The 3 Most Popular Injections For JOINTS.
1) Cortisone (Steroid) Injections: used to treat inflammation. Please understand this is NOT a curative approach, but can certainly help when PT treatment has been working but has hit a plateau. Sometimes this injection “mellows” things out and then allows PT to further advance. A great example is when I’m treating someone with Frozen Shoulder….often times, an injection can help to minimize inflammation and “calm down” the nerves, allowing my hands-on treatment to be much more effective with lasting results. Be careful, cortisone has MANY side effects and can be dangerous, especially if you’ve already had one recently.
2) Synvisc Injections: insurances usually won’t reimburse for these until until they see you’ve tried a cortisone injection first. However, they do work well well administered at the right time. Our joints have a good fluid in them called synovial fluid, which helps to keep our joint cartilage healthy. When we move our joints, it swishes around, lubricating the joint. When someone starts to develop arthritis, not only does the cartilage begin to wear down, but the synovial fluid becomes scarce. Synvisc mimics our synovial fluid, and when introduced into a joint with early-onset arthritis, it can help to preserve (NOT rebuild) the cartilage in the joint. I want to stress that it is MUCH more effective when administered during early-onset arthritis, and it is still important to exercise (to keep the fluid swishing around the joint) and seek out physical therapy to figure out why the joint was wearing down and to make sure all the dynamics of your joint are A++.
3) PRP (Platelet Rich Plasma) Injections: our blood is made up of Red Blood Cells, White Blood Cells, and Plasma. When our blood is put into test tubes and spun really fast, the blood cells separate from the plasma. The plasma separates to the top of the test tubes and contains Platelets. To make it simple, Platelets are really important in the initial phases of tissue healing. If this Platelet Rich Plasma is injected in to damaged tissue, the theory is that it will stimulate (or jump start) the healing phases in chronic cases. For example, if someone has had elbow tendinitis for a year, it is thought that the area never healed, and the healing process became stagnant. It is possible that the PRP restarts the healing process, HOWEVER, in all the studies done so far, the results are “so-so” AND are only decent for Tendinitis. To reiterate, PRP has NOT been shown to be effective for arthritis, meniscus tears, or disc herniations…JUST chronic tendinitis. As of 2019, insurance in the USA still does NOT reimburse for PRP injections due to the mixed results and lack of evidence.