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Knee pain is also the reason for more than 4 million primary care visits a year. Painful joints may lead to more falls, too, which cause their own complications.
In osteoarthritis, joint injection of glucocorticoids (such as hydrocortisone) leads to short term pain relief that may last between a few weeks and a few months. [5] Injections of hyaluronic acid have not produced improvement compared to placebo for knee arthritis, [6] [7] but did increase risk of further pain. [6]
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However, the merits of HA injections are still disputed. HA injections are indicated when other medications fail to offer adequate symptom relief. Symptom relief associated with HA injections may last up to 2 years after an injection. HA injections appear to offer significant pain relief to some patients, while others may see no benefits at all.
A 2010 review concluded moderate evidence exists to support the use of prolotherapy injections in the management of pain in lateral epicondylitis, and that prolotherapy was no more effective than eccentric exercise in the treatment of Achilles tendinopathy. [10] A 2016 review found a trend towards benefit in 2016 for lateral epicondylitis. [11]
Namely, in the 2012 systematic review, Maund, et al. found a single adequate study, but no evidence there of better outcome with MUA versus home exercise. [56] In the 2015 systematic review, Uppal, et al. determined MUA to be equivocal at best, when compared to hydrodilation and steroid injection. [57]
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