Joint Injections

Treating arthritis does not always require surgery. One common type of non-surgical treatment is an injection.

Below are some questions my patients commonly ask about injections.

What kinds of injections are available at The Polyclinic to treat arthritis?

There are four different types of injections:

  1. Steroids
  2. Hyaluronic acid (HA) injections
  3. Platelet-rich plasma (PRP)

What injections can be used to treat hip and knee joints?

Knees can be treated with corticosteroids, hyaluronic acid, PRP and stem cell injections. Hips can be treated with corticosteroids, PRP and stem cell injections.

How do steroid injections work?

The pain and swelling you experience in your joint is a result of inflammation. Steroids help reduce the inflammation which results in less swelling, and pain.

What are the potential risks associated with steroid injections?

Some of the risk associated with steroid injections include: infection, steroid “flare”, increased blood sugar, change in the color of skin at the injection site (hypopigmentation), thinning of skin at the injection site, and flushing. While there are risks, the benefits can be very rewarding for patients experiencing pain.

I heard steroids are bad for your joint, is this true?

Steroids can damage cartilage if administered more frequently than recommended. Steroid injections shouldn’t be performed any more frequently than every three to four months. It’s important to work closely with your doctor to ensure the best treatment timeline for you.

What is hyaluronic acid and how do HA injections work?

Hyaluronic acid is normally produced in joints and serves as a lubricant and shock absorber that assists in joint function.

HA injections, or “gel” injections, are thought to work by:

  • Protecting cartilage cells
  • Improving surface lubrication
  • Decreasing inflammation and pain
  • Decreasing friction within the joint
  • Cushioning joint surfaces

What is platelet-rich plasma and how do PRP injections work?

Blood contains plasma, red and white cells, and platelets. The platelets help the blood thicken and contain growth factors that help tissue heal. PRP injections are made by taking a sample of the patient’s blood and spinning it in a centrifuge, a machine that helps separate different fluids. This splits the platelets from the other blood cells. This is then combined with plasma, the liquid that carries the blood cells, for a concentration that has ten times the amount of platelets than normal. This mixture—the platelet rich plasma (PRP)—can then be injected back into the body. While this is still a working theory, the idea is that the concentrated injection helps heal tissue and lessens pain.

Are these injections covered by my insurance?

Insurance coverage can vary on type of injection.

  • Steroids and hyaluronic acid injections are often covered by insurance but there are exceptions.
  • PRP injections are not covered by insurance, and out-of-pocket expenses will vary based on where you receive these injections.

Check with your insurance company to get more information on your benefit coverage for injections.

If you have questions about treating joint pain with injections and would like to schedule an appointment with Dr. Ibrahim, call 206.860.5578.

September 3, 2020 | by David A. Ibrahim MD