Joint infiltrations

What joint infiltrations are

Intra-articular and peri-articular infiltrations involve introducing a medication directly into the joint or surrounding tissue.

The preparation may be injected into the joint or, in specific circumstances, into peri-articular tissue, both to relieve pain and to treat its cause, such as inflammation or tissue degeneration.

Which substances may be used

Medications may include anti-inflammatory drugs, such as corticosteroids, and painkillers, such as local anaesthetics.

• Hyaluronic acid, a component of synovial fluid that reduces friction between the ends of bones.
• Collagen, a natural component of ligaments, tendons, capsules, bones, cartilage and muscles.

When they are considered

Infiltrations may be particularly indicated for pain affecting the knee, shoulder, elbow, hip, wrist, ankle and small joints of the hands and feet.

Pain may have inflammatory causes after trauma, be linked to overstimulation of the joint, or to osteoarticular conditions such as osteoarthritis, arthritis or cartilage wear.

Before and after treatment

No specific preparation is required, although blood tests to assess clotting may be useful to prevent bruising after the procedure.

If you take anticoagulants, you may be asked to stop them: always bring a list of your medications and report any clotting disorders.

After the infiltration, the joint should rest for at least twenty-four hours and ice can be applied with a cloth protecting the skin.

Contraindications and possible effects

In some cases infiltrations cannot be performed because they may not be safe for your health.

• Joint or peri-articular infection.
• Blood in the joint.
• Inability to stop anticoagulant therapy because of cardiac or clotting conditions.
• Pain, swelling, redness or warmth in the treated joint: side effects are few and mostly temporary.

Within a pain medicine pathway

In severe joint osteoarthritis, infiltrations can certainly improve pain and inflammation, delaying possible surgery.

I assess each case carefully to guide you towards the most appropriate pathway for your health.