Cortisone is a naturally occurring corticosteroid hormone produced by your adrenal glands. It can be injected directly into a joint or around a tendon. After the injection the medicine works to relieve the pain and swelling from arthritis.

The injection will usually take about 24 to 48 hours to work. A local anesthetic (lidocaine) is mixed with the cortisone, so you might feel better a little bit quicker.

As with any medication, results vary from patient to patient. Some patients may have improvement for months, and others may not notice any change at all. Successful glucocorticoid therapy should last approximately 3 months.

If the first injection worked, then you may benefit from another. You can repeat injections up to 4 times a year. If needed more frequently, this can be discussed with Dr. Olszynski.

It is best to rest the joint for 48 to 72 hours after the injection. This might make the injection work better and last longer.

Corticosteroids are a class of medications that are related to natural cortisone. They are designed to work in a similar way inside the body, as does the cortisone produced by your adrenal glands.

Cortisone affects many parts of the body including the immune system. It helps lower levels of prostaglandins, hormone-like lipids that play a role in causing inflammation (heat, redness, swelling, and pain), and it can soften the response of the immune system’s T-cells and B-cells, which are types of white blood cells.

When delivered directly into a joint or tendon impacted by arthritis, corticosteroids mimic the effect of natural cortisone and reduce inflammation. Its relatively fast action compared to many other treatments helps make cortisone injections a useful tool in treating arthritis.

Viscosupplementation is a treatment for arthritis where a gel-like fluid called hyaluronic acid is injected into the joint. This thick fluid can help reduce pain and swelling in your joint (most commonly, your knee).

Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding healthy joints. It acts as a lubricant and shock absorber in your joint.

The bones that make up your joints usually have a cap of cartilage on their ends. This cartilage helps make sure that your bones move smoothly against each other and has a fluid coating that contains hyaluronic acid. In osteoarthritis (“wear-and-tear” arthritis), the cartilage cap breaks down. When this happens, the bones of your joint scrape together abnormally. People with osteoarthritis generally have less hyaluronic acid in their joints than they should, and the little amount of hyaluronic acid that remains in the joint is of poor quality. All of this causes symptoms like pain, stiffness, and swelling. The idea behind viscosupplementation is that replacing this hyaluronic in the arthritic joint greatly improves movement and reduces pain and inflammation.

This injection may take a month or longer before you notice improvements in the affected joint.

As with any medication, results vary from patient to patient. Some patients may have improvement for months, and others may not notice any change at all. Some research studies have shown this to be effective on average for 9 to 12 months.

You may have already tried other treatments for your arthritis, like over-the-counter pain medicines and corticosteroid injections. If you still have significant symptoms, viscosupplementation might be a good choice to help reduce your pain, stiffness, and swelling. The treatment seems to work best in people with mild or moderate arthritis. The treatment may particularly make sense if you are trying to delay getting surgery on your joint.

PRP (or A-PRP) stands for Autologous Platelet Rich Plasma Therapy. In easy-to-understand terms, the therapy uses your blood, specifically the platelets, to heal your joint, cartilage, or tendon. PRP was initially developed over 20 years ago to aid with wound healing and blood loss. It has been used for years in Europe to treat tendon injuries and now also shows promising results in the healing of osteoarthritis and cartilage injuries.

The best way to describe and envision the healing process of PRP is to think of a cut on your hand. Your body’s response is to attract platelets that release growth factors to the cut and promote healing of the skin.

By injecting the concentrated platelets into the affected area, we are aiding the body in the natural healing process.

Just shortly before the injection procedure, one tube of blood** will be collected from you by trained staff in our clinic. This is then prepared into plasma with concentrated platelets. There is no additional medication or additives that go into this preparation. The physician will then inject the concentrated plasma into the affected area.

Depending on the severity of your condition, you may need anywhere from 1 to 3 injections, spaced approximately four weeks apart.

Occasionally, the doctor will advise viscosupplementation be administered at the same time as PRP. Please refer to the “Viscosupplemenation” tab to find out more information.

**If you are having multiple areas injected, this may require additional tubes of blood.

The only preparation that we require is for anti-inflammatories to be discontinued for one week before and one week after the injection, either prescription or over-the-counter medications. If you are not sure, please contact the office.

Initially, you may have some discomfort in the injected area, however, that should subside in a short time.

At home, you may want to apply ice and/or take medications to control your pain. Please discuss the best options with the doctor at your appointment.

The affected area should be rested and used minimally for at least 48-72 hours. If it is your knee, ankle or foot, it is highly recommended not to weight bear; no standing or walking. You may bring crutches with you to your appointment.

You may experience additional benefit with physiotherapy, but this should start NO SOONER than 7 days after your injection.

We also ask that you have someone to drive you to/from your appointment as you will need to minimize your use of the injected area.

This treatment is not a “quick fix”, rather, it is designed to promote long term healing. Response varies between patients and we are unable to predict how long it will be before you start feeling an improvement in your symptoms.

Prior studies show a significant improvement in pain scores at six months and an even higher reduction in pain scores 1-3 years later. Some patients in our clinic have reported mild but noticeable improvements after four weeks, however, as with any medical procedure, there is no guarantee that this treatment will work for you, particularly if your condition is severe.

Physical therapy in combination with PRP will also aid in shortening the recovery process as well as maximizing the improvement to the affected area.

If you have osteoarthritis, rotator cuff tear, golfer’s elbow, knee tendonitis, achilles tendonitis, plantar fasciitis or tennis elbow, PRP may be a viable treatment option for you.

Following an initial evaluation with Dr. Olszynski, it will be determined if PRP is your best option. For many patients, PRP is an alternative treatment to avoid joint or tendon surgery.