Viscosupplementation Injections

A Non-Surgical approach to pain relief from Arthritis

Arthritis can be a debilitating and painful condition to have. It creeps up on you slowly and the pain worsens over time. There are many non-surgical treatment options available to manage this type of pain and help you stay active. Some non-surgical treatment options for Arthritis include changes in activity, weight loss, over-the-counter pain medicines like NSAIDS, corticosteroid injections, viscosupplementation injections, bracing and or physical therapy.

If you have tried conservative treatment and continue to have significant symptoms, if surgery is still not an option you want to entertain then viscosupplementation is a good option to try. This injection series helps to reduce your pain, stiffness, and swelling. The treatment seems to work best in people with mild or moderate arthritis. It makes sense to try this if you are trying to avoid joint replacement surgery for any reason. The U.S. Food and Drug Administration (FDA) approved hyaluronic acid injections (also known as viscosupplements) for treating osteoarthritis.

Viscosupplementation refers to the injection of a gel like fluid called hyaluronic preparation into the arthritic joint. Hyaluronic acid is a natural substance present in the joint space fluid in our body that assists in lubrication so bones can move smoothly over each other and functions as a shock absorber for joint loads. When this fluid goes away and your bones lose the space between them they become “bone on bone” which is what arthritis is. The theory behind these injection series is that injecting a gel like hyaluronic fluid preparation back into the arthritic joint will facilitate movement and reduce pain.

There are numerous types of “visscosuplementation injections” or “Hyaluronic acid preparations”, your physician will tell you, which one he feels is best for you.

What to expect the day of your first Visscosuplementation injection?

Talk to your healthcare provider about all your medical conditions. Tell your healthcare provider about all the medicines you take, including over-the-counter medicines, like aspirin. Take all of your medicines as normal, unless your healthcare provider tells you otherwise.

The day of your procedure, you can eat and drink as you normally would. Tell your healthcare provider about any new symptoms, like fever. You may want to wear loose clothing so that you can easily expose your joint. Viscosupplementation is a relatively quick procedure that you probably can have done during a normal office visit. In general:

• Your healthcare provider will clean the area where you will have your injection.
• Usually, your healthcare provider will spray a local anesthetic into the area around your joint, so you will not feel any pain or discomfort in the area during the treatment.
• Your healthcare provider will use ultrasound guided imaging so that he can inject into exactly the right spot.
• Your healthcare provider will inject the hyaluronic acid into the joint space using a needle attached to a syringe.
• A small bandage will be applied to your injection site.

Depending on which product of Hyaluronic acid is used will determine how many injections you will need. A series can extend between one to three injections normally given on a schedule of one per week. The time it takes for beneficial effects to be felt is variable. The extent of pain relief also varies from patient to patient. Good results can be sustained for as long as 6-12 months.

What to expect after viscosupplementation injection?

You should be able to go home shortly after your procedure. You should be able to drive but it is always good to have someone come with you in case you have significant pain. For about 48 hours after the injection, you should avoid standing for long periods, excessive walking, jogging, or lifting heavy weights.

Some people have slight pain, warmth, and swelling right after their procedure. These symptoms usually do not last long. Using an ice pack will help. Tell your healthcare provider right away if these symptoms do not go away soon, or if you have severe warmth, redness, pain, or high fever. Follow all your healthcare provider’s instructions about medicines and follow-up care.

Make sure to come to all of your future appointments. The procedure may not work effectively if you do not receive the full series of injections.

You should not expect your hyaluronic acid injection to relieve your symptoms immediately. We have found that by the third injection or within a few weeks of beginning treatment you will notice a difference.

As always, any questions, concerns should be directed to your healthcare provider.