Injections are commonly used for pain relief and to promote healing. However, there are various options for injections, and it's important to know when they should be used and if you are a good candidate. While you should always discuss these options with the physician administering the injection, this guide provides a quick overview of a few different types of injections.
Before discussing specific injections, it is also important to know when you might not be the best candidate. If an injury has just occurred, it is usually best to let your body work on healing itself, as the most likely scenario is that the pain will settle on its own. While there are specific scenarios where an injection is all you need, injections are generally most effective when paired with some form of rehabilitation. They often facilitate rehab by providing temporary pain relief or promoting faster healing. If you don’t plan on doing any rehab at all then an injection may not be the right treatment for you.
One of the most common injections is a cortisone, or steroid injection. These injections contain a corticosteroid, which is used to decrease inflammation. Some physicians also mix lidocaine or another anesthetic into the injection for immediate pain relief. The corticosteroid takes about 4-7 days to fully take effect.
These injections are used for a wide variety of injuries and pain. Any injury with an inflammatory component can potentially be improved with anti-inflammatory medication such as a corticosteroid. Cortisone injections are commonly used for various types of arthritis, tendon pain, and muscular pain, and are particularly effective for conditions such as trigger finger and frozen shoulder.
However, it is important to consider that physicians often limit the number of cortisone injections you receive in a year due to the risk of tendon quality degradation. Repeated corticosteroid injections have also been shown to cause some degradation of joint cartilage, which is an important consideration when receiving multiple injections.
PRP, or platelet-rich plasma, injections involve drawing your own blood and then spinning it in a centrifuge. This process separates the components of your blood, including platelets and plasma, which are then injected back into the area of concern.
The goal of this type of injection is to restart the inflammatory process in your body. If recovery has stalled, stirring up the inflammatory process can help an area to heal. The evidence on PRP injections is relatively mixed, and there isn’t one specific injury they are best used for. They are most commonly used for tendon pain that is lingering longer than expected.
While PRP injections are safe, there are a few downsides to consider: pain levels after injection and cost. Because the injection is meant to stir up inflammation, the injected area will usually be more tender and painful for at least a week or two. It is also advised not to overwork the tendon right after the injection, so it is not a good idea to have one if you have an event with a lot of activity coming up. These injections are also paid for out of pocket and can be expensive, generally costing between $500 and $2,000.
Stem cells are cells that have not specialized yet and can turn into multiple different types of cells. The idea is that injecting these into a specific area will cause the stem cells to specialize into cells that will better help to heal the area. The stem cells are usually harvested from bone marrow or fat tissue, with additional processing to prepare them for injection.
In musculoskeletal practice, these injections are mostly used for arthritis or tendon-related pain. Their efficacy is currently unclear, with some studies showing improvement while others do not. Outside of the musculoskeletal field, they have been helpful in treating certain types of cancer and blood-related diseases such as leukemia and multiple myeloma.
Aside from their unclear efficacy, the main downside of stem cell injections is the cost. They usually start around $5,000 and can reach as high as $50,000 depending on the number of treatments.
Viscosupplementation involves injecting hyaluronic acid into joints to help with osteoarthritis pain. Hyaluronic acid is a component of joint fluid that helps keep cartilage healthy and lubricates the joint.
The goal of the injection is to reduce pain in osteoarthritis, particularly knee pain, by decreasing friction with movement and acting as increased shock absorption. Research is mixed on the efficacy of these injections, but they seem to work best in individuals with mild knee arthritis rather than severe arthritis.
There is little downside to this injection besides minor discomfort at the injection site, which is normal with most injections. It may not be covered by insurance, but it is cheaper than the other options discussed previously, costing around a few hundred dollars.
Figuring out whether an injection is the right choice for you and which injection to receive can be a daunting task. While this should always be a conversation between you and your physician, you can start to familiarize yourself with the different options available. These are usually best used when you have stalled in your physical therapy or have pain lingering longer than expected. If you find yourself in this position and would like further advice, don’t hesitate to reach out to the physical therapists here at Maven to assist you in your journey.
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