Welcome to Pain and Spine Clinics

Aches and pains are part of aging. But if you find that your joints are particularly stiff and painful, and the pain doesn’t go away with simple over the counter medications then you might be suffering from osteoarthritis (also known as wear and tear arthritis or degenerative arthritis). In fact, a significant proportion of the American population suffers from osteoarthritis every year. In the over 60’s it’s estimated that about 13% of woman and 10% of men have the disease. The pain can be incredibly debilitating for many and conservative treatments like medications and braces often fail. For these patients, there are a number of options up to and including surgery. For those that don’t want to go under the knife joint injections have become a popular and effective treatment. But what types of joint injections are available and which is the best?

Types of joint injections for osteoarthritis

  • Steroid injections: these injections are used across the world to help reduce inflammation in joints affected by osteoarthritis. Reducing the inflammatory chemicals in the joint stops pain fibers from firing as much and reduces pain.
  • Hyaluronic acid injection: hyaluronic acid is found in a healthy joint. In osteoarthritis, there is a depleted supply so injecting some into the joint can help reduce bone on bone contact in the joint which causes considerable pain.
  • Platelet-rich plasma injection: these new injections use a patient’s own blood to inject mediators of regeneration back into the joint. These molecules help to regrow the cartilage and reduce inflammation in the joint.

Hyaluronic Acid for Osteoarthritis

Hyaluronic acid versus platelet-rich plasma: who is king?

In the past, it’s been difficult to ascertain which therapy is better because research and trials usually involve patients getting a placebo that has no effect or the treatment (either hyaluronic acid or PRP). However, a recent study published in the journal Knee Surgery, Sports Traumatology, Arthroscopy looked at hyaluronic acid injections versus PRP injections directly.

The study recruited 162 patients with different stages of osteoarthritis of the knee. They divided the patients and results up by early and advanced osteoarthritis. Whilst they found that there was an improvement in both pain and mobility for hyaluronic acid and PRP injections, they note that scores for multiple PRP injections were significantly better than hyaluronic acid. When assessing the patients clinically, they found a significantly better response in early osteoarthritis patients when given PRP. However, for late osteoarthritis, there was no difference between hyaluronic acid and PRP injections.

Whilst it might seem that PRP is the clear winner, both techniques have value. It seems that for patients with an earlier disease it’s better to head to a specialist clinic that offers PRP injections, whilst for later disease a mixture of the two can be tried to see what works best for each individual patient. The advantage of getting in contact with a specialist clinic is that they offer PRP injections whereas most family practitioners will not. For early OA most patients don’t seek specialist help but that could be subject to change following these results.