Knee joint nicks
It is known from history that the first injections were done in the middle of the 17th century. How and by what means, it is not clear, since syringes appeared a century later, in 1853.Since then, injections in the joint of the knee are the best way to deliver medicines to the sick body. Analogues of modern disposable plastic syringes were patented in America in 1956.The novelty greatly facilitated the work of medical personnel, the cases of transmission of infection through injections from one patient to another decreased.
Methods of injection of injections
Drugs in the human body can come in several ways:
- directly into the joint( intra-articular nyxes);
- is intraarterial;
Intravenous infusions are two types: inkjet and drip. A small amount of drugs is injected with a 10-20 ml jet of syringes. Large volumes of liquid are dripped with the help of disposable systems( droppers).Intra-arterial injections are necessary for large blood loss that occurs with open fractures of joints with tissue and vascular rupture.
The length of the medical needle can reach 90 mm, diameter - 2 mm
Intramuscular injections are the most common. Are made in the outer upper quadrant of the buttocks. The injection site for subcutaneous injections selects the upper part of the forearm or the anterior thoracic region of the thigh. For each type of infusion, a needle of the appropriate length and diameter( section) is taken.
|Needle insertion method||Needle length in mm||Cross section in mm|
|Subcutaneous||Up to 16||Up to 0.5|
|Intramuscular||30 - 40||0.6 - 0.8|
|Intravenous||40 mm and shorter||0,8 - 1, 1|
|Intraarticular injection||20 - 40||0,4 - 2|
For intraarticular injections, syringes with a capacity of 2-5 ml are used. The smaller the cross-section of the needle, the more painless it will be. Preparations-suspensions( suspensions) are poorly soluble. They can clog the lumen of the needle and make it difficult to administer the medication. For suspensions, needles of large diameter from-1.1 to 2 mm are needed.
Diseases and nyxes
Indications for injections in the joint area are a number of diseases, the classification of which is as follows:
- inflammatory - arthritis, tendovaginitis, synovitis, bursitis, Reiter's disease, enthesitis;
- degenerative-dystrophic - osteoarthritis, gonarthrosis;
- traumatic - joint fractures open or closed, tears, tears, sprains;
- arthralgia is a pain syndrome that arises in response to irritation of the neuroreceptors of the joint by various reagents - allergens, salt crystals, osteophytes( bone growths), etc.
One of the reasons for applying pricks to knee joints is the presence of strong, sometimes intolerable pain, swelling, hyperthermia( heat), inflammation. For their relief, such drugs are used:
- glucocorticosteroids - synthetic analogues of adrenal hormones;
- anti-inflammatory non-steroidal( non-hormonal) drugs;
- antimicrobials or antibiotics;
Diprospan - a corticosteroid with a prolonged action of
The action of drugs with the use of injections is aimed at relieving pain, restoring joint mobility, and reducing the period of incapacity for work of the patient.
Glucocorticosteroids( SCS)Still advised: Injections for the knee joint
( GCS) are most effective for inflammatory diseases, less for degenerative-dystrophic diseases. Local injections in the joint cavity create a high concentration of the drug. The therapeutic effect is not immediately apparent, but it takes quite a long time. Time depends on the type of medication, varies from 6 days to 21 days. The shortest period of action in hydrocortisone, long-lasting - at leaperspan. After injections, temporary exacerbations of the disease are sometimes observed. It is not necessary to be frightened, working capacity is restored quickly.
Of the other corticosteroids, the recent emphasis is on diprospan, Kenalog. Diprospan is used for intraarticular and periarticular administration( in the surrounding soft tissue).The advantage of the drug is a rapid anti-inflammatory, anti-allergic, analgesic and prolonged prolonged period.
This is an extensive group of drugs that have a complex effect - anti-inflammatory, analgesic, antipyretic. Their action is based on the blocking of substances that affect the appearance of an inflammatory reaction. Indications for use are diseases of the musculoskeletal system( joints, ligaments, tendons, muscles, synovial membrane), as well as other types of diseases.
An injection in the joint of the knee quickly removes pain
If acute or chronic knee pains are disturbed, injections of non-steroid drugs into the joint will quickly eliminate pain, prevent them from appearing in the future for a long time. To the group of non-steroid preparations are:
- ketorolag, analog - Ketanov;
- ibuprofen, analog - nurofen;
- diclofenac, analog - voltaren;
- oxicam, analogues - piroxicam, xephox;
- naproxen, analog - pentalgin;
- indomethacin, etc.
Analogues are medicines having a common active substance. Medicines with the same active substance, but different manufacturers can significantly differ in price, but not in quality. Reviews of patients using nonsteroidal drugs confirm that the therapeutic effect of nonsteroid and their analogs is approximately the same.
Preparations are indispensable for degenerative-dystrophic diseases of the knee joint, which occur with destruction of the cartilaginous tissue - osteoarthritis, gonarthrosis. With age, due to the physiological capabilities of the body, the state of the cartilage changes. It is more quickly destroyed, it regenerates worse( it is restored).
Fermatron - the best symptomatic for the knee
The injections of the fermatron are used directly for the treatment of the knee. In composition, it is similar to the synovial( joint) fluid. The active substance - sodium hyaluronate - positively affects the condition of the cartilaginous tissue, activates the formation of its own hyalurate. Simultaneously it is an articular shock absorber, an anesthetic.
Fermatron enters the pharmacy network in a special syringe filled with sodium hyaluronate. This form of release simplifies the introduction of the drug into the joint cavity. What other injections prevent the destruction of cartilage?
- alflutope, rumalon - natural remedies from cartilage of animals and fish;
- glucosamines - regulate the metabolism( metabolism) of bone, cartilaginous tissue;
- hyaluronic acid and preparations based on it restores cartilage, are effective in the early stages of joint diseases;
- chondroitin sulfates are components of cartilaginous tissue, contain glucosamine. Keep water in the joints of the knee, prevent the destruction of connective tissue.
Vitamin preparations are an auxiliary but important means for the treatment of knee joint. Inclusion of them in a compulsory complex of medical procedures is explained by the influence on metabolic processes, the production of enzymes, activation of the body's defenses.
Mildamgam injections are an effective way to treat the knee joint.
Bones and joints need B vitamins, ascorbic acid, vitamin E, rutin. The complex of three vitamins "B" with lidocaine under the name of the injection of milgamma is widely used in the treatment of joints. The drug has a therapeutic and analgesic effect. Injections are made 5-10 days by intramuscular route.
How do the injections
The drug, dosage, way of injections is chosen and prescribed by the doctor, taking into account contraindications. Absolute contraindications are:
- inflammatory diseases of infectious nature;
- hemorrhage of joint tissues;
- deformation with narrowing of the joint space;
- marked osteoporosis, tissue necrosis.
Intra-articular drug administration - first aid for pain
Special preparation before injections is not needed. From the patient it is required a little: it should be pure, in neat clothes. If there is hair on the knee, they need to be shaved.
Injections are made in the treatment room of a medical institution( polyclinic, hospital) by an orthopedic physician, a surgeon, a rheumatologist, a traumatologist who owns this technique. The patient lies on the couch with his back. The injections are made with sterile disposable syringes. Their capacity is determined by the disease, the dose of the drug, it can be 2, 5, 10, 20 ml.
Inserting a needle into the joint is not more painful than a vein. Painful sensations often appear after the injection. Depending on the type of medication and the volume of fluid, there may be a burning sensation, joint flaring, aching pains.
Do not be afraid of injections. What is more important: constant pain, crunch, joint stiffness or minutes of patience and further active life without pain?
List of drugs for the treatment of arthrosis of the knee
Osteoarthritis of the knee joint( gonarthrosis) is a complex disease that does not always give in to treatment. Therefore, in this article, we have prepared for you a list of drugs that are most effective in treating this disease.
Fast navigation for the article:
1st group of drugs: anti-inflammatory drugs
What is the danger of taking NSAIDs?
2nd group of agents: chondroprotectors
What is important to remember when treating chondroprotectors?
Drugs for intra-articular injection
Warning: all information about medicines for arthrosis of the knee joint is published exclusively for informational purposes for personal review. Do not try to use them yourself without consulting a doctor: self-medication can cause irreparable harm to your health!
All medicines for the treatment of knee osteoarthritis can be divided into several large groups by the mechanism of action.
1st group: anti-inflammatory drugs
Aertal - one of the new drugs for gonarthrosis
It is with non-steroidal anti-inflammatory drugs( NSAIDs) that the treatment of osteoarthritis of the knee usually begins.
This group of drugs includes such drugs as aspirin( acetylsalicylic acid), phenylbutazone, etodolac, indomethacin, sulindac, ibuprofen, piroxicam, aceclofenac, tenoxicam, diclofenac, lornoxicam, naproxen, rofecoxib, ketoprofen, meloxicam, nabumetone, tiaprofenic acid, nimesulide, flurbiprofen, celecoxib and others.
NSAIDs differ in both the strength of the action and the likelihood of developing side effects.
These drugs do not contain anti-inflammatory hormones, but nevertheless, in most cases, they are good at coping with joint pain and reducing inflammation in them.
So, the greatest analgesic effect is usually possessed by ketoprofen, diclofenac, indomethacin, while aspirin, ibuprofen, amidopyrin relieve pain significantly worse. But since many people can have individual reactions to different medications, then the effectiveness of these drugs may differ significantly from the generally accepted norms - both in one and the other direction.
It is generally believed that such agents as indomethacin, diclofenac, and flurbiprofen have the greatest anti-inflammatory effect, while ibuprofen, aspirin and naproxen, on the contrary, are able to reduce inflammation worse.
Side effects of
Unfortunately, despite the fact that non-steroidal anti-inflammatory drugs usually help to effectively relieve pain in osteoarthritis and other diseases, they are not very safe for health and have quite strong side effects. That's why doctors usually appoint them not very long courses and whenever possible in small doses.
What is the danger of taking NSAIDs?
a) problems from the gastrointestinal tract, in the first place - the effect on the gastric mucosa
NSAIDs cause side effects from the stomach
The intake of NSAIDs dramatically increases the likelihood of erosion and even ulcers in the gastric mucosa. This is especially true of people who had previously( or at the moment) such diseases as gastritis and peptic ulcer of the stomach and duodenum, as well as elderly patients.
However, recently NSAIDs of the new generation have been synthesized, in which the negative effect on the gastrointestinal tract is significantly reduced.
This group of drugs are called selective inhibitors of COX-2, and include agents such as nimesulide and celecoxib.
b) Side effects from the kidneys
NSAIDs reduce the rate of renal blood flow, and also promote the retention of water and sodium in the body, which can contribute to high blood pressure, as well as the development of acute heart failure and kidney failure.
c) Heart and blood vessel problems
Non-steroidal anti-inflammatory drugs, among other things, affect the blood coagulation system. If they are not properly taken, patients may develop blood vessel thromboses and even stroke or myocardial infarction. To medicines for which such an effect is characteristic, first of all those same COX-2 inhibitors, which reduce the risk of developing gastric complications, are considered.
What to remember when taking NSAIDs
As you can see, non-steroid drugs are not nearly as harmless as it is commonly believed. That is why you should not prescribe yourself such treatment, but you need to see a doctor who will choose the drug that is right for you and its dose.If there is a need to take painkillers for arthrosis of the knee joint for a long time, it is better to use drugs of other groups for this, which, if taken for a long time, do not give such harmful side effects and have a large selective effect, without adversely affecting gastric, renal or cardiovascular diseases,cardiovascular system.
For these purposes, preparations like Movalis are more suitable, which can be taken in long courses - from several weeks to several months and more - but, of course, also only under the supervision of a doctor.
In addition, the intake of NSAIDs is fraught with the fact that it "obscures" the symptoms of arthrosis: as you know, pain is a signal from the body that something is wrong in it. If the pain is completely removed by the reception of these medicines, the likelihood is that a person with such a disease will wave a hand on the disease, relax and will not do anything for recovery, except for taking pain medications.
This approach is very dangerous, because despite the absence of pain, the disease continues to progress, the cartilaginous tissue is still destroyed, and a person can think that everything is in order with health and there is nothing to worry about.
In fact, the correct approach to taking NSAIDs should be as follows: it is necessary to take these medicines as prescribed by the doctor, but not to forget about the disease, but to create the opportunity to undergo complex treatment without joint pain: take other medications,which are necessary for the treatment of osteoarthritis, undergo the necessary physiotherapeutic procedures, massage courses and other medical measures that could not be carried out in the presence of pain.
The second group of agents: chondroprotectors
chondroprotectors are the most important drugs for arthrosis of joints.
Chondroprotectors( CP) are drugs that promote the protection of cartilage tissue and enhance its formation( synthesis) in the joints.
Unlike anti-inflammatory drugs, HP not only remove the symptoms of arthrosis of the knee joint, but also affect the very cause of osteoarthritis - they contribute to the improvement of cartilage tissue nutrition and its recovery. In this sense, chondroprotectors are one of the most important medicines for the treatment of this disease.
This group of agents includes such active ingredients as chondroitin sulfate and glucosamine. They can, in various combinations, be a part of various medications - such as Dona, Terafrex, Arthra, Structum, Chondroxide, Elbona, Chondroitin Akos, Chondrolon, Zinaxin, Arthrin and others.
Arthra is a combined preparation containing equally and glucosamine, and chondroitin sulfate( 500 mg each in one capsule).The drug is produced by the American company Unifarm, the cost of one of its packages, depending on the number of capsules, costs from 500 to 1,700 rubles. Arthra is considered one of the best chondroprotectors at the moment.
This medication is also combined: one capsule contains 500 mg of glucosamine and 400 mg of chondroitin sulfate, and is manufactured by the German company Bayer. Take teraflex, depending on the stage of the disease, 2-3 capsules per day. It is worth, depending on the number of tablets, from 600 rubles( for packing 30 capsules) to 1500( 120 capsules) and above.
Don contains only glucosamine. Produced by Don in the form of sachets( bags with powders for oral administration), capsules, as well as ampoules for intramuscular injection. For the most effective treatment, manufacturers recommend combining it inside with intramuscular injections.
This drug is manufactured by Rottafarm( Rottapharm) and its price ranges from 1000 to 1300 rubles - both for capsules and sachets, and for ampoules.
This is a mono-drug of chondroitin sulfate, which is manufactured by the Russian pharmaceutical company Microgen. It is produced as a dry substance in ampoules for dilution and subsequent intramuscular administration.
One ampoule, which must be diluted in 1 ml of water, contains 100 mg of active substance. Enter chondrolone for 1 or 2( with good tolerability) of the ampoule every other day by a course of 25-30 injections. Its price at the beginning of 2013 is from 1000 to 1200 rubles per package of 10 ampoules.
Structum is also a mono-drug that contains chondroitin sulfate in the amount of 250 and 500 mg. Produced by Pierre Fabre Medicaments Productions( France).
It is prescribed in a dose of 1000 mg per day, i.е.It is necessary to take 2 capsules a day for 500 mg or four - about 250 mg. Packing with 60 capsules of this chondroprotector will cost you 1200-1300 rubles.
Elbona is a Russian remedy, which includes only glucosamine sulfate. This drug is produced in 2 ml ampoules( plus 1 ml ampoule with a solvent) for intramuscular injection;one ampoule contains 400 mg of active ingredient.
As seen from the name, this CP is also a mono-drug containing chondroitin sulfate in an amount of 250 mg of active ingredient in one capsule. This medicine, as well as the previous one, is produced in Russia.
ointment chondroxide for joints
This medication contains only one active ingredient - chondroitin sulfate, but is produced not only in the form of capsules( 250 mg each) but also as a 5% ointment. It is produced by the Russian pharmaceutical company Nizhpharm.
For the therapeutic effect, the dose of this drug, like other members of this group, should be 1000 mg of active ingredient per day, i.e.4 capsules per day.
Packing of 60 capsules will cost 400-500 rubles. Ointment in a 30 gram tube will cost from 250 to 300 rubles() .
What is important for a patient to remember when treating chondroprotectors?
- primarily, chondroprotective medications are time-consuming drugs. This means that the effect of treatment develops very slowly, and it can be seen only after 3-5 months, and the course of treatment with these drugs is from 6 to 12 months and sometimes more;please be patient.
- CP only work in the early stages of arthrosis - at 1 and 2 degrees;at 3 degrees of this disease, chondroprotectors do not make sense anymore, because on it the entire cartilaginous tissue of the joint is already destroyed and there is simply nothing to restore.
- among doctors now there is no general opinion about whether it is worth taking glucosamine and chondroitin sulfate together or separately. There are studies that suggest that with the joint administration of these two substances they can weaken each other's action. But while this question remains open, it is better to leave it at the discretion of your attending physician and, if possible, give preference to the products of large, reliable pharmaceutical companies with high quality products.
Medications for intra-articular injection( injections inside the joint)
In addition to drugs administered internally and intramuscularly, a large therapeutic effect in osteoarthritis gives the introduction of various drugs directly into the joint cavity( intraarticular injections).Thanks to this method of administration, the drugs directly fall directly into the area of action-into the synovial fluid through which the cartilaginous tissue is fed.
Most often, corticosteroid anti-inflammatory hormones are used to inject the joint: hydrocortisone, Kenalog, celeston, diprospan, flosteron, and others. These drugs are injected into the joint, because when taken in tablets such medications give very many side effects. But when injected directly into the joint, they very quickly and effectively reduce pain and inflammation in the joint, facilitating the patient's condition.
Important point: corticosteroids, like NSAID preparations, do not treat osteoarthritis, but only have anti-inflammatory and analgesic effect. In order to really treat this disease, you need to use other drugs - the same chondroprotectors.
Also in recent years, such a method of treatment as intraarticular administration of hyaluronic acid( sodium hyaluronate) has been used. This tool acts on the joint as a "liquid prosthesis" or an additional synovial fluid that seems to create a protective layer in the joint that improves movement in the joint, helps to reduce the trauma of the joint during movements, moisturizes the cartilaginous tissue and improves its nutrition.
Sodium hyaluronate is available in the form of such drugs as fermatron, duralan, ostenil, synviscus. The therapeutic effect of the administration of these medications is usually very good, but, unfortunately, not everyone can afford this treatment.
So, one dose of a fermatron for intra-articular administration will cost 3500-4000 rubles, while the curative course is 3-4 injections once a week in each diseased joint. Therefore, a large price is the only factor that hinders the development of this method of treatment.
A good therapeutic effect in gonarthrosis is provided by various medications used locally.
So, such ointments as Fastum-gel, indomethacin and butadion ointments, Menovazine, Voltaren-gel, Nikoflex-cream, Espol, diclofenac-ointment, and many others have shown themselves as therapeutic ointments and gels for topical application.
They have a good curative effect, but it is important to remember that only 4 to 8% of the drug substance passes through the skin to the "destination" - the joint of the patient, therefore, anti-inflammatory and analgesic treatment with ointments, creams and gels is almost always necessary with drugs, taken orally or intramuscularly.
Various medicinal substances for external use can be used for the preparation of medical compresses. These include, for example, bischofite( an oil derivative that has a beneficial effect on arthrosis), dimexide( an anti-inflammatory and analgesic medicine that penetrates well through the skin), and a medical bile that has good warming and absorbing properties.
However, in order to control such a complex disease as arthrosis of the knee joints, sometimes it is not enough just to take the drugs in one form or another.
Drug treatment should be combined with physiotherapy procedures for arthrosis of joints, spa treatment, and if your doctor does not object, you can use effective folk recipes for treatment of gonarthrosis.
And remember: for effective therapy of arthrosis of the knee joint, it is dangerous to engage in self-medication. If you have joint pain, consult a doctor!
What shots do in the knee: names |Are joints aching?
The knee joint is most prone to physical wear. The process of wear and tear is associated not only with age, but also with weight, physical loads, the choice of shoes and the overall level of human activity. Gonarthrosis is characterized by swelling, painful aching pain during walking, as well as during flexion and extension of the knees.
To regain the former ease of gait and get rid of daily pain, it will take time and a competent approach to therapy.
Treatment of the knee joint is a long process, its effectiveness largely depends on the professionalism of the doctor and the proper selection of drugs.
The knee joint can be healed by a medicamentous and operative method. Fear of surgery often pushes patients to treatment in the first way. The most effective are injections in the knee joint. Tablets are effective, but their effectiveness is manifested after a longer period of time. Ointments and compresses are designed to relieve symptoms and relieve pain. And only an injection in the knee joint acts at the heart of the disease, concentrating as much as possible on the causes of the disease. My patients use a proven means, which can get rid of the pain in 2 weeks without much effort.
The name of the injections
It is worthwhile to look more closely at the names of the injections in the knee for joints, which are most often used by doctors.
1. Corticosteroid hormones.3. Hyaluronic acid.
Corticosteroid hormones are a kind of treatment start. They are called not to treat joint diseases, but to remove the possible swelling of the knee and pain sensations. These drugs fight with inflammation in the tissues, which is the cause of edema and pain. But corticosteroid hormones have no healing effect on cartilage and bone tissue and are not able to normalize blood circulation. Therefore, using them as the only method of treatment is meaningless. Such medicines are a necessary element of all-encompassing therapy. For example, after relieving pain and swelling, you can proceed to therapeutic gymnastics, physiotherapy.The efficacy of corticosteroid hormones is the highest in the first injection and occurs after about 10-14 days. Over time, the result of hormones is leveled. If, at the first manipulation, the effect of using the drug is weak and not pronounced, it is worthwhile to choose another medicine and change the site of the injection: the action of corticosteroid hormones is directly related to the accuracy of medication administration to the focus of inflammation.
Injecting hormones is necessary no more than once in two weeks and no more than 4-5 times in one knee. This will help reduce the risk of side effects. The most popular names for joints for joints with drugs with hormones are hydrocortisone, celeston, kenalgon, flosteron and diprospan.
Chondoprotectors are medications that help to avoid surgical intervention. Due to their effect, the knee joint heals, the cartilage nutrition improves and its destruction slows down. They are used mainly in cases when the knee disease is caused by a trauma or a malnutrition of the articular tissue. Chondoprotectors can stimulate the production of natural chondroitin and collagen in the body. Also these drugs do not allow to destroy hyaluronic acid and collagen in tissues. Thanks to injections of hondoprotectors in the joint, the reproduction of cartilaginous cells and natural lubricating fluid is stimulated.
Prick in the knee with arthrosis
Such pricks with arthrosis of the knee joint help to relieve pain and the main signs of orthopedic pathology, but do not eliminate the problem itself. That is, treatment with corticosteroid hormones does not contribute to the restoration of damaged bone and cartilage tissues, does not normalize blood circulation and does not strengthen the joint. Independently, these injections for arthrosis apply senselessly. In addition, frequent injections into the joint cavity can even damage and aggravate the situation. Therefore, it is not recommended to abuse such treatment measures and it is necessary to perform injections only in cases of extreme necessity.
When to inject
An injection in the knee with arthrosis using corticosteroids is advisable to do only with the development of synovitis, which is manifested by swelling and the formation of fluid. When pathology is accompanied by such a complication, it is difficult to carry out any physiotherapeutic measures. In order for a patient to have the opportunity to massage a damaged joint, engage in gymnastics, and attend medical procedures, the doctor prescribes injection treatment. After a shot, the edema subsides within a week, the pain recedes and mobility improves, but only for a while. This allows for a therapy aimed specifically at preventing the development of the disease.
In the absence of fluid and strong swelling, injections with arthrosis of the knee joint should not be done.
Rules for the administration of
- Injections into the knee joint can be done only once every two weeks. This is due to the fact that the drug is administered only after 7-10 days.
- If an injection in the knee with arthrosis did not bring relief within a week, you should replace the drug or enter it more precisely into the area of the inflammation focus.
- To avoid side effects, do not do more than 5-6 injections in one joint during the entire treatment.
Than pricks are dangerous
The introduction of corticosteroids is considered to be an effective method of eliminating accumulated fluid and swelling. However, injections can also damage the joint, especially if they were performed more than required and without observing the 10-day interval. So, what is dangerous abuse of injections?
- First, with each injection of the drug, the articular structures are injured by a needle.
- Secondly, during the injection, there is a risk of getting into the infection joint cavity.
- Third, the frequent use of hormonal injections leads to disruption of the ligament and muscle structures, as a result of which they lose elasticity and the joint becomes loose.
Injections with arthrosis of the knee using corticosteroids are not recommended for patients suffering from such diseases:
Age, weight, long walking on heels, playing sports, deficiency of vitamins B1 and B6 - possible causes of joint wear and,as a consequence - the destruction of cushioning cartilage, painful and persistent pain. This disease in medicine was called arthrosis of the joints.
Aching joint pains disturb sleep, are able to loosen the nervous system and lead to an imbalance in blood pressure. Osteoarthritis more often affects the following joints:
If you have the first symptoms of arthrosis, you need to start treatment, using painkillers that can stop the pain of the shoulder and knee joints for a while. It should be noted that analgesic drugs in injections( both intramuscular and subcutaneous) against tableted drugs help much faster. But the inflamed joint does not a little anesthetize, it is necessary to remove the inflammatory reaction. So:
Drugs for intramuscular injection
- Analgesics .Such as actually Analgin and Baralgin. Dull pain of the knee joint, shoulder joint, do not have arthrosis.
- Spasmolytics .For injection by injection subcutaneously with joint arthrosis, one antispasmodic, Midokalm, works well. Quickly removes spasms from the musculature of the skeleton, while reducing the pain in the joints.
- Non-steroidal anti-inflammatory drugs .The most popular are Ibuprofen, Diclofenac, Ketonal, etc. These medicines can not only relieve the pain, but also remove puffiness and stop the inflammation of the hip, knee, shoulder and other joints. At course treatment it is possible to forget about pain for ever. But to use these drugs should be cautious: the fact is that anti-inflammatory drugs are very irritating to the mucous membrane of the stomach and contribute to the formation of ulcers in it. Therefore, these medications are usually prescribed by short courses and strictly under the supervision of a doctor. After the course of such drugs, it is worthwhile to take a course of support with vitamins B1 and B6.
- Steroid preparations .Ambene is the first in terms of efficiency. This is a complex preparation consisting of six special syringes: in the amount of three pieces with solution A( lidocaine hydrochloride and dexamethasone) and three with solution B( vitamin B1, B6, cyanocobalamin, lidocaine).These drugs have pronounced both analgesic and anti-inflammatory effects, regenerating the processes of the knee joint. The content of lidocaine makes the injections completely painless. Solutions A and B are mixed, injected into the gluteus muscle deeply, before the introduction of the solution, warm up to body temperature.
In modern medical practice, it is possible to treat arthrosis with the help of an effective technique, the essence of which is the introduction of drugs not subcutaneously, but directly into the joint. Preparations are made on the basis of hyaluronic acid, corticosteroid hormones, vitamins for the restoration of cartilage tissue B1 and B6, as well as other components.
Intra-articular injections are prescribed in cases where the usual pain relievers described above are no longer effective. The most popular and common drugs for these types of injections are the drugs listed below.
Drugs for intraarticular injections
Intraarticular injections are administered for the treatment: corticosteroid hormones Celeston, Kenalog, Flosteron, Diprospan, Hydrocortisone. Corticosteroids are valued for the rapid and effective suppression of pain of the knee, shoulder and other joints. But the downside is that these substances are not able to cure arthrosis. There is no influence on the joint: they do not improve the condition of the cartilaginous tissue, do not restore blood circulation( especially the knee).In this regard, use of such intraarticular prick is necessary in conjunction with vitamins B1 and B6.
Hyaluronic acid - an innovation in the physician's arsenal - is a lubricant fluid that helps slip almost destroyed cartilage and is an absolute substitute for synovial fluid of the knee joints. Often, intra-articular injections are performed with lesions of the knee and shoulder joints as the most vulnerable. It should be noted that treatment with this drug is effective, but expensive. For the injection of enough 3 to 5 injections, which contains acid.
These are medical intraarticular preparations, which heal joints. They are more often used for malnourishment of the joint( often with a deficiency of vitamins B1 and B6) or when injuring the shoulder joint or knee.
It is advisable to start treatment and use intraarticular nuzzles for knee, hip and shoulder arthrosis only after removal of inflammation.
Intra-articular prick with chondroprotective agents exert their effect faster, against oral medication. Having already received the first injection the result will not be long in coming. The knee or shoulder will get sick less.
All described preparations for intraarticular injections do not pass without a trace - after their treatment it is necessary to restore the balance of some vitamins( B1, B6, B12, A, C, etc.) using Neurobeks( B1, B6, B12), Triovit, C, E) or directly administering these vitamins subcutaneously or intravenously.
Often used for arthrosis of the shoulder and knee joints. This is a special treatment, during which an injection of novocaine with a certain frequency and frequency as an intramuscular injection is injected into the inflamed area of the shoulder joint affected by arthrosis, as well as adjacent tendons and muscles. The use of the so-called Novocain blockade in medicine makes it possible to remove painful contracture. The procedure is repeated 1 to 3 times a month. It is also combined with mandatory vitamin therapy( B vitamins, especially B1 and B6).
All these injections are good, but self-medication is not worth it. Therefore, it is important to see a doctor and get expert help in diagnosing and in the appointment of correct and effective treatment if pain symptoms of knee, hip and shoulder joint arthrosis appear.
Preparations for injection into the knee joint
Osteoarthritis of the knee joint is periodically accompanied by pain and swelling.
To facilitate the patient's condition, doctors often use intraarticular injections as an emergency.
What exactly drugs and in what cases are injected into the knee joint - that's the topic of this material.
Drugs used for injection into the knee joint
As a rule, with gonarthrosis hormonal preparations of the corticosteroid group are introduced into the knee joint. This is Kenalog, Hydrocortisone, Diprospan, Celeston or Flosteron. Why are corticosteroids used in these cases? Because these drugs quickly and efficiently remove the pain syndrome and relieve inflammation in synovitis, that is, with swelling and swelling of the knee joints. The special popularity of corticosteroid injections among the prescriptions of doctors is explained by the speed of the therapeutic effect with which these funds operate.
In what cases are injections given in the knee joint?
The rapid and pronounced effect of corticosteroid drugs led to the fact that hormonal intraarticular injections began to be prescribed even if really necessary. For example, some zealous doctors prescribe hormonal injections only for prevention, to prevent the development of arthrosis. And meanwhile, just arthrosis is not treated with corticosteroid drugs, respectively, and to prevent its development, these funds are not able to.
Corticosteroids can not do the main thing - improve the joint cartilage, strengthen bone tissue and restore normal blood circulation in the joint. All that corticosteroids can do is to reduce, and at best remove the reciprocal inflammatory response of the body to damage in the joint cavity. Hence the conclusion: to use intra-articular injections of hormonal drugs as an independent method of treatment is simply meaningless, only in complex therapy their use is justified and carries a certain therapeutic burden.
Examples when you need and when you do not need to take pricks in the knee joint
If a patient has a second degree gonarthrosis with joint edema, it is likely that the fluid has accumulated in the joint - synovitis. Synovitis makes it difficult to carry out any medical procedures - gymnastics, manual therapy, physiotherapy. Therefore, in such a situation it is necessary to carry out intra-articular injection of a corticosteroid drug. The goal is to eliminate the synovitis in order to start active therapeutic measures in a week or two. This approach is correct. If, however, the patient also diagnosed gonarthrosis of the second stage, but there is no accumulation of fluid in the joint and there is no swelling, then hormonal preparations do not make sense. Since there is no inflammation, it means that there is no point of influence for corticosteroids either.
Rules for the administration of corticosteroids to the knee joint
- But even with a real need for hormones, you need to adhere to a number of rules.
- In the same joint, injections can be done no more often than once every two weeks. This is due to the property of the drugs to start "working" 10-14 days after the introduction. Therefore, to assess the effect immediately does not work.
- The first hormonal injection into the knee joint brings real relief, but there will be no such effect in the future. Therefore, if the first injection has failed, it is natural that the result will not be either after the second, or after the third injection of the same drug in the same place. It is necessary or to change the drug, or choose a more precise place of injection. If in this case there is no result, then it is better to refuse the method of treatment of arthrosis of the knee joint with injections.
- It is highly undesirable to inject corticosteroids into the same joint more than 4-5 times, as the risk of many side effects increases.
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