Joint injection therapy is a localized treatment method that involves directly injecting medications or biological materials into the affected joint. It is primarily used to alleviate arthritis, injuries, or chronic pain. This therapy can precisely target the diseased area, reducing systemic side effects of medications. Common injected substances include corticosteroids, hyaluronic acid, platelet-rich plasma (PRP), and stem cells. The main goals are to reduce inflammation, repair tissue damage, and restore joint function.
This therapy is suitable for patients who do not respond well to conservative treatments such as medication or physical therapy and can effectively delay the need for surgery. Physicians will develop personalized treatment plans based on the patient's age, type of joint, and severity of the condition.
Corticosteroid Injections: The main components are dexamethasone or methylprednisolone, which quickly reduce redness, swelling, heat, and pain by suppressing inflammatory substances such as prostaglandins and cytokines. The effects typically last from several weeks to months.
Hyaluronic Acid Injections: Mimic the components of synovial fluid, increasing the viscosity of joint fluid, reducing friction of articular cartilage, and are commonly used in degenerative joint disease. Their action is slower but longer-lasting, requiring multiple injections spaced several weeks apart.
PRP and Stem Cell Therapies: Utilize autologous blood or stem cells to promote tissue repair, suitable for ligament injuries or chronic degeneration. The mechanisms involve stimulating collagen production and neovascularization.
Mainly used for the following conditions:
In specific cases, such as pain management before or after surgery, or when patients are unable to undergo surgery, this therapy can serve as an alternative. It should be performed after evaluation by an orthopedic or rehabilitation specialist.
The treatment is usually performed in a clinical setting, involving:
After injection, ice application and activity restriction of the joint for 24 hours are recommended. Some patients may experience short-term swelling, which usually subsides within three days.
Main advantages include:
Compared to surgery, this therapy is more cost-effective and carries fewer risks, suitable for early to moderate cases. PRP and stem cell therapies can further promote tissue repair and delay the need for joint replacement surgery.
Common short-term side effects include:
Serious risks include joint infection (incidence approximately 0.1%), cartilage or ligament damage, and long-term corticosteroid injections leading to osteoporosis. Monitoring for cumulative effects of repeated injections is necessary.
Contraindications include:
Diabetic patients receiving corticosteroid injections should monitor blood glucose levels, and immunodeficiency patients should be carefully evaluated. All chronic diseases and medication histories should be disclosed to the physician before treatment.
Combining with oral corticosteroids may increase blood sugar fluctuations, requiring adjustment of hypoglycemic medications. Combining with non-steroidal anti-inflammatory drugs (NSAIDs) can enhance pain relief but warrants caution regarding gastrointestinal irritation.
Physical therapy, such as rehabilitation exercises post-injection, is often combined to restore joint mobility. Repeated use of other joint injection therapies within a short period should be avoided.
Multiple randomized controlled trials show that corticosteroid injections significantly improve pain scores in degenerative joint disease for over 6 weeks. Long-term studies (2 years) on hyaluronic acid injections for knee osteoarthritis indicate that 50% of patients experience more than 30% pain reduction.
PRP therapy has demonstrated in clinical trials higher tissue repair rates in tendinopathies (e.g., patellar tendinitis) compared to placebo by 40%. However, the long-term effects of stem cell therapy still require further research.
Medication: Non-steroidal anti-inflammatory drugs or topical analgesic patches, though they may carry gastrointestinal or renal risks.
Surgical options: Arthroscopic debridement or joint replacement, which require longer recovery and carry infection risks.
Physical therapy: Heat therapy, ultrasound, and other modalities can relieve mild pain but are less effective for severe inflammation or structural damage.
What preparations are needed before receiving joint injections?
It is recommended to fast for 4 to 6 hours before treatment and avoid anticoagulant medications or supplements (such as fish oil, vitamin E). Patients should inform their doctor of their medical history, current medications, and allergies. Imaging or physical examination will be used to confirm the injection site to reduce complications.
How can pain or swelling after joint injection be alleviated?
Temporary discomfort may occur post-injection. Applying ice to the injection site for 15-20 minutes can reduce swelling, and avoiding excessive activity is advised. If pain persists beyond 48 hours or is accompanied by fever, contact your healthcare provider immediately. The doctor may prescribe NSAIDs to relieve symptoms, to be used as directed.
Do I need to modify daily activities during joint injection treatment?
Strenuous exercise or heavy lifting should be avoided within 24 hours after treatment, but gentle joint movement can promote circulation. Using crutches or knee braces can reduce joint load, and maintaining varied positions is recommended. The doctor will adjust activity restrictions based on recovery progress, and regular follow-up visits are advised.
How are the intervals and number of joint injections scheduled?
The frequency and interval depend on the severity of the condition. Typically, corticosteroid injections are spaced at least 3-6 months apart, while hyaluronic acid injections are spaced several months apart. The physician will evaluate pain levels, imaging results, and quality of life improvements to plan subsequent treatments, avoiding overuse that could damage tissues.
How is the efficacy and prognosis of joint injection therapy assessed?
The effects usually become apparent 2-4 weeks post-injection. The physician will assess pain improvement using the Visual Analog Scale (VAS) and evaluate functional activities such as stair climbing to gauge quality of life. About 60-80% of patients experience short- to medium-term relief, but individual differences exist. Some patients may require additional physical therapy or other interventions to prolong benefits.
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