Knee pain is a common problem with many causes, from acute injuries to complications of medical conditions. It can be localized to a specific area of the knee or it can be spread over the entire knee. Also, it is often accompanied by physical limitations. A thorough physical examination usually establishes the diagnosis of knee pain. Treatment for knee pain depends on the underlying cause. However, sometimes you may also feel Knee pain worse after gel injection. The prognosis for knee pain, even severe knee pain, is usually good, although it may require surgery or other interventions.
Types of Injections for Knee Pain
1. Cortisone Injections
Typically, cortisone injections are recommended for knee arthritis patients when they experience pain and swelling. They can be very effective for knee pain and osteoarthritis symptoms. The injection can relieve these symptoms quickly, usually within 1-3 days. Symptom improvement and VAS (visual analog score) improvement, which measures pain numbers on a scale of 1-10, usually improves even more during the first 6 weeks after these injections, but may tend to decrease around week 12 after the injection. This is often referred to when Sharp stabbing pain in knee comes and goes. These injections may be given as often as every 3 to 4 months if symptoms recur. However, we usually recommend waiting until the pain/swelling symptoms return. Prophylactic injections and more frequent cortisone injections tend to make them less effective over time and eventually stop working as well.
2. Gel Injections
You may also have heard of “gel” injections. These are viscoelastic supplement injections that are a derivative of hyaluronic acid, which is a naturally occurring chemical in normal synovial (joint) fluid. These are often referred to when Knee hurts when straightened.
In an arthritic knee, the amount of hyaluronic acid naturally decreases. This substance typically binds to the chondral (cartilaginous) surface of the joint and helps cushion the joint. With less and less cartilage in the knee, this leads to increased pain. The idea behind gel injections is that reintroducing the substance will help soften the surface of the joint and improve pain.
These injections are usually recommended as an alternative to cortisone injections and can be given every 6 months. Medicare covers them every 6 months and different insurance companies cover them at different intervals. These are not usually given on the same day as the cortisone injection, but instead may be spread out over several weeks to try to help prolong the effects.
Which Type of Knee Injection is Right for Me?
Cortisone injections tend to work better in patients with severe pain and acute swelling because they take effect quickly. Gel injections do not take effect as quickly and their full effect can take 4-6 weeks, so we recommend administering them when the patient is suffering from dull, aching pain rather than acute swelling. In these conditions, we often provide a cortisone injection to reduce pain and swelling. If symptoms do not fully subside within 2-4 weeks with continued dull, aching pain, then a gel injection can be given to prolong the effects. Like , sometimes one may face Knee pain worse after gel injection. But, These injections can typically show a trend toward improvement in reduced VAS scores beginning 4-6 weeks after injection and lasting 3 to 6 months in some studies.
What if Knee Injections Don’t Work?
A knee replacement would be the last step in the treatment process for a patient with knee arthritis. However, this should only occur after the patient has tried and failed injections, braces, NSAIDs, cane/walker use, and most importantly a formal physical therapy program to maximize strength, movement, and weight loss if necessary. When these treatments do not work or stop working, then the patient’s options are to live with their current symptoms or proceed with knee replacement.
A knee replacement is the only thing that will change the x-ray appearance and actually get rid of arthritis. All other treatments control symptoms. Knee replacement is an open surgical procedure in which the ends of the femur and tibia where the cartilage is damaged are removed and metal caps are placed over the ends of the bone with a polyethylene insert between them. This becomes the new knee joint. Nowadays, patients usually go home the same day and walk with assistance on the day of surgery. Physical therapy follows and patients usually recover in about 3 months. Knee replacement is a beneficial operation in the right candidate with typically 85-90% excellent results.
Here’s How to Treat Severe Knee Pain;
Knee injections can provide quick and effective relief from knee pain and inflammation, but the effects are only temporary. As OA progresses, a person may experience a decrease in mobility and quality of life. At this point, your doctor may recommend knee replacement surgery or “knee replacement.” There are two main types of knee replacement — total knee replacement and partial knee resurfacing.
● Total Knee Replacement
Total knee replacement involves removing the worn cartilage of the knee and covering it with metal and high-quality plastic. The prosthesis allows the individual bones of the knee joint to slide smoothly over each other, reducing pain and improving the range of motion in the joint. The operation usually takes 1-2 hours. The person may then need to stay in the hospital for 1-3 days to recover from the surgery.
● Partial Knee Resurfacing
Partial knee resurfacing involves removing and replacing only the damaged surface of the knee joint, leaving any healthy cartilage intact. Doctors may recommend this procedure to people who have disease or damage to only one area of the knee. Because partial knee replacement preserves healthy bones, cartilage, and ligaments, it can feel more natural than total knee replacement. Compared to total knee replacement, partial knee replacement involves a smaller surgical incision. OrthoInfo associates it with the following benefits:
- Faster recovery time
- Less pain following surgery
- Reduced risk of infection and blood clots
Which is Best?
When faced with the option of surgery, some people may wonder which is the most effective method – total knee replacement or partial knee resurfacing. The table below compares the pros and cons of both procedures.
|Partial Knee Resurfacing||Total Knee Replacement|
|Doctors may recommend if OA is in just one of three knee compartments.||Doctors may recommend if OA has progressed and affects mobility and quality of life.|
|May last up to 10 years, after which a person may need revision surgery.||May last up to 20 years.|
|Faster recovery time, lower risk of infection, and less pain following surgery.||Surgery typically lasts 1–2 hours and may require a stay in hospital for 1–3 days.|
|May feel more natural than a total knee replacement.||Involves inserting a prosthesis made of metal and plastic.|
|A person may feel more residual anterior knee pain, or frontal knee pain, after the procedure.||May allow someone to resume normal activities if other nonsurgical options are no longer helpful.|
A 2020 randomized controlled trial analyzed findings from 528 patients who had either total knee replacement or partial knee resurfacing. The researchers collected follow-up data for 5 years after surgery. They found that both surgical methods were effective and both had similar clinical outcomes. They also found that both methods had similar reoperation and complication rates.
However, the study found that partial knee resurfacing had significantly higher patient approval rates than total knee replacement in some cases. This may mean that patients were generally more satisfied with the results of partial knee resurfacing. The researchers also found that partial knee resurfacing was more cost-effective than total knee replacement after 5 years.
Also, Have a Look on Some Risks of Knee Surgery
As with other types of surgery, knee replacement surgery is associated with the following risks:
- Nerve damage
- Complications from general anesthesia
- Blood clots or deep vein thrombosis (DVT)
- Heart attack
However, people should be aware that delaying knee replacement surgery may lead to further deterioration of the knee joint. This presents other risks, such as:
- An increased risk of abnormalities developing inside and outside the joint
- An increased risk of muscles, ligaments, and other structures becoming weak and losing function
- Increased pain or an inability to manage pain
- Increased disability or lack of mobility
- Difficulty with normal daily activities
Before electing to have knee replacement surgery, a person should speak with a doctor about the potential risks and benefits of the procedure.
My Knee Pain Worse After Gel Injection: What Do you Do?
Sometimes Knee pain worse after gel injection. This increase in pain may only be short-lived. However, in some cases, the knee becomes swollen and inflamed. In these cases, you may experience an allergic reaction. About 2-3% of patients have an allergic reaction. If you have experienced an allergic reaction, you should consult your doctor. In some cases, you will need to have the knee drained.
Few Things to Try at Home to Ease Knee Pain
The following home remedies can help relieve knee pain in some cases:
- Avoid straining the knee: A person should rest the knee as much as possible and avoid standing for long periods of time.
- Apply a cold compress: A person can try applying an ice pack to the knee to help relieve the pain. It is important to wrap the ice in a cloth or towel first. Applying ice directly to the skin can result in permanent injury.
- Take over-the-counter pain relief: Acetaminophen can help relieve knee pain, while nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help reduce both pain and inflammation.
- Exercise: Light, low-impact exercise, such as exercise on a stationary bike, can be beneficial for the knees.
- Avoid stairs: Using stairs can worsen knee pain.
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