A lot of people ask, do knee steroid injections work?  Do Synvisc (or Supartz or Hylagan) injections work?  The answer is “Yes.”  A better answer is “Yes, in the right people, and the improvement seen is moderate.”

A better answer is “Yes, in the right people, and the improvement seen is moderate.”

What are knee steroid injections?

These are strong anti-inflammatory drug that reduces inflammation in the synovium and thus decreases pain.  They are long acting and tend to remain in the knee for about six weeks.

Do knee steroids help?

Several scientific studies have proven that the knee steroids help patients. According to The American Academy of Family Physicians after studying all of the scientific studies, knee steroids are effective.

The most common way to manage musculoskeletal conditions in patients is injections. Injecting corticosteroid into articular, periarticular or the soft tissue help relieves pain, improve mobility and reduce inflammation. The use of these injections can provide crucial diagnostic information for use in postoperative pain management.

For rapid pain relief, a patient can be injected with local anesthetic and corticosteroid for instant pain relief. For treating conditions like Quervain tenosynovitis and trochanteric bursitis, steroid injection is effective. During physical rehabilitation from lateral epicondylitis and rotator cuff syndrome, doctors can use steroid injections. And for osteoarthritis and rheumatoid arthritis, intra-articular steroid injection is the solution.

There is still no evidentiary guide to aid in selecting the right medication for therapeutic injections. There should be a guiding goal when selecting the medication like the therapeutic or diagnostic purposes, the clinical experience, and the underlying diagnosis. Even though there are rare cases of complications from using steroid injections, doctors should understand the potential risks and help the patients understand.

For more than 50 years, injections have been a major part in the management of musculoskeletal disease. And just like it is with any other procedure, the success lies with knowing the right diagnosis and injecting it correctly with the right drug.

What are Synvisc injections?

Even though there is a wide use of the word cortisone to mean corticosteroids, the corticosteroids have been used for so long as injections for knee pain. Only a few studies have been done comparing Synvisc to corticosteroids hence the difficulty making the comparison. A study involving 100 patients compared Synvisc to betamethasone in treating knee osteoarthritis and found no difference at six months between the two options.

Cortisone is a potent anti-inflammatory drug used when there is inflammation, especially for diseases like rheumatoid arthritis and gout.  The injections will help relieve the pain for a few weeks and up to 3 months.

Synvisc and cortisone are different drugs. Synvisc is a lubricant injected into the knee to help patients suffering from osteoarthritis. It is not easy predicting which of the two medications will work best for any patient, but patients report positive responses to each of the drugs. Those who don’t respond well to one should try the other.

Do Synvisc (or Supartz or Hyalagan) knee injections help knee pain?

Yes they help knee pain, to a moderate degree.  Synvisc knee injections have been shown to help knee problems to a good percentage of the respondents. According to the AHRQ, a US government and an authority on this subject, the 18 separate studies have reported moderate improvements in patients.

The injections will bring about an improvement in knee pain, though it won’t be dramatic. The effects will last a few months, and in the case of severe arthritis, it does not delay total knee replacement.

Other ways to relieve osteoarthritis knee pain

• Doing home-based exercises like tai chi can give medium-term benefits like function, reduction of primary pain, and improved quality of life, there is, however, no data on its long term benefits.
• Performing strength and resistance training transcutaneous electrical nerve stimulation and pulsed electromagnetic field therapy provide short-term benefits. Agility training, however, has both short and long-term benefits.
• General exercises and weight loss have shown medium and long-term benefits.
• Whole body vibration, balneotherapy, and intra-articular platelet-rich plasma have medium-term benefits to patients.
• Using chondroitin sulfate or glucosamine-chondroitin and glucosamine has medium-term benefits for pain and knee function.

Most of the treatment options for osteoarthritis assessed for efficacy demonstrate short-term benefits on pain and function. The only options with long term benefits are weight loss, general exercise, and agility training programs. There is a need for larger randomized controlled trials for longer durations to get more specific data. This will help determine which treatment options are the best for knee pain and function.