Targeted Anti-Inflammatory Injections

If pain pills haven’t helped and you’re not quite ready for surgery, anti-inflammatory injections are another option for pain relief, especially in the knee and elbow joints. At Mount Sinai, we use several types of anti-inflammatory injections. We pick the approach that is most appropriate for your condition and overall health.

In general, our pain specialists perform injections in their offices. The procedure, guided by ultrasound or X-ray imagery, takes only a few minutes. We clean your skin and apply a local anesthetic and then we inject the medication into your joint through a needle, which may cause some pressure or discomfort. Anti-inflammatory injections can provide long-lasting relief but we may need to perform the procedure again periodically to keep you pain-free.

We use a number of types of medications. The most common are:

• Corticosteroid injections are the most common type of anti-inflammatory injections which reduce inflammation. You may feel better almost immediately and they can last months or longer. While you’re feeling better, we prescribe a targeted regimen including physical therapy to help prevent your pain from returning
• Hyaluronic acid (HA) injections are only for the knee. They are especially appropriate for people with diabetes, so that steroids can be avoided. Hyaluronic acid is similar to the fluid already in your knee joint and these injections augment the fluid already present. It acts as a lubricant and sometimes a buffer to keep the bone from rubbing against another bone. Sometimes HA injections stimulate your body to produce more hyaluronic acid on its own. We may need to remove some of your natural hyaluronic acid before the injection. You will receive injections weekly for about a month and relief usually lasts between four months and a year
• Platelet-rich plasma (PRP) injections use your own blood to reduce inflammation and promote healing. This approach uses the regrowth capabilities of blood. First, we take some blood from you and separate out the plasma cells. We increase the platelet concentration between five and 10 times the original amount, and inject that back into your joint. PRP injections work best on osteoporosis joint pain. We also use this treatment for a variety of conditions including tendinitis, rotator cuff injuries, torn muscles and ligaments, tennis or golfer’s elbow, and plantar fasciitis

You will probably need to take anti-inflammatory medications, for four to six weeks after receiving one of these injections. You may also need to limit physical activities during recovery. Your doctor will give you instructions for your specific situation. We rarely, if ever, use opioids.