Arthritic joint pain from your knee? Hip? Shoulder?
If your joints ache, they have lots of company. Over 46 million Americans suffer from arthritis. Osteoarthritis of the knee is the most common type, and the way it affects the knee is painfully simple. Osteoarthritis causes the lubricating properties of the synovial fluid in the knee joint to diminish, resulting in less protection and cushioning. In addition, osteoarthritis wears down the cartilage, resulting in your bones grinding against each other. That grinding hurts! You can feel it climbing stairs, working in the garden, walking or bending your knees to sit. It may even keep you up at night. Similar issues can affect many other joints, including the shoulder, hip and even the fingers.
Our first line of treatment if oral anti-inflammatories do not work is to inject a solution of steroids into the joint. We used to do this in the office without the use of x-ray many years ago until we noticed that patients did so much better if we were able to direct the injection with the use of the x-ray. The problem with many patients that have severe arthritis of their joints is that due to the narrowing of the joint a lot of the injections done in the office never actually get into the joint.
If you look at the second picture you can see that there is only a small space to get into the joint. Attempting to inject this knee in an office setting without the use of x-ray would lead to the possibility of the steroid not getting into the joint. Even if it got into the knee joint there is very little likelihood that it would get into the narrowed area which is exactly where the steroid is needed. The other advantage of using x-ray for these procedures is that we can even do small joints such as fingers and toes. These procedures can be done with or without sedation. If done without sedation you are able to drive yourself home after the injection.
Synovial fluid is a naturally occurring lubricant or cushion present in your knee joints that helps your knee joints work efficiently and without friction. Synovial fluid properties degenerate in the early stages of osteoarthritis. As it breaks down, joints can become painful. Fortunately, there is a natural treatment available that injects supplement hyaluronate, the substance in synovial fluid that provides the cushion and lubrication inside of the joint. We are now using a substance called Gel One which is a single injection of supplemental synovial fluid. We usually use this if we do not get long term relief from the steroid injection.