Unfortunately, once a joint has been replaced, nonsurgical options become very limited. Every joint injection carries a small risk of infection. And while this is rare, an infection in a replaced joint is quite serious and usually requires additional surgery to treat. Simply put, the risk of infection and its consequences far outweighs the benefit of injection-based treatments after a joint replacement.
There are some pain relief options that can be done, however, and our providers can visit with you regarding these.
Unfortunately, we don't inject into the spine because of the high risks associated with these procedures. However, if you are experiencing neck or back pain there is a high possibility that the source of the pain could be misdiagnosed and originating outside the spine. A common, and easily treated, source of chronic low back pain is SI joint dysfunction. This is often overlooked when diagnosing low back pain. Studies also show that muscle tension and spasm are among other commonly misdiagnosed sources of back pain (Allegri 2016).
Our providers can perform a thorough evaluation to help determine the source of pain. If the pain is identified as muscular or is originating from the SI joint, hip, or shoulder (common alternative sources of spine pain), treatments such as injections are available. For pain originating in the spine, there are non-procedural options that our providers can discuss with you.
Any injection can cause mild soreness for up to 24 hours, and rarely an inflammatory flare-up will occur after a needle-stick or an injection. You are able to go back to every-day life and work after any of our procedures, but we do ask that you take it easy for a few days. Because it is more invasive, a advanced cellular therapy will likely cause an inflammatory flare-up for a few days after. You can usually still perform activities of daily living, yet these are likely to be painful. Most patients return to normal within 3-5 days. We typically recommend avoiding strong, sudden movements, especially against resistance for up to three weeks.
Typically, the observed effectiveness of PRP is determined by the severity of the condition. Most patients notice a significant reduction in pain after one treatment; however, patients with bone-on-bone arthritis often require three treatments of PRP before they experience adequate pain relief. Regardless of your level of pain reduction, you may rest assured that the PRP is helping to heal the joint on a cellular level and that it can take time for this healing to manifest in pain relief. Once you achieve satisfactory pain relief, this level can be maintained with repeat injections, usually spaced 6-12 months apart.
Most insurances cover braces, HA injections in the knees (you can receive them in other joints for out of pocket price), cortisone injections, and office visits. In fact, our regenerative therapies (PRP and advanced cellular therapy) are the only things most insurances don't cover.
Most insurance companies will pay for an HA series twice a year. HA injections are usually the least expensive way to maintain joint health, and so we recommend receiving these series every 6 months to keep the overall cost of treatment down. If additional pain control options are needed, we can discuss the treatment plan that's best for you medically and financially.
Absolutely! Injuries often have long term repercussions and can leave you with chronic pain and limited function. This is exactly what our clinic focuses on treating. If you have had pain for longer than three months it is likely that it will not heal on its own and will require treatment. When is the best time to come in? Today.
Depending on your actual diagnosis, there are many things you can do for yourself that will aid in treating your condition. However, it is important to note that these should not be considered a replacement, rather a supplement for treatment. We will discuss common at-home treatments below, however, you can discuss additional at-home treatments with one of our providers during your appointment after we find your specific diagnosis.
At Home Exercises
Chronic pain often prevents people from being as active as they want to be. In fact, because arthritis has been labeled as a wear-and-tear condition many falsely assume that the more active they are the worse their condition becomes. In truth, "motion is lotion", an active lifestyle is healthier for your joints. We can provide personal exercises specific to your diagnosis during your appointment.
A healthy diet and weight correspond with healthy joints. Weight loss greatly contributes to pain reduction, specifically in your back, hips, knees, and ankles. Because of this, one of our services is medical weight loss. As you move towards a healthier diet, consider the following additions and restrictions that aid in joint pain specifically.
- Cutting out sugar in your diet as it is a natural pro-inflammatory.
- Taking natural anti-inflammatories such as; Fish oil, turmeric, apple cider vinegar, ginger, SAM-e (S-adenosylmethionine), etc.
- Taking natural substrates (building blocks) for cartilage and joints such as glucosamine, chondroitin, and HA.
Please keep in mind that oral supplements are significantly less effective than injectable treatments. Though they may still benefit you, they should be considered a supplement to injectables rather than a replacement. When ingesting a supplement, a very small amount (if any) actually makes it to the treatment area before being broken down in the body. This is why injectable treatments are by far more reliable as they administer the treatment directly into the desired area.
A steroid injection (cortisone) works relatively quickly (within 2-3 days). However, these injections are strictly for pain relief and do not address the underlying problem. HA injections act more slowly (2-3 weeks) but address the underlying problem as well as provide pain relief.
(For more information click on the bolded links.)
Attention is given to making your injections as painless as possible. Before any needle touches your skin, the site is sprayed with a topical anesthetic to numb it and then injected with lidocaine to numb the needle track. The guided injection is then administered with the smallest possible needle using an injection approach rated least painful. However, for those patients who desire even more comfort, nitrous oxide (laughing gas) is available during the procedure.
The length of pain relief depends on the treatment as well as the severity of your condition. Typically HA injections last for 5-6 months, PRP lasts 8-9 months, and stem cells last 2-5 years.
This depends on the severity of your condition as well as the treatment you choose to receive. In regards to pain relief cortisone is the fastest acting treatment taking only 2-3 days. Other treatments such as HA, PRP, and advanced cellular therapy typically take a little longer to aid in pain relief. It is expected that most of your pain relief will occur within 6 weeks.
All of our procedures have specific risks that are outlined below. However, the main risks include local infection (less than 1% chance), and pain at the site of injections. These are the same risks associated with any common blood draw, injection, or procedure.
Cortisone is the only treatment that is classified as a medication because some of it can get absorbed into the bloodstream and have systemic effects. Some risks associated with cortisone injections are (but not limited to) deterioration of the joint, tendon weakening and rupture, increase of blood sugar, and overall suppression of your immune system.
Injected HA has been FDA approved and available since 1995. The HA brands we use are the purest HA products, and most closely resemble healthy human HA. There are some HA brands/products that have reported allergic reactions, but we avoid these brands completely at our clinic.
Any complications reported are usually due to the puncture wound more than the medication. Pain and soreness over the injection site, mild swelling, and painful weight-bearing have been reported, but these will fade as the HA begins to work in your joint.
Because PRP is from your own blood, there is no chance of having an allergic or immune reaction. The main risks include local infection (less than 1% chance), and pain at the site of injections. These are the same risks associated with any common blood draw, injection, or procedure.
ActiJoint has invested in a PRP system that more purely separate the healing components of your blood from the contaminants. Because of this, we have reduced many of the inflammatory side effects caused by other systems.
Advanced Cellular Therapy
Because mesenchymal cells are derived from your own adipose tissue, there is no chance of having an allergy or immune reaction. The main risks include local infection (less than 1% chance) and pain at the sites of injection and harvest. These are the same risks associated with any common blood draw, injection, or procedure.
In order to enhance the effectiveness of this treatment, it is necessary to allow a more intense inflammatory response to take place. This usually includes significant soreness in the treatment area for 3-10 days.
*This is not an exhaustive list as there could be some potential side effects that are extremely rare or unknown.