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Entering: The Wild West Of Joint Injections . Over the past 15 years, as my wounded knee deteriorated, I’ve researched the five most popular types of (supposedly) pain-relieving shots.
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]
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]
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.
Use of analgesia, intra-articular cortisone injection and consideration of hyaluronic acids and platelet-rich plasma are recommended for pain relief in people with knee osteoarthritis. [ 113 ] Local drug delivery by intra-articular injection may be more effective and safer in terms of increased bioavailability, less systemic exposure and ...
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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