Joint pain that is caused by minor muscular strains, worn cartilage, bursitis, excessive exercise or mild osteoarthritis could benefit from either non-operative treatment or minimally invasive surgery. This can delay, often for several years, the need for more serious operations such as a joint replacement.
It is, however, important to have early and accurate diagnosis of the causes of your chronic pain to determine the best options.
Depending on the results of the diagnosis, chronic pain can be eased or eliminated using non-surgical techniques, which include the following:
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Platelet Rich Plasma (PRP):
A Platelet Rich Plasma (PRP) injection is used to treat osteoarthritis of the knee. It was developed to provide relief from pain without surgery.
The PRP injection collects “good inflammatory cells” from your own blood. A small sample of blood is taken and put in a centrifuge device to separate out the the different components. These are then injected into the joint or site of pain. Level 1 evidence studies have shown PRP injections to be more effective at pain relief for mild to moderate knee osteoarthritis than hylaronic acid injections or steroids.
Injections:
The cartilage that coats the bones in the hip or knee joint ensures that they move smoothly. It is lubricated by the synovial fluid, which is produced by the coating of the capsule, which holds the bones in place. If the cartilage is damaged or becomes worn, the synovial fluid is often less concentrated, less able to lubricate and with bone-on-bone movement, causes inflammation and pain in the joint. The solution to this can be an injection, of which the two most commonly used are:
- Depo-medrol – is an anti-inflammatory steroid, which is injected, often with a long-lasting local anaesthetic, to reduce chronic pain or swelling caused by inflammation.
- Hylaronic acid supplements – contains synthetic stabilised hyaluronic acid, which is similar to the lubrication naturally produced in the joint.
Injections for the knee and ankle joints are carried out in the clinic and do not involve hospitalisation. Injections for the hip joint do require an anaesthetic and image control.
Orthotics and braces:
Orthotics is a specialist process, which involves the design, manufacture and fitting of orthoses that will support or restrict joints following injury or trauma. They are usually purpose-designed and made, and are often used after a fracture or in the case of ligament/cartilage tears. They help to prevent strain and further injury, and thus help recovery. Knee and ankle braces, often padded or elasticated, are also used for this purpose.
Targeted physiotherapy:
Targeted physiotherapy by a qualified and experienced practitioner has been proved very effective for treatment of joint pain caused by bruising, strains or muscular-inflammation, and which result in swelling and chronic pain.
We do not recommend you change your physiotherapist. We like to work with your choice of physiotherapist to ensure we are coordinating your treatment to get maximum benefit.
Non-Operative Treatments for Osteoarthritis
There is no cure for osteoarthritis. Other treatments to relieve the symptoms include:
- Painkillers: taking over the counter medication like Paracetamol can help to manage the pain of osteoarthritis. You may also need to take an anti-inflammatory like Ibuprofen to reduce the inflammation. These are not suitable for everybody so talk to your doctor, particularly if you have asthma, a peptic ulcer or angina, or if you have had a heart attack or stroke.
- Hot and cold packs can be effective at relieving the pain of osteoarthritis for some people
- Corticosteroid injections may be recommended if the pain is severe.
- Viscosupplementation is the injection of hyaluronic acid directly into the affected joint. You will receive up to five injections over a period of several weeks. If the procedure is successful it may be repeated at six monthly intervals. Hyaluronic acid is found in the synovial fluid in joints and acts as both a lubricant and shock absorber.
- Platelet rich plasma can reduce the inflammation in joints. It can be given with hylaronic acid supplements.
- Maintaining a healthy weight and exercising regularly. Exercise helps to build up muscles and strengthen joints. Maintaining a healthy body weight helps to reduce pressure on the joints.
Operative Treatments for Osteoarthritis
Joint replacement may be offered in cases where other treatments have been ineffective or where the joints are severely damaged. Surgery greatly improves mobility and quality of life in many cases. A newer type of surgery called resurfacing may be offered, particularly for younger patients.
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If you are experiencing pain in your pelvis, hip, knee or ankle, or are suffering from a sports injury, seek specialist help to get you back to living your life. Contact can be made direct, or through your GP.
Email:
enquiries@carrothersorthopaedics.co.uk
Phone:
+ 44 (0) 1223 667 376.