Peripheral Joint Injections

What are Peripheral Joint Injections?

Peripheral joint injections are injections administered into the joints of the limbs such as the shoulder, elbow, hip, knee, and joints of the hands and feet. They help diagnose and treat joint pain and inflammation and improve mobility.

When are Peripheral Joint Injections Recommended?

Peripheral joint injections are recommended when you have significant joint pain which does not respond to medications and you are not willing or able to undergo surgery.

Types of Peripheral Joint Injections

Corticosteroid Injections

Corticosteroid injections are used to treat symptoms of osteoarthritis by reducing inflammation in the treated joint. A local anesthetic may also be combined with the corticosteroid to provide immediate pain relief.

Hyaluronic acid injections

Hyaluronic acid is naturally present in joint fluid and acts as a lubricant and shock absorber. Osteoarthritis can result in depletion of this substance, thinning the joint fluid and increasing friction. Hyaluronic acid injections provide a natural supplement allowing the joint to function smoothly. It is usually recommended for the knee joint. Hyaluronic acid injections also have anti-inflammatory effects and may even promote the production of natural hyaluronic acid in the knee.

Platelet Rich Plasma (PRP) Injections

This injection contains a fluid rich in platelets which are prepared from your own blood. Platelets contain a lot of growth factors that promote healing. Studies show that PRP even reduces inflammation.

Placental Tissue matrix Injections

This is an injection prepared from donated placental tissue following a healthy delivery. Placental tissue does not trigger the immune system and is hence found to be effective in many patients. The growth factors in the placental tissue promote healing.

Arthrocentesis

Arthrocentesis is the removal of excess fluid that has accumulated in the joint using a hollow needle. This can bring immediate relief of symptoms. The fluid removed may be tested in the laboratory to evaluate your condition. Removal of excess fluid creates space so that injections can be administered, usually through the same site.

Talk to your doctor to learn which type of injection is best for your condition.

Peripheral Joint Injection Technique

A joint injection usually involves the following steps:

• Your doctor may draw a few lines on the skin to mark the injection site. 
• Your skin is cleaned with an antiseptic at the infection site.
• The needle is injected into the soft tissue and advanced towards the joint. The drug is injected into the joint. 
• Imaging guidance such as ultrasound or fluoroscopy may be used to accurately inject the drugs into the joint.
• A band-aid is usually placed over the injection site

Following a corticosteroid injection, you will experience immediate relief for a few hours due to the local anesthetic. Once this wears off, your joint may feel sore for about 3-5 days. Ice may be applied to the injection site. You can usually return to work the next day but should avoid strenuous activity for a day or two. The effect of the corticosteroid is more gradual and long-lasting. 

Joint injections may be effective for a few weeks to 6 months or longer. A single treatment may involve one or more injections spread out over a few weeks. Your doctor may schedule repeat treatments if indicated. 

Side Effects of Peripheral Joint Injections

Although peripheral joint injections are found to be effective in many patients, a few may experience pain, infection or an allergic reaction.

Corticosteroid injections given repeatedly over a long duration can result in the breakdown of cartilage so your doctor will limit the number of injections you receive. They are also known to increase blood glucose levels and may not be suitable for diabetic patients. Hyaluronic acid is considered a better option for diabetic patients. Oral anti-inflammatory medications are contraindicated while taking PRP injections.

Advantages of Peripheral Joint Injection

Peripheral joint injections are beneficial as they can provide better relief than other conservative methods often delaying or avoiding the need for surgery.