Pain Management
Joint Pain
What causes joint pain?
Joints are part of your skeletal system. They are the connection where two bones meet.
Cartilage tissue at the ends of bones helps them move and glide. Synovial fluid cushions and lubricates joints and cartilage. Joint pain, inflammation and swelling occur when something reduces the synovial fluid, cartilage or both.
Conditions that cause joint pain include:
Arthritis, including osteoarthritis, gout and psoriatic arthritis.
Autoimmune diseases, including rheumatoid arthritis and lupus.
Bacterial infections, including Lyme disease.
Bursitis and tendonitis.
How does arthrocentesis (joint aspiration) work?
Fluid buildup in joints (effusion) puts pressure on the joint. Excess fluid causes pain and swelling. You may find it difficult to bend and move the joint.
Dr. Strell may drain the fluid and send a sample to a lab. Tests can determine the cause of the fluid buildup.
As a treatment, joint aspiration eases swelling and joint pressure. You should have less pain and find it easier to move after this procedure. Excess fluid often comes back. You may need joint aspiration again.
Dr. Strell will typically use arthrocentesis on the:
Hips, knees, ankles and feet.
Elbows, shoulders, wrists and hands.
What are joint injections?
After joint aspiration, Dr. Strell may inject corticosteroids into the joint. This anti-inflammatory medication eases pain, swelling and stiffness. The drugs may also slow the return of excess fluid to the joint.
Steroid injections work best for inflammatory conditions like arthritis and tendonitis. Treatment effects last a couple of months. You shouldn’t get more than four injections in the same joint within a year. Steroid overuse can damage the joint and weaken supporting tendons and ligaments.
What is viscosupplementation?
Viscosupplementation is a type of joint injection that specifically treats osteoarthritis. Research on the effectiveness of this treatment shows mixed results. Some people have less pain and improved movement after treatment. But some people see no change.
Dr Strell can inject hyaluronic acid into a joint (usually the knees). This substance occurs naturally in synovial fluid surrounding joints.
Typically, three injections each week for three weeks are given. It can take several weeks for symptoms to improve. Viscosupplementation may relieve pain and improve mobility for about six months. You can get the treatment again. In many cases Dr Strell will prefer to start with a local steroid injection and depending on the results a decision will be made regarding the best, next step in care.