Injections

• Viscous supplements (joint lubricant)
• Steroids

There are several types of joint lubricant injections that are available on the market. They are marketed as “natural” joint lubrication that helps reduce the effects of osteoarthritis on the joint. There is very little scientific evidence that they achieve what they are advertised to do. In my opinion they have a rather limited use in the early stages of osteoarthritis of the knee.

Steroid injections, especially to the knee joint, do have an established role in the management of osteoarthritis. They can provide significant relief of pain and inflammation within a few days of the injection and the effects can last for up to several months. The benefits of steroid injections into the hip joint are not as good, in my experience. It is difficult get into the hip joint with the needle and therefore it has to be done by an experienced radiologist under x-ray control. Even then, there is often lack of significant pain improvement.

It is important to understand that the steroid does not “cure” the arthritic condition but can ease the symptoms of it. However, repetitive injections can have a negative effect on the joint and potentially accelerate the progression of osteoarthritis. Therefore it should be used only occasionally (no more than 2 to 3 times a year) and avoided in younger patients (under 50 years of age). On the other hand it is a useful treatment for a patient who is destined to have the total joint replacement but for whatever circumstances needs to delay surgery for a period of time. It can also be useful if the joint replacement option is contraindicated.