Intraarticular joint supplement injections
Hyaluronan (also called as hyaluronic acid or hyaluronate) is an anionic, non-sulfated glycosaminoglycan distributed widely throughout connective tissues and in joint fluid. The injection of hyaluronate into a degenerative osteoarthritic joint has been shown to improve joint health for more than 6 months by:-
Hyaluronate injection should be considered for patients with mild to moderate degenerative osteoarthritis where there has been a poor response to the conservative treatment. It does not have significant effects on advanced degenerative osteoarthritis.
Glucosamine is a precursor of glucosaminoglycan which is a major component of cartilage. Intra-articular glucosamine injection can achieve pain alleviation in a study done in 19811.
Facet joint injections
The spine is made up of vertebrae. The facet joints link the vertebrae together, provide stability of the spine, control the degree of movement as well as carry some of the load. With age, the facet joints become more prone to injury and wear-and-tear, and are common causes of neck and back pain.
Facet joint injections can be both diagnostic and therapeutic. To diagnose whether or not a facet joint is the cause of pain, local anaesthetic can be injected into the facet joint. If the pain abolishes shortly, this suggests that the facet joint is causing the pain. Steroid can be injected at the same time to suppress the inflammation inside the facet joint if that is the cause of the pain and restriction of joint movement. For resistant cases, radiofrequency ablation can be used to burn out the nerve supplies the facet to procure permanent cure of the facet joint pain.
Prolotherapy is also known as regenerative injection therapy. It involves the injection of a proliferant solution into the body where connective tissue has been weakened or damaged through injury, strain or sprain, generally in the region of tendons or ligaments for the purpose of strengthening weakened connective tissue which are usually the root causes of musculoskeletal pain.
A commonly used prolotherapy solution used is concentrated glucose solution (usually 15 to 25% depending on the site injected). Since the glucose solution used is more concentrated than the body’s glucose concentration (5%), the injection will trigger a local inflammatory response which will then initiate growth factor production in the injection site. Growth factors are very important for self repair and healing of those weakened or damaged ligaments, tendons, joint capsules, cartilage etc.
HKIMM Annual Scientific Meeting 2017
An Update on Musculoskeletal Medicine Skills
7 – 9 July 2017
Diagnostic Musculoskeletal Ultrasound & Injection Technique Workshop
18 – 20 August 2017
The Salisbury – YMCA of Hong Kong