What Type Of Knee Injection Will Help? 6 Options For Chronic Knee Pain

Are you looking for relief from your knee problem and you’re thinking that an injection might help you out. In this video today, I’ll be discussing the six types of knee injections that are out there, the costs associated with them, and also how long you can expect to get relief from each one.

My name is Dr. David Middaugh, and I’m a specialist physical therapist at El Paso manual physical therapy. On this channel, we help people stay healthy, active and mobile, while avoiding unnecessary surgery injections and pain medications. please consider subscribing so that you don’t miss out on any of the helpful videos that we post every single week when we get into the six injections next.

But stick around to the end of the video because I’m going to give my opinion about what I think of each injection when you shouldn’t get them at the beginning here. I’m just going to give you the information for each injection as objectively as I can without giving you my opinion. I’ll save that to the end.

Number one is steroid injections, cortisone injections of the most common type of injections out there that people get for knee problems. And these are used for just general knee pain, whether you have arthritis, you had an ACL tear, you have another type of ligament injury, a meniscus problem. cortisone injections are the typical injection that people get for knee problems. And their effect on the body is to provide an anti-inflammatory response meaning they stop the inflammation process and also pain relief.

They usually fast acting so you can expect to get relief within a day or two of having the injection. And the cost of a cortisone injection is usually anywhere from 100 to $200 each injection. Now there are some side effects of cortisone injections. They do tend to break down ligaments, tendons, cartilage, and even bone.

They affect connective tissue and all those tissues are made up of different types of connective tissues. It typically affects people that get recurring cortisone injections, and most doctors will limit you to no more than three to four cortisone injections per year. Because of this side effect, there is a bit of a danger to diabetics as well as cortisone, steroids are known to spike blood sugars.

If you end up getting a cortisone injection, you can typically expect relief to last anywhere from two to four months, with reports of people going longer than that. And there’s also people that tell us that they didn’t get any relief from a cortisone injection. Number two highly ironic acid injections otherwise known as gel injections.

These are typically used for osteo arthritis situations in the knee. The idea behind this is it’s fluid that mimics joint fluid. And that’s what they’re injecting into your joints. The idea is it’s gel like kind of like the fluid the synovial fluid is what it’s called inside the joints, and the trying to replace the joint fluid in there to offer a more healthy solution than what you might have in your knee.

Currently, there’s usually several treatments involved to get several injections, they’ll take out some joint fluid, in some cases, in order to make space for the new fluid. And then once they inject the new fluid, you might have to have this done repeatedly over time.

The cost of this is anywhere from $500 to upwards of 15 $100 each injection, and you can expect to get relief for about six to nine months. And usually this is not fast acting, you won’t get relief immediately.

It can take anywhere from one to two months to begin to see the effects of the hyaluronic acid injections. The third injection that’s out there is gene therapy injections. This is highly experimental and gene therapy treatments are currently being developed.

They’re not always approved. In fact, many are in clinical studies. So if you do end up getting gene therapy, you’re probably going to be in a study or pay lots of money for it as it’s not a widespread, easily produced thing at this point.

Like all the other injections are, what gene therapy is it’s a lab developed virus that is designed to cause our cells to produce certain inflammatory responses or stock or inflammatory responses. It’s a genetically engineered virus that is controlling the cells inside our body to act a certain way and heal better. It’s it’s experimental, as I said, and there aren’t many people out there getting gene therapy done on their knees.

The exact costs of gene therapy are unknown, but there are reports that it’s over $100,000 per treatment. And the length of time to get relief is unknown as well. We just don’t have very much information about gene therapy and its effects on knee pain. Number four is platelet rich plasma injections, otherwise known as PRP injections.

This is often used for knee arthritis as well. And this is not a medication, it’s actually made from your own blood. When you go into the doctor’s office for a PRP injection. They’ll take some blood out of your arm and they’ll put it in a machine called a sin fuse, which spins your blood really, really, really fast. And it separates out the blood into the blood cells. And the plasma, which the plasma has a bunch of platelets in it.

That’s why they call it platelet rich plasma injections, they then take that plasma and inject it into your knee joint. And the hope is that the platelets inside the plasma will stimulate healing processes inside your knee joints and help to repair the cartilage or the meniscus or whatever they’re trying to affect specifically in your knee.

The cost of a PRP injection is estimated at 1000 to $2,000 per injection. And you can expect relief to last you about four to six months, of course varying depending on on your specific situation. But that’s what I found in the research.

The fifth type of knee injection you might get is prolotherapy injections. prolotherapy is a type of sugar that’s injected into ligaments and tendons and joint capsules, which are types of ligaments and tendons with the hope that it irritates the tissue and causes it to stiffen up.

Now, this is typically not used for arthritis. And instead it’s used for people with loose problems, where they’re loose in their joints or stretched in their ligaments, and they need those ligaments to shorten. In order to provide more stability to the knee joints.

The cost of this treatment is anywhere from three to $600 per injection, and you can expect relief to last anywhere from four to six months. And they do encourage you to get another treatment once the effects of it are done. The sixth type of injection that you might get is stem cell injections for knee arthritis.

That’s what it’s typically done for the stem cells come from your own body, they’ll take a very, very thick needle and injected into bone in your body, typically in the hip bones. And they’ll pull out bone marrow, which looks kind of fluidly kind of yellowish. If you want to Google videos or YouTube videos on this, you’ll see plenty of them.

And then they centrifuge that they’ll put it in one of those machines and spins the fluid and they separate out the stem cells from there, and then they’ll injected back into your knee joint so that you can hopefully get some brand-new cells in there. They’ll also pull it from fat, they will take it from fat in the glute area or in the on the love handle area the flank. And they can centrifuge that and also get stem cells from your fat cells.

The cost of this treatment is anywhere from $4,000 to over $12,000 each treatment. And the expected time to get relief is unknown. We just don’t have a whole lot of information on how effective stem cell treatments are at this time. Now, as a physical therapist, let me give you my opinion on these knee injections. I think that they have a place in healthcare for sure.

As a specialist physical therapist who deals with the mechanical aspect of the body, which means how the joints move how the cartilage works, how the ligaments and tendons and muscles work, other nerves play a role.

When it comes to considering the mechanical aspect of things, injections at large, just don’t take that into consideration. But injections can be used as a tool to aid you in correcting the mechanical problems so that you’re not dealing with pain at certain points, or you can get some more stability. And that leads me to tell you about the pros of injections. I’m going to list you three.

The number one Pro is specifically with cortisone injections. If you’re in a ton of pain, and you just can’t think straight, you’re grumpy. Maybe you’re not getting enough sleep at night and you’re tired as a result of that.

Getting some pain relief that might be a little more powerful than over the counter pain medication or maybe even prescription strength pain medication. Or perhaps you’ve got a reaction or an allergy to some of the oral medications that you’ve taken for pain.

A cortisone injection might be very helpful in calming the pain down enough for you to participate in physical therapy or do something that fixes the long term problem in your knee. But just keep in mind that it’s not going to typically resolve your knee problem forever. It’s only a short term solution and use it as a tool to work on the long term solution.

Another pro is prolotherapy. prolotherapy can stiffen up joints, in the case of somebody with lacks joints. Like we’re talking like an ACL laxity or an MCI laxity or the patella that moves way too much. The ligaments around the kneecap are too loose, prolotherapy might be a benefit to that.

But I’ve still got to ask the question of what’s causing those ligaments to become loose. They don’t just become loose for no reason. There’s typically some mechanical problem that sets up the loose ligaments and that needs to be addressed.

That’s why the prolotherapy is encouraged to do on a on a regular basis. You know, once it wears off about every six months or so, well, you got to fix the underlying root problem and it’s not To get the stiffening of those tissues, but if they’re going to stiffen again, there’s something that’s causing that.

So again, it’s a something to use in the short term to help you fix a long term problem. And this is especially beneficial for people that just don’t get relief from cortisone injections or other pain medications.

For the right person, prolotherapy might be beneficial to them. And we’re talking people with loose ligaments and their knee typically have lots of popping and clicking, but not necessarily arthritis. And when it comes to PRP injections and stem cells the way it’s currently done, I like these in that they’re more natural solutions.

They’re not really, drugs were developed in a lab or viruses like gene therapy, they’re pulled from your own body. And so typically, they’re tolerated very well. And if they end up working for you, they can be great solutions.

But also in the short term, there’s still mechanical problems that need to be addressed in order to truly resolve any pain problem for the long term. Now let’s talk about the cons of the injections. I’ve already alluded to it, the mechanical problem is a huge deal. But consider this analogy.

If you think about a vehicle, your vehicle that you might drive, or any car out there, if your tires continue to get worn down in appropriately, and you go to the tire shop, and the guy says, Yeah, your tires are balding, only uncertain edges, you he probably is not going to just say replace your tires every time.

I mean, he’ll say that if your tires are bad enough. But he’s going to be thinking about the root problem, which is probably an alignment issue. Or it could be the way that you drive or the surfaces that you’re on.

There’s other factors that are causing your tires, to balled too fast. And those factors need to be addressed rather than just constantly replacing the tires all the time, it’s the same thing for somebody addressing the mechanical problem in their knee.

If you’re going to the doctor and getting recurring injections, or getting multiple cortisone injections, or PRP injections, or any of these types of injections, you have to consider what is the root cause of your knee problem.

It may not just be the loose ligaments, it may not just be that you’re older, there’s something about the way that you move about your muscle strength, your muscle balance around your knee joint that’s causing excessive pressure or stretching of certain tissues, and leading you into this knee problem. And that needs to be found out. And injections just don’t solve that problem.

They’re intended to be short term related to this issue. There’s no consideration of the lower back the hip joints, and the foot and ankle joints which are between the knee if this is your knee joint in the middle, you got your hip and back above your foot and ankle below that those joints, those body parts, highly influenced the knee joints.

And if you’ve got a hip issue a back issue of foot and ankle issue old injuries in the past, and you’ve never talked to your doctor about that. And you’re just getting injections over and over again, that needs to be discussed and solve. Maybe you need insoles, maybe you need to undergo some back treatment to solve your knee problem.

There’s other issues that need to be addressed. Typically, in order to fix your knee problem and knee injections just don’t solve that. Another con is your activity level needs to be considered. If you are very active, say you’re exercising several times a week, four or five times a week, especially if it’s higher level activity like you’re a distance runner, maybe you do half marathons and marathons or even five K’s and 10 K’s that’s quite active on your knee joints.

Or if you’re not that active, if you haven’t exercised in a long time, and you’re maybe just into walking or doing something simple around the house, then you have to consider that too. So these injections are kind of a one size fits all thing. And you need to talk with your doctor about what is the long term solution for your knee problem.

In light of the activities that you usually do. Your job might require to require you to be active, you might be on your feet a lot or you might be sitting you might be more sedentary. And then what’s your lifestyle outside of your job? Are you active in the house? Are you outside more?

Or do you tend to sit more, that’s fine if you do so we just have to take that into consideration for the health of your knees. And the last con is these injections can get pricey, especially the more experimental ones.

They’re not covered by insurance usually like your gene therapy, the stem cells, the PRP injections, those tend to be quite expensive. And it’s just not a sustainable thing to be getting them on a recurring basis, except for the few that can afford that of course, but most people need something that’s affordable, that will last them a long time.

The most common treatment that happens next, if injections don’t work is a knee replacement surgery. Now in the United States, the replacement surgeries cost over $22,000 on average. Now that’s way more expensive than some of these injections. Especially like cortisone injections 100 to $200 isn’t that much relative to to $22,000.

But the nice thing about near placements is they have advanced so much. And if you absolutely need to get one if your knee arthritis is so bad if you got some other knee injury that it looks like there’s no turning back from a knee problem, near placements tend to last a long time. And surgeons are usually good at doing these procedures, and insurances see the benefit of it, so we’ll cover it.

Oftentimes, knee replacement surgeries are covered by most health insurances. Now there’s still a con to knee replacements, I go back to the mechanical part, of course, I’m biased being a physical therapist. But if the mechanical aspects aren’t addressed, getting a replacement doesn’t solve that either. It does replace the mechanics of the knee joint.

But if your movements and appropriately your hip and back, your foot and ankle haven’t been addressed, then there’s a chance that that knee replacement can eventually fail or wear down a lot faster than it’s supposed to. And you might be stuck with a knee problem again.

And let’s talk about physical therapy, the cost of physical therapy is anywhere from 2000 to $3,000 per treatment plan, which can last months depends on the severity of the individual, it’s typically customized to the person and the quality of physical therapy varies around the country. And even in specific locations. I can tell you about locally where I’m at.

We’re the only clinic to my knowledge that focuses on helping people avoid surgery, avoid injections, and avoid medications. Whereas most clinics around here are set up to help people out after they’ve had surgery. And they’re excellent at doing that. If you have a knee replacement surgery, you’re going to need to gain your motion back and be able to walk again.

And physical therapists typically help with that, with these clinics aren’t good at is helping people prevent surgery because that’s its own specialty. And you typically can’t do the same exercises to prevent surgery that you’ll do after surgery.

It’s a whole different ballgame. And so you have to look into which physical therapist you’re going to so if you’re going to consider physical therapy for your knee problem, because you don’t want to rely on injections, do some research and find a physical therapist that fits your specific situation. Now if you’re not in a position where you can access physical therapy or you’re not sure about it, you want to see learn a bit more about how it might help out your knee problem.

We’ve got a program called the 28 day knee health and wellness boost program. It’s a 100% online and on demand program that you can purchase right now and get access to training from me about how to make your knee healthier.

I put a link to more information in the description for the 28 Day Health And Wellness Boost Program. And the cost of it is about the cost of one physical therapy visit. I hope you got a lot out of this video. Please give us a thumbs up if you did. Consider subscribing if you’re not already subscribed and if you have any questions drop in the comments below and we’ll get to it. first chance we get Thanks so much guys. Have a wonderful day.