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 knee joint quickly relieves 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;
- deformity 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 in 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?
Effective pain relievers for pain in joints: pills, injections, suppositories, external
Anesthetic tablets for pain in joints may be needed at any time. Diseases of the joints are very often accompanied by severe pain. It can overtake suddenly. Often the pain in diseases of the musculoskeletal system can be unbearable. It literally immobilizes a person. Pain in the back can "shoot" at the slightest movement with such force that a person can not even straighten. Assistance in such cases is needed urgently. Regardless of the cause of pain, immediate effective pain relief is required.
What are analgesics?
These are the most popular pain killers in the world. They quickly and effectively remove various types of pain. In addition to anesthesia, these drugs have an anti-inflammatory and antipyretic effect.
Metamizole is still known as analgin. Has a mild anti-inflammatory and spasmolytic effect. But it's better than some other analgesics to relieve pain and fever. Injections of metamizole give faster and stronger anesthesia. The action time reaches 5-6 hours with a minor pain syndrome.
Ketorolac( ketanov, ketoprofen) is one of the most powerful analgesics among analgesics. Even the pills perfectly relieve very severe pain. The duration of action is about 6-8 hours. If the pain is very severe, the tablets will have to be taken more often.
Dexketoprofen( dexalgin) has a weak anti-inflammatory effect. But it does a good job of anesthetizing and relieving fever. Begins to act 30 minutes after taking the pill inside. The action lasts 4-6 hours.
Lornoxicam( ksefokam, larfix) differs from other analgesics with pronounced anti-inflammatory effect. Appointed with a mild pain syndrome pills or injections. Has antirheumatic effect.
Acetylsalicylic acid( aspirin) is one of the weakest analgesics. It is an effective antipyretic. It also has a blood thinning effect. Produced in the form of ordinary and soluble tablets.
Preparations of NSAIDs of antirheumatic action
They differ from analgesics in that, in addition to anesthetizing, they have a therapeutic effect on the joints. The high efficacy of non-steroidal anti-inflammatory drugs has the opposite side. These drugs have a negative effect on the gastrointestinal tract. Long-term use is strongly discouraged. Serious health problems can arise. With extreme caution, people with digestive system diseases should be treated. To reduce the side effect of non-steroidal anti-inflammatory drugs should be taken only after meals.
Diclofenac( dicloberl, olfen) in tablets removes severe pain of non-rheumatic origin and swelling. Can be used topically( as an ointment) or rectally( with suppositories).In rheumatic diseases, the drug greatly facilitates the patient's condition.
Ibuprofen is prescribed for the initial stages of joint disease. By force of action, he concedes indomethacin, but better tolerated. Removes moderate pain. Has an immunomodulatory effect. Produced in the form of tablets, suppositories, ointments.
Nimesulide has an analgesic and anti-inflammatory effect, it prevents the destruction of cartilaginous tissue. It has antioxidant properties.
Meloxicam( rheumoxicam, movalis) is used for the treatment of joint diseases. The drug removes severe pain and inflammation. Intravenous application of the solution is prohibited. Treatment begins with intramuscular injections. The effect of intramuscular injection is faster and stronger. After 1-2 days, injections are replaced with tablets.
Drugs with narcotic effects are considered to be the most powerful painkillers. They are prescribed, when pain can not be removed by anything else. A serious drawback of narcotic analgesics is the addiction to them of the patient. The course of treatment with such drugs is usually small. With long-term treatment, several short-term courses are taken in combination with other types of pain medication. Narcotic analgesics have a psychotropic effect. This means that a person can become drowsy or, conversely, too vigorous and fall into a euphoric state. Narcotic analgesics are produced in the form for injections. But there are drugs in the form of tablets. For example, tramadol or promedol.
Tramadol( tramal) relieves severe pain after 15-20 minutes. The strength of the effect is second only to morphine. The validity period is up to 6 hours. You can take it as an intravenous or intramuscular injection, orally, in the form of tablets, candles.
Trimeperidine( Promedol) is a pain reliever. After 10-15 minutes, its effect is felt. There is in the form of both injections and tablets. Its advantage is good tolerability of the body.
These preparations are not available on the market. They are implemented only by prescription.
Preparations with opioid-like effect are similar in degree to the impact on narcotic analgesics, but they are not addictive. They also do not have psychotropic effects. The analgesic effect is powerful.
Nalbuphine exerts a very strong analgesic effect, with fewer side effects than narcotic analgesics. It does not cause addiction, it does not change consciousness. Intramuscular injection is able to give an effect similar to that after taking morphine. With very severe pain, repeated injections are allowed every 3-4 hours. Nalbuphine is calming, not causing drowsiness. It should be noted that this drug is relatively new. His effect on the body is still not fully understood. It is not recommended to treat this drug for more than 3 days.
Medications of other groups
The causes of the pain may be different. It can be a muscle spasm in the back or inflammation of the tissues around the joint. Often accompanied by pain, the destruction of the cartilaginous tissue of the joint. The use of drugs that act directly on the cause of pain, helps to remove it. For example, the use of antispasmodics eliminates spasm, and the pain caused by it disappears.
Tizalud and midocalsm are drugs that effectively relieve muscle spasm, for example, associated with functional and static spine disease( lumbar and cervical syndromes).
Glucocorticoid hormones( methylprednisolone, medrol) effectively relieve inflammation. Hormones stop acute inflammatory processes with various types of arthritis, including rheumatoid and gout-induced disease. Are taken topically( in the form of ointments) or inside( in tablets).Intra-articular, intramuscular or intravenous injections may be given.
Combined drugs combine the action of non-steroidal anti-inflammatory drugs with antispasmodics( spasmalgon or renalgan).
How to choose the right treatment?
The first rule for the use of pain medication is a selection from weak to potent. In other words, trying to quickly get rid of the pain, you can not immediately use strong drugs. First, it is worth trying to remove the pain by less powerful and safer means.
With very severe pain, an articular block is performed. In the affected area, injections of hormonal anti-inflammatory drugs are made. The purpose of the blockade is to bring the medicine to the hearth of inflammation.
The blockade helps to quickly remove pain, inflammation and return the joint mobility. The effect lasts for weeks. Acute pain caused by inflammation or as a result of trauma is easier, faster and more effective to remove nonsteroidal anti-inflammatory drugs.
It is hardest to treat chronic joint diseases. Here we must take into account the destructive processes that always accompany chronic diseases. It is necessary to take into account all available symptoms, since the intensity of pain can be caused by their total action. In addition to anesthesia, blockade, glucocorticoids and muscle relaxants can be shown. Often appoint paraffin wrap.
It is important to remember that you can not take painkillers uncontrolled. Only the doctor should determine the dose and duration of treatment. Such actions are not only fraught with side effects, but also a decrease in the susceptibility of the organism to them.
- OTC analgesics-antipyretics for oral administration: mechanism of action and safety profile. Yu. B.Belousov, K.G.Gurevich, S.V.Chausov. Medical scientific and practical journal "The treating doctor", №1, 2015.
- Back pain: where to start therapy? Reference book of the polyclinic doctor, №09, 2011. Yu. A.Merkulov, A.A.Onsin, D.M.Merkulov. Neurological Center. B.M.Hecht of the Health Department of JSCo «Russian Railways»;2NII general pathology and pathophysiology RAMS, Moscow.
Joint shots return to normal
- joint shots
Recently, the number of joint diseases has increased significantly. Today, not only the elderly complain of pain in their knees, but such symptoms can be found in young, socially-active people. To restore the joints to their former health, and you - the ability to actively move without pain, medicine has in its arsenal of many ways to cure. One such technique is a non-surgical method of treatment - intraarticular injections or arthrocentesis.
- Methods of treatment and prevention of arthrosis
What are joint pricks?
Arthrocentesis is a method of administering a drug directly into the joint cavity. With this method of treatment, the medicine will act directly at the site of the pathological process.
For the treatment of arthrosis or arthritis, several groups of drugs are used( depending on the presence of symptoms of the active inflammatory process and the purpose of the drug administration).
- chondroprotective agents
- hyaluronic acid preparations
Most commonly, corticosteroid hormones are administered to the damaged joint( Kenalog, Hydrocortisone, Diprospan, Flosteron, Celeston, Depomedrol, Metipred).The main purpose of the introduction of such drugs is to quickly eliminate the symptoms of inflammation in the joint. This injection will greatly facilitate the patient's condition, relieve him of pain, swelling, redness of the knee.
The course of treatment consists of 4-5 injections at intervals of 2 weeks. It is undesirable to inject more often. It should be noted that relief comes immediately after the first injection. If this did not happen, then you need to think about the advisability of using such treatment.
Thanks to its action, corticosteroids have gained special popularity among patients. But you need to know that these drugs, although they effectively eliminate the symptoms of arthrosis, but do not interfere with the progress of the disease. Consequently, they can not cure osteoarthritis. Their use is justified in cases of exacerbation of the disease and the presence of symptoms of active inflammation.
A very effective method of stopping the progression of arthrosis is the introduction of chondroprotectors into the joint( Alflutop, Noltrex, Adgelon, Hondrolon).Such treatment should be conducted by a course of 10-15 injections in one joint, the course should be repeated 2-3 times a year.
These drugs, in contrast to corticosteroids, do not relieve the symptoms of inflammation, but affect the very cause of the disease. They improve the condition of intraarticular cartilage, promote its regeneration.
In the past few years, new drugs for the introduction to the joint have appeared on the pharmaceutical market - drugs based on hyaluronic acid( Ostenil, Noltreks, Fermatron, Sinocrom).Such drugs are called intra-articular fluid substitutes or liquid prosthesis.
They increase the viscosity of synovia, restore its protective and damping properties, protect the cartilage from microtraumas, slow the degenerative processes of the articular surfaces of bones.
Joint pricks: pros and cons
Pros of intraarticular injections:
- The drug acts directly at the site of the pathology. This ensures the maximum concentration of
- of the drug and prevents its inactivation with a different route of administration.
- Minimal systemic side effects of drugs.
- Fast effect of injections.
Injections for arthrosis of the knee
Pain sensations in the knee joint most often speak of the destruction of the cartilaginous tissue. Such degenerative processes are caused by a disease such as arthrosis. To treat this ailment, complex therapy is used, which includes taking medications, injections, physiotherapy and therapeutic gymnastics. It is the pricks with arthrosis of the knee joint that play a huge role in restoring the lost functions of the knee.
Effectiveness of medical injections
Age changes, weight gain, long walking on high heels, professional sports, as well as low intake of B vitamins - are the main reasons for the development of arthrosis of the knee joint. The destruction of cartilaginous tissue, accompanied by constant aching pains can not only deprive a person of sleep and rest, but also make him disabled.
Avoiding severe consequences of the disease will help to inject from arthrosis. The therapeutic blockade with the use of medications is designed to reduce pain, to stop inflammatory and degenerative-dystrophic lesions of the knee joint. Also, injections perfectly relieve swelling, improve the structure of cartilage and increase the amount of synovial fluid. In comparison with tablets and ointments, the injection blockade allows to achieve immediate results without side effects on other organs of the body.
For arthrosis of the knee joint, several types of injections may be prescribed by a specialist:
• intramuscular;• intra-articular;• Painkillers.
As the practice of treating arthrosis shows, it is almost impossible to achieve full recovery without using injections. Therefore, the only way to preserve the ability to work in a sick person remains a complex approach with the mandatory inclusion of an injection blockade.to table of contents ↑
For intramuscular administration with degenerative-dystrophic processes in the knee joint, specialists usually prescribe a number of drugs that are selected based on the course of the disease, the patient's age and the degree of knee joint damage.to contents ↑
Non-steroidal anti-inflammatory drugs
Injections with non-steroidal anti-inflammatory drugs are designed to reduce inflammation in the cartilage tissue of the knee joint. In addition, they effectively stop pain, remove puffiness from the affected area. The main advantage of this type of injection is the speed of the reaction.
The disadvantages of non-steroid drugs include the negative impact that they have on the work of the digestive tract. NP injections cause ulcers on the gastric mucosa, the work of the liver and gallbladder worsens.
For this reason, injections are prescribed in a process that has a neglected form of the disease and only short courses in a strictly defined dose. After completing the course, the patient must necessarily take a vitamin course with a high content of vitamins B1, B6.
The following injections of NP from arthrosis are widely known to date:
The appointment of analgesics( analgin, baralgina) for arthrosis is necessary to relieve pain, so when the cartilage tissue in the knee joint is destroyed, they strongly disturb the patient. Sometimes the pain is so strong that without the injection of an analgesic, it can not lead a habitual way of life. However, like the previous preparations of analgesics, they only reduce the symptoms of the disease, and they do not restore cartilaginous tissue in the knee joint.
Very often there is a need to remove the spasm of muscle tissue, which inevitably appears with arthrosis. In this case it is recommended to use Midokalm, Baclofen, Sirdalud. The course of treatment is about a week. There are practically no contraindications, except for pregnancy, lactation and allergic reaction to the components of the drug.to the table of contents ↑
In cases of severe knee joint damage, in some cases steroid injections may be prescribed by a specialist. The most famous and often used drug today is Ambien. Its effectiveness is manifested in the rapid removal of pain in the knee, reducing the inflammatory process and the restoration of the joint.
However, feedback after using such tools can be heard is not the best. The presence of highly active aggressive components in the preparation causes the cartilage to be weeded out to the ability to form new cells. Therefore, it is desirable to resort to the appointment of steroid preparations in the most extreme cases.to contents ↑
The vitamin complex containing vitamins B1, B6, B12 is an indispensable preparation for the restoration of cartilaginous tissue in the knee joint. Usually for intramuscular injections are used Kombilipen, Neurorubin, Copligam B, Trigamma, Milgamma. The intake of the vitamin supplement reduces the pain syndrome and improves the conductivity of the impulse along nerve fibers that innervate the affected joint.to table of contents ↑
The introduction of the therapeutic drug directly into the knee is the most effective method of treating arthrosis, as the substance enters the affected area quickly and in a concentrated form. Injections into the knee joint are especially necessary in the first stage of degenerative processes.
Blockade of arthrosis in a similar way is the suppression of infection due to the introduction of an antimicrobial drug in the knee( antibiotic, antiseptic).Drainage of the joint can also be prescribed as an aid.
It should be borne in mind that intraarticular injections for arthrosis are complex procedures and require some practice. Therefore, it is best to contact a qualified specialist who has experience in administering such drugs to the knee.to table of contents ↑
The most powerful drugs to date are hondoprotectors. In composition they are very close to the structure of the cartilage of the knee joint, which allows very quickly to heal and regenerate the damaged tissue. Components of the medicine are made on the basis of substances of animal origin: cartilage, tendons and ligaments.
However, practice shows that it is very difficult to cure arthrosis with injections using only these drugs. Therefore, in order to obtain the maximum effect, they should be administered in combination with other drugs. Most often, the chondoprotectors consist of several active ingredients - glucosamine and chondroitin sulfate. And to obtain the desired result, as an auxiliary, it is desirable to add hyaluronic acid injections to the course of hondoprotectors.
The downside of using such drugs is the length of the course. To obtain a long lasting effect, it is necessary to inject the drug into the knee joint for half a year. Given the high cost of hondoprotectors, such treatment is considered an expensive exercise and not every patient can afford it.to table of contents ↑
How to choose the hondoprotector
The peculiarity of nasal administration is the initial stage of the disease, in which there are still small patches of cartilage in the knee that are capable of synthesizing new cells and increasing synovial fluid in the joint bag.
Good reviews after using intraarticular injections were obtained for the following types of hondoprotectors:
- alfputop. Usually it is prescribed 1-2 mg( 1-2 ampoules) once in 3-4 days. The course of treatment is 5-6 injections;
- don. The composition of the drug includes glucosamine. Assign 1 injection to the knee joint 3 times a week. The course of treatment is 12 injections with a mandatory repeat in 4-6 months;
- chondrolon. The drug is chondroitin. The course of treatment is about 20-25 injections.
Of the above described drugs, you can not single out any and say that it is the best. Each medicine has its own particular components that have a certain effect. Therefore, when choosing a hondoprotector for the knee joint, it is mandatory to undergo a diagnosis, after which the doctor determines which drug is suitable in this case.to table of contents ↑
Especially popular preparations containing corticosteroid hormones were received for the rapid removal of pain syndrome and suppression of the inflammatory process. Immediately after the first session, the patient feels relieved.
However, this drug does not contribute to the synthesis of cartilaginous tissue and does not restore blood circulation, it only removes inflammation in the affected areas. Therefore, it is usually prescribed in combination with vitamins of group B.