preparations in pharmacies at present are:
Hyaluronic acid preparations for injection into the joint are available ready-made in disposable syringes, which is very convenient for use.
It can be stated that an injection of hyaluronic acid into the knee joint is a modern means for treating diseases associated with the musculoskeletal system. In the initial stages, the drug has an amazing effect and allows you to forget about the manifestations of arthrosis for a long time. This safe liquid implant significantly reduces the load on the joint, supplies the cartilage with nutrients and forms a natural (natural) prosthesis, which is very similar in composition to human synovial fluid.
Intra-articular administration of these drugs has a rapid and long-lasting effect.
In this case, various medications are used that can be introduced into the body using intravenous, intramuscular or subcutaneous injections.
These medications relieve pain, reduce swelling and inflammation in the sore joint. Without these drugs, treatment of arthrosis is impossible. They can be roughly divided into:
That is why such medications:
These are very effective drugs that act on the main “substrate” of the disease – articular cartilage. These medications contain the main components of normal cartilage: chondroitin and glucosamine. They help restore damaged areas of this tissue and help improve the synthesis of joint “lubricating” fluid. These drugs can be used only in stages I-II of arthrosis, when there are still at least small sections of cartilage tissue; later such drugs become useless.
In order for drugs of this kind to be effective, you need to know the following rules:
Chondroprotectors can be used both as a single drug (that is, one of them contains only chondroitin, the second - only glucosamine) and as a complex drug.
The following chondroprotectors are recommended in the form of injections:
These are drugs that are used to relieve pathological muscle spasm, which inevitably occurs with arthrosis and are intended to reduce pain in the joint. If such muscles are not relaxed, then they begin to suffer from a lack of oxygen, and pain also occurs in them. To relieve muscle spasms, medications are used - central muscle relaxants: Mydocalm, Baclofen, Sirdalud.
Muscle relaxants are administered over a course of 5-7 days, intramuscularly. They have few contraindications: allergies to the drug, pregnancy, lactation, myasthenia gravis.
It is optimal to use them in the form of a complex - B1, B6, B12. These are the drugs “Milgamma”, “Trigamma”, “Compligam B”, “Neurorubin”, “Kombilipen”. You can also inject each of these three main vitamins in the form of a separate intramuscular injection; for this there are special schemes when vitamins B1 and B12 are administered on one day, and B6 and B12 on the second.
The purpose of using these drugs is to reduce joint pain and improve impulse conduction along the nerve endings that innervate the affected joint.
In addition to the above several groups of medications, in the complex treatment of arthrosis, drugs are used that help improve blood flow to the diseased joint. They are administered either intramuscularly or intravenously (mainly in a dropper):
In the treatment of arthrosis, injections into the joint are also used. This is a rather serious manipulation, which sometimes cannot be avoided. The following drugs can be injected into the joint:
Thus, in the treatment of arthrosis, a wide range of different injectable drugs, that is, injections, can be used. They can be administered in various ways: intramuscularly, into a joint, intravenously or subcutaneously. Their correct use guarantees effective treatment.
An injection into the joint for arthrosis is given with corticosteroid hormonal drugs, hyaluronic acid and chondroprotectors.
The most effective corticosteroids are Kenalog, hydrocortisone, flosterone, celeston, diprospan. They relieve inflammation and instantly (within a few minutes) relieve pain.
But corticosteroid drugs do not cure the disease and are not able to restore damaged cartilage tissue. In addition, they lead to microtraumas, causing the risk of infection entering the joint.
Frequent injections into the knee inhibit regeneration processes in the joint, constrict blood vessels, promoting tissue destruction, and increase hypertension, peptic ulcers, and diabetes. Therefore, injections of corticosteroid hormones are given only during periods of severe exacerbations, if other means do not produce results. Drugs can be administered no more than 2 times a month.
“Liquid prostheses” is the name given to hyaluronic acid. It serves as a complete replacement for synovial fluid.
Injections injecting hyaluronic acid form a thin film on the surface of the joint. It acts as a lubricant and protects the cartilage from damage and friction.
Due to its ability to retain water, hyaluronic acid has a moisturizing and nourishing effect, protects the joint from drying out and makes the cartilage tissue elastic and elastic, improving leg mobility.
Hyaluronic acid has no side effects and can be used for a long time. Its only drawback is its high cost.
Usually 3-4 injections of medication are given per year. They give an effective result in the first and second degree of damage. At the third stage of arthrosis, the introduction of hyaluronic acid gives only a temporary effect.
Chondroprotectors are recommended to be administered after the inflammation in the knee has been relieved. They nourish cartilage and stimulate its regeneration processes. An injection into a joint for arthrosis is much more effective than the oral administration of chondroprotectors, since it has a targeted effect. Typically, the course of treatment consists of 5–10 injections.
An injection into a joint for arthrosis is performed only in the clinic by a traumatologist. It is advisable to administer drugs into the joint under ultrasound control.
After the injection, there may be redness, swelling and swelling in the joint area, as well as increased pain and stiffness. These symptoms may last for several hours or days.
Injections for arthrosis have a cumulative effect. Their number depends on the stage of development of the disease. For minor joint damage, the effect appears fairly quickly. If the disease is advanced, treatment can last for months or years.
It is recommended to inject hyaluronic acid and chondroprotectors in courses so that the body can start restoration processes in the joint. Each course consists of 10–20 procedures.
Injections in the knee for arthrosis are contraindicated if:
Age, weight, prolonged walking in heels, playing sports, deficiency of vitamins B1 and B6 are possible causes of joint wear and, as a result, destruction of shock-absorbing cartilage, painful and constant pain. This disease in medicine is called arthrosis of the joints.
Aching joint pain disturbs sleep, can weaken the nervous system and lead to imbalance in blood pressure. Arthrosis most often affects the following joints:
When the first symptoms of arthrosis appear, it is necessary to begin treatment using painkillers that can relieve pain in the shoulder and knee joints for some time. It should be noted that painkillers by injection (both intramuscular and subcutaneous) versus tablets help much faster. But it is not enough to anesthetize an inflamed joint; it is also necessary to relieve the inflammatory reaction. So:
In modern medical practice, it is possible to treat arthrosis using an effective technique, the essence of which is to administer drugs not subcutaneously, but directly into the joint. The preparations are made on the basis of hyaluronic acid, corticosteroid hormones, vitamins for the restoration of cartilage tissue B1 and B6, as well as other components.
Intra-articular injections are prescribed in cases where the usual painkillers described above are no longer effective. The most popular and common drugs for this type of injection are the drugs given below.
For treatment, intra-articular injections are administered: corticosteroid hormones Celeston, Kenalog, Flosteron, Diprospan, Hydrocortisone. Corticosteroids are valued for their ability to quickly and effectively relieve pain in the knee, shoulder, and other joints. But the downside is that these substances are not able to cure arthrosis. They no longer have any effect on the joint: they do not improve the condition of cartilage tissue, they do not restore blood circulation (especially to the knee). In this regard, it is necessary to use such an intra-articular injection in combination with vitamins B1 and B6.
Hyaluronic acid - an innovation in the doctor's arsenal - is a lubricating fluid that helps the sliding of almost destroyed cartilage and is a 100% substitute for the synovial fluid of the knee joints. Intra-articular injections are often given for lesions of the knee and shoulder joints as the most vulnerable. It should be noted that treatment with this drug is effective, but expensive. For injections, 3 to 5 injections containing acid are enough.
These are medicinal intra-articular drugs that heal joints. They are more often used when the joint is malnourished (often with a deficiency of vitamins B1 and B6) or when the shoulder joint or knee is injured.
It is advisable to begin treatment and use intra-articular injections for arthrosis of the knee, hip and shoulder joints only after the inflammation has subsided.
An intra-articular injection with chondroprotectors has an effect faster than taking medications orally. Having already received the first injection, the result will not be long in coming. Your knee or shoulder will hurt less.
All the described drugs for intra-articular injections do not pass without a trace - after their treatment it is necessary to restore the balance of some vitamins (B1, B6, B12, A, C, etc.) using the Neurobex complexes (B1, B6, B12), Triovit (A, C, E) or direct administration of these vitamins subcutaneously or intravenously.
Often used for arthrosis of the shoulder and knee joints. This is a special treatment during which an injection of novocaine is injected into the inflamed area of the shoulder joint affected by arthrosis, as well as adjacent tendons and muscles, with a certain frequency and frequency, as intramuscularly. The use of the so-called novocaine blockade in medicine allows you to remove pain contracture. The procedure is repeated 1 - 3 times a month. It is also combined with mandatory vitamin therapy (B vitamins, especially B1 and B6).
All these injections are good, but you should not self-medicate. Therefore, it is important, if pain syndromes of arthrosis of the knee, hip and shoulder joints appear, to consult a doctor and receive qualified assistance in making a diagnosis and prescribing correct and effective treatment.