Updated: Aug 13, 2018
Osteoarthritis a progressive joint disease that results from the wear and tear of the cartilage (aka the cushion) between two bones. It is often associated with advanced age because the more miles we put on our feet the more the cushion tends to wear out. However, arthritis in itself can develop as a result of trauma, abnormal biomechanics, and certain systemic disorders. With the loss of this cushion, the bones start to rub on one another, often causing pain.
Steroid injection therapy has long been a popular treatment option for arthritic joint pain as it can help decrease inflammation and the associated pain, as well as prolong the need for surgery, which may be a joint replacement or joint fusion. Steroid injections are also affordable (starting at $100 at At Your Feet). They are not without their potential complications, though, including tissue atrophy and/or discoloration of the skin, along with the potential of causing weakening of other surrounding soft tissue structures, including tendons and ligaments.
Fortunately, there are alternatives treatment options available. Below is a list of three other injection therapies for chronic joint pain and osteoarthritis. Keep in mind that the research on these is limited, especially in the foot & ankle, and so these procedures may not be covered by insurance; however, if they prolong, or prevent, the need for surgery, it may be worth cost.
Prolotherapy (Dextrose/Sugar Solution) injections
Purpose: Prolotherapy (aka proliferation therapy) is a serial injection treatment option for chronic musculoskeletal (tendon, ligament, joint) conditions. A dextrose solution is injected into the affected area to stimulate an acute low-grade traumatic process, allowing the body to use its own inflammatory markers to aid in the body’s healing process naturally, thus regenerating and repairing damaged tissues, restoring joint stability, and improving pain.
What to expect:
The dextrose solution is prepared and then injected into and around the affected area.
After each injection session, you are allowed limited weight-bearing in a walking boot for the first 3 days. You can then slowly transition back into regular shoes, as tolerated.
Patients receive injections about every 4 weeks until symptoms are resolved (estimate 4-6 injections) or until improvement is no longer noted.
Cost: $200+ per injection site
Platelet-Rich Plasma (PRP) Injections
Purpose: Blood is made up of plasma, red and white blood cells, and platelets. Platelets function to help with clotting of blood, but they also contain growth factors that aid in the healing process. Platelet-rich plasma, or PRP, is plasma that contains a higher concentration of platelets than normal. The purpose of PRP injections is to increase the number of growth factors into and around an area of soft tissue damage, thus stimulating and speeding up the healing process. The ultimate goal is decreased pain, improved function, and return to sports and activities.
What to expect:
Blood is drawn from the patient’s arm and then centrifuged.
The PRP is prepared and then administered into and around the affected area.
After the procedure, you may be put into a walking boot for about a week.
Patients may need multiple injections, which are typically given 4-6 weeks apart.
Cost: $600+ per injection site (+ cost of blood draw)
Hyaluronic acid injections (e.g. Supartz®)
Purpose: Supartz® is a viscosupplement of sodium hyalonurate that is injected into painful, arthritic joints to help provide lubrication to the joint, in turn, increasing range of motion and decreasing pain.
What to expect:
Local anesthetic is typically used to help numb the area around the injection site. The pre-mixed Supartz® solution will then be injected into the affected joint using a small needle.
Patients are encouraged to move the joint immediately afterwards; however, limitations on certain activities may be recommended for the first couple days.
Injections are done weekly for a number of weeks to help increase the time the medication is in the joint and to aid in the anti-inflammatory cascade within the affected joint. Benefits may last 6 months or longer (1).
Cost: $1000+ per injection site
DISCLAIMER: The above information is meant for educational purposes only and should not be construed as medical advice. The above pricing is based on Dr. Falk’s practice and is subject to change. Should you have questions or concerns related to your health, please contact the doctor or your own healthcare professional.
1. Sun, S. F., Chou, Y. J., Hsu, C. W., Hwang, C. W., Hsu, P. T., Wang, J. L., ... & Chou, M. C. (2006). Efficacy of intra-articular hyaluronic acid in patients with osteoarthritis of the ankle: a prospective study. Osteoarthritis and cartilage, 14(9), 867-874.