Arthrosis of the knee joint (gonarthrosis) is an irreversible and slowly progressive degenerative-dystrophic lesion of the structures of the knee joint, which leads to complete destruction of the joint, its deformation and loss of function. Unfortunately, today this disease is one of the main causes of disability among the population. In addition, the pathology affects not only older people, but also young and middle-aged people.
It is impossible to get rid of the disease, since the process of destruction of intra-articular cartilage is irreversible, but it is quite possible to stop the progression of the pathology at one of the stages of its development (grade 1-2 arthrosis). In severe cases (stage 3 arthrosis), only knee replacement will help get rid of constant and unbearable pain, as well as restore lost function to the joint.
In order to relieve acute joint pain, slow down the progression of joint tissue destruction and delay knee replacement surgery as much as possible, intra-articular injections for arthrosis of the knee joint can be used, which have their own advantages and disadvantages in the treatment of this disease.
With gonarthrosis, all components of the knee joint are destroyed and, unfortunately, it is completely impossible to get rid of this disease
Intra-articular injections are made not only if the patient has arthrosis, they are also used for the development of arthritis, traumatic damage to joint structures, adhesive capsulitis, synovitis and other pathologies. But in the case of gonarthrosis, such injections are most often used to provide first aid in cases of severe pain and inflammation. Such an injection will help quickly and effectively relieve the patient’s suffering and will provide an opportunity to begin other treatment methods that were unavailable due to pain.
Another indication for injections into the knee cavity is the patient’s desire to delay the time of joint replacement surgery as much as possible. If in the first case we were talking about glucocorticoid drugs, then in this case we are talking about injections of chondroprotectors, hyaluronic acid and other intra-articular injections, which are “designed” to slow down the progression of arthrosis changes in the affected joint.
Synovitis sometimes aggravates the course of gonarthrosis and requires active medical intervention, for example, intra-articular administration of corticosteroids
Unfortunately, today injections into the knee joint for arthrosis are performed much more often than is actually necessary. This tactic of many doctors is likely to do more harm to the patient than good. Therefore, you need to be very careful when deciding in favor of such manipulation, and also carefully choose a specialist in this field of medicine.
The main advantages of intra-articular injections for gonarthrosis:
Important! In no case should you rely on intra-articular injections as the only treatment for arthrosis. They should only complement the main therapy of the disease - physical therapy, physiotherapy, dietary nutrition, drug treatment, etc.
Arthrocentesis (puncture) of the knee joint can be performed with or without ultrasound guidance. In the first case, the specialist has visual control over the procedure, which significantly reduces the risk of complications. In the second, the doctor carries out all manipulations blindly, following his feelings and experience.
Ultrasound control during an injection into the knee joint significantly reduces the risk of complications after such manipulation
Arthrocentesis is performed in a sterile operating room in an inpatient setting by trained medical personnel. The patient's position is supine with the lower limbs straight and relaxed. A small cushion is placed under the knees to relax the muscles as much as possible and fix the leg in the desired position.
The skin at the injection site is carefully treated with antiseptic solutions, after which the doctor administers local anesthesia - injects lidocaine into the soft tissue around the knee.
The puncture itself is performed with a syringe with a thin and long needle. The specialist selects the puncture site using ultrasound control or relying on his own sensations. As a rule, this place is located on the side of the patella (here the articular capsule is located as close as possible to the surface of the skin and there are no significant obstacles to the passage of the needle in the form of muscles, cartilage discs, ligaments and tendons). The doctor will know that the needle has entered the knee cavity by the characteristic sensation of “failure” or with the help of an ultrasound monitor.
The doctor chooses the place for inserting the needle individually in each case.
At the next stage, the specialist removes the fluid from the knee, freeing up the necessary space for administering the drug. If necessary, the joint cavity is washed with antiseptic or antibacterial solutions, after which the required dose of the drug is administered.
Then the needle is slowly removed, and the puncture site is treated with an antiseptic and a sterile bandage is applied.
Important! To reduce the risk of infection of the joint cavity during such a procedure, before inserting the needle, the specialist slightly moves the skin over the puncture site. After removing the needle, the skin is released and it returns to its place. Such a simple manipulation makes it possible to cover the wound tract with an undamaged area of the skin, which prevents the direct penetration of infectious agents from the external environment into the cavity of the joint capsule.
Injections into the joint cavity are contraindicated in the following cases:
Complications of intra-articular injections may include the following:
Only a highly qualified specialist should determine indications and contraindications for intra-articular injections
If you ask about what injections are most often given to the knee joint, then the answer is clear - injections of corticosteroid drugs.
Representatives of such medicines:
The main advantage of corticosteroid hormonal medications is that they are very effective and quickly eliminate inflammation and relieve pain. Thus, for gonarthrosis, these drugs are administered only in case of exacerbation of the disease in combination with reactive synovitis (inflammation of the joint capsule). Such injections help eliminate pain, swelling, swelling of the joint, increase range of motion and quickly restore knee function.
It was the speed of achieving a therapeutic effect that became the reason for the particular popularity of these injections among doctors. But unfortunately, this has also led to the abuse of corticosteroids and the frequent need for such injections.
For example, you can sometimes hear that a doctor recommends taking a course of intra-articular corticosteroid injections in order to prevent further progression of gonarthrosis. This is complete absurdity, because drugs from this group do not treat the disease itself and cannot do so. They are not able to improve the condition of intra-articular cartilage tissue, strengthen bone tissue or establish microcirculation in the tissues of the joint. All they can do is reduce the activity of the body's inflammatory response in response to damage present in the knee joint.
Diprospan is a long-acting corticosteroid
That is why it is not advisable to use corticosteroid injections as an independent method of treatment; they should be used only in complex therapy and only if there are strict indications, that is, a pronounced inflammatory reaction in the joint at the time of the injection. Otherwise, for example, in the remission phase of arthrosis, when there is no active inflammation and, accordingly, there is no “point of application” for this medicine, they will not only be ineffective, but will also cause significant harm.
If, nevertheless, the doctor has correctly determined the indications for this type of treatment, then you need to follow some recommendations:
It is important to remember that corticosteroids (even those injected directly into the joint) have many side effects and complications. The main ones among them: worsen the condition of patients with diabetes mellitus, arterial hypertension, kidney failure, obesity, osteoporosis, gastric and duodenal ulcers, purulent infections, tuberculosis, mental disorders, destruction of cartilage and bone tissue at the site of insertion into the joint, muscle tissue degeneration , ligaments and tendons, increased fragility of blood vessels, atrophy of the soft tissues of the joint.
Chondroprotectors are drugs based on chondroitin and/or glucosamine, which are important components of cartilage tissue.
Recently, drugs from this group have become very popular among many doctors and patients. But it is important to know that not a single clinical study has shown the real effectiveness of chondroprotectors in the process of restoring damaged cartilage tissue during the development of arthrosis.
These drugs for intra-articular administration are used outside the inflammation phase, and the goal of such treatment is not to relieve pain, but to slow down the progression of arthrosis changes in the joint.
Representatives of chondroprotective drugs for injection into the knee cavity:
Dona is the most popular chondroprotector, which is also used for intra-articular administration
A course of such injections helps no more than 50% of patients with gonarthrosis, and it is necessary to perform 15-20 injections, which is already dangerous and poses a high risk of complications during such a number of arthrocentesis procedures.
This treatment is especially effective in the initial stages of arthrosis; if the pathological changes have already progressed, the introduction (even intra-articular) of chondroprotectors will be useless.
Much more effective than chondroprotectors in terms of inhibiting the progression of arthrosis changes is the intra-articular injection of hyaluronic acid. Today, such treatment is considered an innovative technique, since in practice it has been used for only about 5-7 years.
Hyaluronic acid is also called a “liquid prosthesis”, which is due to its properties to replace intra-articular fluid, which nourishes and protects the hyaline cartilage inside the joint, reduces the friction force between the two articular surfaces and slows down the destruction of cartilage and subchondral bone of the knee joint.
Also, hyaluronic acid molecules are able to penetrate deep into the hyaline cartilage, thereby helping to restore its shock-absorbing abilities. As a result, the intensity of pain during movements in the joint decreases, their amplitude increases, and the function of the knee is partially restored.
Representatives of sodium hyaluronate preparations for injection into the joint:
Synvisc is a hyaluronic acid preparation for intra-articular administration.
Treatment with hyaluronic acid also needs to be carried out in courses. One course requires three or four injections into each diseased joint with a minimum interval of one to two weeks. Therapy can be repeated after 1-1.5 years.
Such injections are characterized by a minimal number of side effects and complications; they are well tolerated by almost all patients and have very few contraindications. The only and sometimes very serious drawback is the price of the issue. On average, each such injection costs 3-5 thousand rubles, depending on the chosen drug, the qualifications of the specialist and the level of the clinic. More information about hyaluronic acid injections into the knee joint can be found on this page.
It is important to know! Any hyaluronic acid preparation is immediately destroyed in the joint cavity, where active inflammatory processes occur. Therefore, it is not advisable to administer them to patients with an active stage of exacerbation of arthrosis. Only after achieving remission will there be any benefit from such injections.
This treatment is also called "carboxytherapy." In this case, carbon dioxide is injected into the joint cavity as a medicine using a special injector gun.
A sharp increase in the concentration of carbon dioxide in the knee cavity is perceived by the body as a lack of oxygen. In order to correct the situation, the activity of capillary blood flow in the area of the knee joint increases, which brings with it an increase in oxygen delivery to the cells, improvement of metabolic processes and nutrition of cartilage tissue. Thus, carbon dioxide is quickly removed from the body through the blood, and the positive effect of the procedure remains for a long time.
Gun for carboxytherapy
The technique is based on the injection of plasma from the same patient, pre-treated and enriched with platelets (growth factors), into the knee cavity. As a result, the process of destruction of the structures of the knee joint slows down, their nutrition improves and good conditions are created for the regeneration of destroyed tissues.
The advantage of the procedure can be considered its relative safety, since the plasma is used from the same patient, which minimizes the risk of allergic reactions.
The course of such injections is 5-7 procedures with an interval of 4-7 days. Further, for maintenance therapy, you can perform one injection of autoplasma into the knee per year.
I have been suffering from gonarthrosis for 7 long years. Over the past two years, the disease has worsened, and unbearable pain has often begun to bother me, an unpleasant and loud crunching sound has appeared, and it has become difficult to perform any movements in the knees or climb stairs. After another treatment with analgesics, my attending doctor advised me to try injecting hyaluronic acid directly into the joint. Relief came after the second injection. In total, I received 3 injections in each knee at intervals of 2 weeks. 5 months have passed, and the pain does not bother me, and the range of motion in the joint has increased. I plan to repeat the course in six months, even if the symptoms do not return, so to speak, for the purpose of prevention.
Knee pain has been bothering me for the past 5-7 years, but I have so far managed to cope with it on my own with the help of tablets and diclofenac ointment. One “beautiful” day, my right knee became swollen, the pain became very intense, and I could not take a step. At the clinic, the surgeon offered to give me a Kenalog injection in the knee. I immediately agreed, as the pain was unbearable. The procedure is not at all scary and I went through it without any complications. Relief came within 4 hours, and after 4 days the pain completely disappeared.
Drug therapy plays a huge role in the treatment of arthrosis. The injection form of drug administration is preferred. This way, the medicine will be delivered quickly and accurately to the target, while no “interferences” such as the acidity of the environment in the gastrointestinal tract or how long ago you have eaten will play a role. What injections can be used for arthrosis?
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.
Injections in the treatment of arthrosis of the knee joint are considered an important aspect. Intra-articular and muscle injections are aimed at improving the condition of the knee joints. Injections are prescribed by orthopedic doctors and surgeons. The introduction of medicinal substances into the lesion helps to quickly eliminate the inflammatory process as the accuracy of the effect increases.
A correctly prescribed injection helps eliminate side effects, since medications act only on inflamed soft and cartilaginous tissue and muscles of the knee joint. Effective injections into the knee joint are done when you consult a doctor.
Intra-articular and intramuscular injections are used as first aid for exacerbations of arthrosis. Long-term therapy is aimed at preserving the motor activity of the knee, improving the motor activity of the knee, and restoring cartilage. Patients note that proper procedure guarantees the absence of pain.
The procedure is allowed only under sterile conditions. Home treatment measures will not give positive results. Performing injections on your own can worsen the clinical picture of arthrosis.
For a therapeutic effect, the medication must be prescribed correctly.
Injections for arthrosis of the knee joint are aimed at the following improvements:
Injections are prescribed at any stage of arthrosis. The direct effect of the remedy promotes the regeneration of affected tissues. In some cases, pain is eliminated only by performing intra-articular injections.
Injections are an additional treatment in the fight against arthrosis. Complex treatment is required, since courses of physiotherapy and exercise therapy are prescribed to prevent exacerbations.
Treatment of arthrosis requires different injections. Each type of treatment is aimed at eliminating symptoms.
Glucocorticoids are hormonal anti-inflammatory drugs. These drugs are considered the most effective when treated correctly.
Basic principles of corticosteroid use:
Corticosteroids are considered one of the main therapeutic drugs for arthrosis.
Experts have developed special medications that specifically act on the cartilage tissue of the knee joint. The correct composition of chondroprotectors contributes to a pronounced effect on the cartilage of the knee joints, as a result of which unpleasant symptoms are eliminated and the motor activity of the knees is improved.
The treatment course is long-term. Sessions are distributed over periods of up to six months. Prices for injections are considered quite high.
In Russia, standard treatment regimens with chondroprotectors are used:
The chondroprotector is prescribed by the doctor after examining the patients. The choice depends on the expected effectiveness of the remedy. The cost of the medication and the duration of the treatment course cannot be considered as the main factors.
Injections with hyaluronic acid are most often prescribed. Such injections into the knee for arthrosis are effective because they prevent complications of arthrosis and help restore joint function.
Injections are used taking into account the following factors:
Hyaluronic acid is considered one of the most effective in the treatment of arthrosis.
For advanced forms of arthrosis, it is recommended to use injections with novocaine. The injection eliminates pain and improves joint structure. For positive changes, novocaine is injected into the cavity of the knee joint so that the benefits are manifested in relation to the muscles of the knees and soft tissues.
Novocaine is used in conjunction with vitamin complexes. Taking vitamins eliminates side effects.
Drugs and injections into the knee joint for arthrosis are considered important therapeutic agents. Arthrosis is characterized by aching pain, stiffness of the knee joint, and problems with motor activity. The development of the disease leads to a disability group.
Injections for arthrosis are considered one of the most effective. They reduce pain, eliminate manifestations of the inflammatory process, stop the destruction of cartilage tissue, and relieve swelling. To achieve better results, injections are carried out in courses prescribed by a doctor.
Additionally, the doctor prescribes vitamin complexes to support the body.
Injections are given not only into the knee joint, but also into the knee muscles. Intramuscular injections restore damaged tissue and improve the patient's health. For this, effective intramuscular injections are prescribed.
The use of intra-articular and intramuscular injections for arthrosis is possible with appropriate doctor’s prescription. The course helps improve the condition of the knee joint and eliminate unwanted symptoms.
“Injections for knee arthrosis are an unpleasant procedure. However, a high level of efficiency can almost always be noted. The improvement in well-being lasts for a long time. Intra-articular injections are considered the most useful in the treatment of arthrosis. It is advisable to carry out such a treatment course when visiting a doctor.”
“I was diagnosed with arthrosis of two knees. Not long ago we managed to carry out a course of injections into both knee joints. At the first injection I howled. The second injection was tolerated. The effect was evident from the very beginning of the treatment course. Aching pain during prolonged walking, swelling of the knee, and impaired motor activity of the joints disappear. A correctly selected drug in the form of injections acts purposefully, resulting in an improvement in health. “I am grateful to the doctor that he recommended this particular method of treatment to me, because I know that arthrosis of the knees threatens disability.”
“I lead a sedentary lifestyle and eat poorly. As a result, I was diagnosed with stage 3 arthrosis. The disease is characterized by unpleasant symptoms. The knees constantly ached, there was swelling, and a violation of motor function was detected. I decided to immediately contact an experienced doctor for diagnostics and an accurate diagnosis. After identifying arthrosis, I immediately began complex treatment. I applied compresses, started eating right, but there was no improvement in my health. Only intra-articular injections contributed to improved health. After the first procedure, I noticed a tendency towards complete elimination of all symptoms.”
“For several months I did not pay attention to the pain in my knees and the feeling of stiffness. Later I went to see a doctor. A diagnosis of arthrosis of the knee joint was made. I was prescribed anti-inflammatory drugs, but they didn't help much. Only intra-articular injections, performed under medical supervision, improved my health.”
Reviews of injections into the knee for arthrosis of the knee joint indicate that this method of treatment is considered the most effective. A course of injections for arthrosis is carried out under medical supervision to improve health and achieve stable results.
The ancient Greek philosopher and scientist Aristotle declared: “Movement is life.” However, not everyone is able to enjoy freedom of movement. Ten percent of the world's inhabitants suffer from pain caused by physical activity. They complain of internal joint stiffness, which reduces their quality of life. This is how arthrosis manifests itself. Next, we will consider how the disease is treated if injections are performed into the joint for arthrosis. You will learn what drugs are injected into the joint for arthrosis.
Joints with arthrosis begin to gradually deteriorate due to damage to the intra-articular cartilage. The disease develops in older people due to the natural aging of body tissues. But arthrosis is already recorded in women and men who have barely reached the age of forty. This is due to a decrease in physical activity of people:
To treat the pathology, doctors recommend giving injections directly to the site of inflammation for arthrosis of the joints. The causes of secondary disease are sometimes traumatic lesions (fractures, dislocations and bruises), excessive stress in workers and athletes. Other factors can also create prerequisites for the occurrence of the disease:
Human joints (regardless of their location in the body) have a similar structure - the articular surfaces are lined with cartilage tissue and are enclosed inside a synovial bursa filled with fluid. The structure of cartilage is elastic and smooth, which reduces friction during joint movement. The joint is nourished through the synovial fluid, since cartilage does not have blood vessels. Because of this, cartilage becomes vulnerable, because a failure of metabolic processes or excessive joint load causes degenerative changes in cartilage tissue, while insufficient nutrition makes tissue restoration extremely slow.
Due to the thinning of the layer, joint friction during movements increases, the cartilage is quickly destroyed, and inflammatory processes begin. This causes stiffness, pain, and limited mobility. At this stage of the pathology, injections into the joint for arthrosis help. At the final stage of the pathological process, the cartilage is completely destroyed, replaced by inelastic connective tissue, due to which the mobility of the joint disappears.
To prevent this development of the situation, chondroprotectors are used. These drugs act early in the development of the disease. The treatment lasts for months, since the cartilage tissue is restored slowly. The dosage regimen, duration of the course, names of drugs and dosages are determined only by the doctor, guided by the condition of the joint and changes during treatment.
For arthrosis, treatment is carried out with medication or surgery. The latter involves joint replacement. The goal of drug therapy is to try to stop the destruction of cartilage while maintaining joint mobility. The therapy is aimed at relieving inflammation, eliminating pain, and regenerating cartilage tissue. Used for this:
Anti-inflammatory non-steroidal drugs
Medicines for this type of joints reduce swelling and inflammation, relieve fever and relieve pain. Popular painkillers:
NSAIDs do not cause drowsiness, euphoria, or addiction, but prolonged use leads to problems with the digestive tract. Therefore, to eliminate acute pain, injections of the drug Diclofenac into the joints are prescribed. It is also possible to use an injection to relieve pain with the drug Ketonal, injectable forms of Artrosilene or Flamax. When an injection is performed into a damaged joint. They wait 8 hours before the next injection.
Chondroprotectors and corticosteroids
When the pathology is in the acute stage, hormonal injections are advisable. Hormonal medications help quickly suppress inflammation, but prolonged use destroys the joint, causing adverse reactions. Because of this, doctors prescribe only Hydrocortisone, Kenalog and Diprospan, which have a low likelihood of side effects.
Chondroprotectors refer to drugs that help restore new elements of cartilage tissue. drugs help cartilage regenerate, preventing destruction. The ingredients of chondroprotectors are chondroitin sulfate and glucosamine, which are necessary for the restoration of synovial fluid.
Chondroprotectors are available in the pharmacy in the form of:
The classification of chondroprotectors is based on the methods of administration:
Alflutop is considered the most effective remedy for this pathology. The drug is based on extracts from several species of marine organisms. The action of this medication is aimed at improving metabolic processes in cartilage tissue.
Other drugs have similar effects. These include:
Medicines are used intramuscularly, 1 ml. The course of therapy is three weeks. In case of a pathological process in large joints, injections of 1 or 2 ml are carried out into the joint into each affected joint once every three days.
The total number of injections is about six injections, and then intramuscular injections administered for 20 days. Health therapy should be repeated after six months.
Often, for arthrosis of the joints, doctors prescribe Rumalon. The medicine consists of tracheal cartilage and calf brain extract. The prescription of the drug involves deep intramuscular injections. The adult dose is 1 ml three times a week or 2 ml twice a week.
The healing effect of using such therapy occurs after 14 days of treatment. The full therapeutic course is 25 injections of 1 ml each or 15, but 2 ml each over 8 weeks. Courses of injections must be repeated at least twice a year or once a quarter, subject to existing complications of the disease.
Medicines with glucosamine and chondroitin
The following medications are widely used in the fight against arthrosis of the joints:
Combined medications:
The most common medications containing hyaluronic acid are the following:
Hyaluronic acid medications are intended for injection into the joint. The use of these medications helps achieve the following results:
Recently, domestic medicine has been using gas injections in the fight against this disease. The drugs are injections of highly purified carbon dioxide, injected into the joint tissue using a medical gun. Therapy helps improve blood supply to the joint and normalize metabolic processes.
In addition, these injections reduce pain and quickly restore motor activity. The treatment course using these techniques is 4–6 procedures. Manipulations are carried out after 3–4 days. They also use the classic method of relieving pain and inflammation at the site of exacerbation using special blockades. They are: intra-articular and periarticular. Blockades are carried out through:
Thanks to their effect on the patient:
The number of procedures should be selected by the doctor, according to the severity of the disease.
It is safe to say that injections of hyaluronic acid into the knee joint are a fairly effective and modern means for treating this pathology. In the initial stage of the disease, the medicine can have an amazing effect and allows you to forget about unpleasant discomfort for a long time.
This safe liquid composition helps reduce stress on the joint. In addition, by supplying the cartilage with useful substances, the drug forms a natural prosthesis, which is quite similar in structure to human synovial fluid.
Medicines containing glucosamine and chondroitin also have a positive effect. Their introduction directly into the joint allows for quick and long-lasting effects. However, it is worth understanding that achieving maximum effect and preventing exacerbation of the disease is impossible without daily compliance with preventive measures, as well as scrupulous compliance with all instructions of a qualified attending physician.
Treating joints is not easy, no matter what kind of disease we are talking about - arthritis or arthrosis. The treatment regimen must be comprehensive, and strict adherence to all the doctor’s instructions is also important. Injections are an effective option for using medications, especially during relapses.
The injectable form of drugs for arthrosis or arthritis may have different purposes. First of all, injections are used to quickly relieve acute symptoms - to reduce severe pain and inflammation, and relieve swelling from the joint.
Basic agents for the treatment of rheumatoid (abbr. RA) and psoriatic arthritis are also produced in the form of solutions for intramuscular or intravenous administration. Their action is aimed directly at the autoimmune cause of inflammation in the joints. In any case, the choice of drug should be entrusted to a specialist.
Basically, injections for the treatment of arthritis are prescribed during the period of exacerbation with pronounced pain syndrome, or in the later stages of the disease, that is, in situations where tablets and ointments do not bring the desired result.
Advantages of the injection form:
Many medications are administered by intramuscular injection. For rheumatoid arthritis, basic drugs, muscle relaxants and non-steroidal drugs are used in this way. Intra-articular administration is indicated not only for RA, but also for arthrosis of various locations, carpal tunnel syndrome, gout, osteoarthritis, tendonitis, synovitis, and post-traumatic joint injuries.
Attention! Any injections must be absolutely sterile, and the procedure must be performed by a specialist.
Medicinal solutions come in oil and water. There are also drugs in the form of powders and suspensions - they are pre-dissolved in water or saline in accordance with the instructions.
Injections for the treatment of arthritis or arthrosis are contraindicated if:
After an injection into the joint, redness and swelling of the skin sometimes appear. In this case, a cool compress or ice pack helps.
The range of drugs that can be used in the form of injections for joint diseases is quite wide. These are vitamins, hormones, painkillers, anti-inflammatory drugs and other groups.
At the first stage of arthritis, both tablets and injections can be used to relieve pain and relieve inflammation. However, the latter act faster, last longer and, unlike oral medications, do not have such a negative effect on the gastric mucosa. At the early stage of rheumatoid inflammation, NSAIDs cope well with the symptoms of the disease.
Attention! Let me remind you that if you have any problem, you can seek advice from our specialists.
Attention! Injections have fewer side effects, but if the dosage is exceeded and used incorrectly, they can lead to a heart attack, gastric bleeding, blood clots and the development of peptic ulcers.
Examples of names of non-steroidal injections:
Hormonal injections are indicated for intense pain and inflammation that cannot be treated with tablets or capsules - for RA, degenerative changes in the joint, and sometimes for arthrosis. Basically, they are administered locally into the joint cavity, and examples of drugs are Diprospan, Celeston, Flosteron, Hydrocortisone.
GCS should not be administered frequently and is contraindicated for use in:
Glucocorticosteroid injections are effective, but their treatment is carried out strictly as prescribed by the doctor. Otherwise, there is a high risk of side effects - internal bleeding, exacerbation of chronic infections, decreased immunity, and others.
The dosage regimen and type of drug are chosen only by the doctor. The course usually consists of 2-5 injections with intervals between injections of 1-3 weeks.
For rheumatoid and other types of arthritis, B vitamins are prescribed in the form of intramuscular injections (less often tablets). The most important of them are B1, B6, B12. They improve the nutrition of the joint and relieve the pain a little. Vitamins are part of complex therapy for arthritis; injections are administered in a course of at least a week.
The most popular vitamin injections prescribed for arthritis:
Many of these products contain lidocaine, which provides an additional analgesic effect. Neurorubin is especially effective for neuralgia of various natures.
In the later stages of arthritis, the pain intensifies, because of this the muscles are in involuntary tension, metabolic products accumulate in them and oxygen deficiency develops, and the range of motion in the diseased joint decreases. Muscle relaxants have a relaxing effect on the muscles. They are prescribed for rheumatoid arthritis, ankylosing spondylitis and other joint diseases. Examples of drugs are Mydocalm, Tizanidine, Sirdalud, Baclofen.
Attention! Many muscle relaxants are contraindicated for peptic ulcers and children under one year of age. Pregnant women should only use it under medical supervision.
If treatment with muscle relaxants causes nausea and malaise, dry mouth and problems sleeping, stop using the drug immediately and consult a doctor.
What injection medications are the most effective? The answer to this question will vary depending on the type of arthritis or arthrosis, the stage of the disease, and the individual characteristics of the patient. For example, with rheumatoid inflammation, in some cases a combination of a basic drug, NSAIDs and vitamins is ideal, while in others it is impossible to do without the periodic use of hormonal injections.
Still, there are medications that are prescribed more often than others. Among the NSAIDs, Ketoprofen and Indomethacin are effective in relieving pain, while Piroxicam and Diclofenac have a more pronounced anti-inflammatory effect. Movalis is often prescribed not only for arthritis, but also for osteochondrosis of various localizations.
Among cytostatic basic agents, Methotrexate remains the leader. But sulfonamides (Sulfasalazine) act more slowly, but have far fewer side effects compared to gold salts and cytostatics.
In addition to the NSAIDs and corticosteroids described above, new generation drugs, cytostatics, gold salts, sulfonamides and other drugs are also used in the treatment of rheumatoid joint inflammation.
Immunosuppressants (cytostatics), unlike NSAIDs and corticosteroid injections, do not affect the symptoms of rheumatoid arthritis, but the main mechanism of its development - the activity of immune cells. By suppressing it, they stop inflammation and slow down the destruction of joints.
Cytostatics are the basis of basic therapy for RA, the main ones being:
Methotrexate injections are administered intramuscularly, less often intravenously, the standard dosage involves administering 7.5 mg of the drug once a week, or three times 2.5 mg.
It is important to know! Methotrexate is prohibited for use by pregnant and lactating women, since the drug can cause intrauterine fetal death or cause irreversible disorders in the infant.
The medicine is also contraindicated for alcoholism and liver problems. Based on methotrexate disodium, another injectable drug with an immunosuppressive effect has been created - Methoject. It is produced immediately in sterilely packaged disposable syringes. Administration options are intramuscular, subcutaneous or intravenous. The main indications in rheumatology are psoriasis and rheumatoid arthritis. The course of therapy with cytostatics is long, usually several years.
These drugs are represented by monoclonal antibodies, which are created using genetic engineering. Their main property is the ability to block tumor necrosis factor, which causes inflammation. An example of such a drug is Rituximab, it is treated in courses of 8 weeks with breaks of 1.5 months.
Other new drugs block immune cells called interleukins and T cells, such as Adalimumab. The injection is given twice a month, the therapeutic course lasts for years.
This drug suppresses the aggression of the immune system, affecting lymphocytes, and is administered intravenously or subcutaneously. Abatacept is indicated for any stage of rheumatoid arthritis. It can be combined with basic and symptomatic drugs, but never used together with TNF blockers. Abatacept is contraindicated for children under 7 years of age, for acute infections, severe conditions and for individual intolerance.
Arthrosis is the destruction of cartilage, which, with active development and without treatment, leads to exposure and deformation of bone surfaces. To combat pain in this disease, as in arthritis, NSAIDs and corticosteroids are effective, and injections of chondroprotectors help slow down the destruction of cartilage tissue.
From this group, the doctor can prescribe any drug - Prednisolone, Hydrocortisone, Diprospan. A popular drug is Flosteron, created on the basis of the synthetic glucocorticosteroid betamethasone and produced in the form of an injection suspension. Methods of administration: periarticular, intraarticular, intradermal and rarely intramuscular.
Important! In large joints (pelvis, knee), no more than 4 injections per year are given for each joint and no more than 2 ml of solution at a time. The maximum volume of medicine for small joints is 0.5 ml; for gout, it can be increased to 1 ml.
Flosterone, like other corticosteroids, has a large list of contraindications and dangerous side effects, so self-medication is prohibited.
Glucosamine and chondroitin sulfate are the active ingredients of chondroprotectors. They improve the nutrition of cartilage tissue and slow down its destruction, increase the viscosity of the joint fluid. Effective at stages 1-2 of arthrosis. Examples of chondroprotectors in the form of injections:
The number of injections per course is determined by the doctor, most often it is 4-6 procedures, then a break is taken for 1-2 weeks. After the injections, chondroprotectors are prescribed in tablets, which are taken for at least 3-6 months.
Injections of hyaluronic acid into the joint help improve mobility, reduce crunching and pain. This is a kind of synovial fluid prosthesis. Examples of products are Gialgan, Crespin gel, Sinvisc (contains hylans), Ostenil.
Juvenile arthritis is a form of rheumatoid joint inflammation that affects children under 16 years of age. The treatment regimen includes cytostatics, NSAIDs and other drugs that are used for RA. The prescribed drugs must be approved for use in pediatric practice.
Among symptomatic ones, preference is given to non-steroidal drugs from the COX-2 group - Meloxicam (it is approved after 15 years) and Nimesulide (has no age restrictions). Methotrexate remains the basic drug of choice.
A conversation with a doctor about the treatment of arthritis, arthrosis and intra-articular injections.
Injections in the treatment of joint diseases allow you to quickly cope with pain, inflammation or the very cause of the disease. For arthritis and arthrosis, many drugs are prescribed in the form of injection solutions. Among them are hormonal and non-steroidal anti-inflammatory drugs, chondroprotectors, immunosuppressants and other drugs. Whatever your diagnosis, trust the choice of therapy only to a specialist.