Blockade injections - instant relief for joint pain

To quickly relieve the pain that has settled inside the joint and makes you shudder with every movement - this is the request of patients who come to the clinic during a period of acute joint pain, when there is no strength to endure, and applying pain-relieving ointments has long been ineffective. Intervertebral hernias or protrusions, neuralgia, arthrosis and arthritis, heel spurs - all this does not allow a person to relax and think about something other than sensations.

To quickly relieve pain, a specialist often uses drug blockades. These are injections of anti-inflammatory and painkillers that are injected exactly into the area where there is damage.

Content

• Benefits of blockades
• How to do a blockade for leg pain
• Treatment of knee joint diseases with blockades

• Cost of treatment
• We recommend reading

Pain levels

0 — 3

Mild pain

- does not interfere with everyday activities, but you can adapt to the pain.

4-6

Moderate pain

- prevents you from doing business, prevents you from concentrating, the patient remains independent

7-8

Strong pain

- it is impossible to carry out daily activities, it is difficult to think about anything other than pain, the patient cannot function independently

9-10

Unbearable pain

- requires urgent care, bed rest, disables the patient

Mechanism of pain relief

Long-lasting pain causes not only subjective discomfort, but also triggers a number of processes in the nervous system, which often form a vicious circle and lead to chronicity and changes in the nature of pain, which can bother the patient even after the injury or inflammation that initially caused the pain syndrome , are long gone. One of the main components of this vicious circle is muscle spasm. The blockade allows not only to relieve pain at the site of the lesion, but also to relax the surrounding muscles, increase blood supply, improve trophism and metabolism, which in itself can bring relief. Pain significantly reduces quality of life, disrupts sleep and normal daily routine. Getting rid of pain improves the general condition of the body and sets it up for recovery. For these reasons, modern medicine recognizes prompt and effective pain relief as an important component of therapy. Doctors are confident that there are no rational reasons to endure pain; you need to seek help from professionals as soon as possible.

Benefits of blockades

Blocking the knee joint for arthrosis allows you to quickly eliminate acute pain, relieve swelling and inflammation. The effect is observed almost immediately after administration, so after 10-15 minutes the patient can freely step on his foot. If necessary, the procedure can be repeated; the course consists of 5-7 injections.

The technique allows the doctor to immediately begin treating the joint disease and quickly relieve pain. The only downside that can be noted is the injection itself, which involves puncturing the skin.

Blockade of the knee joint is prescribed for arthritis, tendovaginitis, synovitis, bursitis and other diseases of the knee.

During the blockade, special drugs are injected into the joint, since the medicine acts at the site of inflammation, then after 10-15 minutes the patient feels a decrease in pain. Thanks to such injections, movement in the joint is restored faster.

Pros and cons of novocaine blockade

Blockade injections of novocaine have the following advantages over other analgesic procedures:

• quickly relieve pain;
• the medicine is delivered to the source of pain, bypassing the bloodstream and gastrointestinal tract, so the negative impact on the body is minimal;
• effective in cases where other medications do not provide the desired effect;
• have low toxicity;
• there are no side effects or complications;
• have a wide range of effects, especially multicomponent solutions: eliminate spasm of muscle tissue and blood vessels, inflammatory processes.

Although novocaine blockade is the most effective and safe procedure for pain relief and reduction of inflammation, it has disadvantages.

The manipulation is complex and requires special conditions, experience and qualifications of the doctor. Incorrect actions can lead to serious consequences: damage to blood vessels, nerves, spinal cord, walls of internal organs, as well as secondary infection.

If the concentration of the drug is exceeded, nervous overexcitation is likely, which is manifested by convulsions, rapid breathing, and palpitations. Individual intolerance to novocaine and side effects cannot be ruled out.

Negative reactions occur rarely, in 0.5% of cases. These include:

• fatigue;
• dizziness;
• headache;
• decrease or increase in blood pressure;
• nausea, vomiting.

The injection should only be given by a specialist in the field of neurology after examination, then the treatment will be safe and effective.

Therapeutic blockades are carried out by the attending physician

To make an appointment with a neurologist from the SmartMed clinic, you need to call @. Before the procedure, the doctor will conduct diagnostics, identify possible contraindications, and assess individual tolerance to the drug.

How to do a blockade for leg pain

For treatment, doctors use the following methods:

• Blockade of the knee joint with diprospan is used to relieve inflammation in synovitis, bursitis and arthritis. Valid for up to several days.
• Dexamethasone injection - prescribed for moderate symptoms. The action lasts up to 3-5 days.
• Injection of Kenalog and Lidocaine - the effect occurs in 15-20 minutes, and has a prolonged effect of up to 2-3 weeks.
• Novocaine blockade only relieves pain and does not affect the inflammatory process. Sometimes novocaine solution is replaced with lidocaine or trimecaine.

The administration of the drug is always carried out after preliminary anesthesia. Success depends on the professional skills of the doctor, as well as the stage of development of the disease.

Make an appointment with a doctor
After the procedure, the patient is recommended to:

• Avoid physical activity for 5-7 days;
• Do not wet or stain the injection site;
• Follow all recommendations of your attending physician.

You can find out the price of drug blockade or injections for arthrosis of the knee joint, read reviews and make an appointment directly on our website.

Pain in the knee joint can occur both due to damage to the structures of the joint itself (hyaline cartilage, subchondral bone, inflammation of the synovium) and periarticular structures (entheses, tendons, periarticular bursae). If the process is local in nature, then it is most effective to apply the local focus of therapeutic actions. In addition to orthotics, physical rehabilitation methods and systemic drug treatment, blockades with drugs are widely used. It is important to choose the right drug and the structure into which it should be administered. Of course, this is determined by the doctor, but the patient’s knowledge of this method helps to seek help from a doctor who knows local therapy techniques.

For inflammation in the knee joint, anti-inflammatory drugs are prescribed in tablet or injection form. But, as a rule, their effect is delayed and incomplete. Long-term use of anti-inflammatory drugs may be accompanied by a number of adverse effects.

Experiments to solve this problem by using NSAIDs locally in the form of ointments and gels in some cases achieve the goal, however, in terms of effectiveness, these forms are significantly inferior to tablet drugs. The reason is that the drug does not penetrate deep enough through the skin.

An alternative to taking NSAIDs to suppress the inflammatory process during inflammation in the joint is local injection therapy with glucocorticosteroids (GCS), which has been used in rheumatology for more than 50 years. The principle of the method is the local administration of a suspension of slowly soluble GCS crystals, which quickly and effectively suppress the aseptic inflammatory process in the structure (synovium, bursa, tendon sheath, enthesis) responsible for the pain syndrome. Intra-articular administration of GCS for pain in the knee joint is carried out only in the presence of clear signs of inflammation (pain at rest, exudate, fever), determined clinically or instrumentally (ultrasound).

For blockade, as a rule, drugs such as hydrocortisone acetate, methylprednisolone acetate or betamethasone dipropionate (diprospan) are used. The use of tramsinolone (kenalog) is unjustified due to the ability of this drug to cause local tissue atrophy.

Single doses of drugs injected into the knee joint: hydrocortisone 125 mg, methylprednisolone 40–80 mg, diprospan 3.5–7 mg (0.5–1 ml).

L local injection of GCS is a one-time procedure; the total frequency of injections into one joint should not exceed 4 during the year. The lack of effect or its short duration (less than 2 weeks) from 2 injections of GCS is a contraindication for further use of this method.

If the direct source of pain is a lesion (enthesopathy) of the pes anserinus - “crow's foot” (the place of attachment of the tendons of the semitendinosus, semimembranous and graceful muscles of the thigh to the medial surface of the tibia in the area of ​​the knee joint). The pathology is designated by the term “anzerine tendobursitis,” which extremely often accompanies arthrosis of the knee joint (especially associated with longitudinal flatfoot) and is often the only clinical manifestation of the disease. This diagnosis is made if the zone of maximum pain is 4–5 cm below the joint space on the inside of the joint. The introduction of GCS into the corresponding structure leads to the complete disappearance of the pain syndrome.

Synovitis in arthrosis is often accompanied by the formation of a Baker's cyst - an accumulation of synovial fluid in the popliteal bursa . Due to the anatomical features of the knee joint, in some patients, subjective and objective symptoms of the cyst (mass formation, mechanical obstruction to flexion in the knee joint, pain in the popliteal region) may prevail over the symptoms of synovitis itself. However, it should be taken into account that the source of excess formation of synovial fluid is the synovium of the joint. In this situation, to successfully relieve synovitis (and eliminate Baker's cyst in fresh cases), GCS must be injected into the joint cavity, and not into the cyst. Only when this approach turns out to be insufficient, the Baker cyst itself is punctured and emptied.

Intra-articular injection of hyaluronic acid preparations

Taking chondroprotectors orally implies, on the one hand, their incomplete penetration of the intestinal barrier, and on the other hand, leads to its distribution throughout the body, i.e. very little of the drug reaches the clinically significant joint. An alternative to the oral use of chondroprotectors is the use of hyaluronic acid preparations.

The therapeutic effect of hyaluronic acid preparations is associated with the properties of sodium hyaluronate, which improves the quality characteristics of intra-articular fluid and increases joint mobility. Hyaluronic acid, when broken down, enters the intercellular space, stimulating the production of its own hyaluronic acid, which affects the quality of the matrix (intercellular fluid). Since there is no cellular regeneration in cartilage tissue, the destroyed cartilage components are filled with intercellular fluid enriched with hyaluronic acid from the preparations. Extracellular regeneration occurs, providing elasticity, firmness and the gliding effect of cartilage tissue in the joint. Currently, evidence has been accumulated confirming the effectiveness of hyaluronic acid preparations for the treatment of arthrosis of the knee joint.

The most studied and effective drug from this group is FERMATRON. Intra-articular administration of GLA preparations requires an impeccable technique for intra-articular injections. The drug must be administered into a “dry” joint, which is often altered by a degenerative process, which is technically more difficult than puncture of a joint with effusion.

Treatment of each patient with pain in the knee joint is individual, and the doctor choosing the optimal treatment regimen for a particular patient must undoubtedly keep in mind the possibilities and advantages of local injection therapy.

appointment with a rheumatologist for an appointment and a therapeutic blockade in Samara by calling the phone number on the contact page of our website.

Prices for drug blockades

Symptoms

• A history of malignancy or symptoms characteristic of neoplasia (weight loss, deformity, swelling or swelling, discomfort).
• Skin erythema may indicate a tumor or infection.
• Signs of systemic disease that may indicate polymyalgia rheumatica or giant cell arteritis.
• Fever may indicate a malignant disease or infection.
• A history of trauma, recent convulsion, or electrical shock may indicate unreduced dislocation.
• A change in shoulder contour with loss of range of rotation suggests dislocation.
• The presence of significant sensory or motor deficits suggests neurological involvement.

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hope 05/31/2021 13:56:28

I was forbidden to do diprospan. The doctors were also told not to do these blockades. the joint is destroyed.

Show answer

KHOLIKOV Timur Vyacheslavovich 06.06.2021 21:02:57

Good afternoon Nadezhda! A blockade with diprospan is done according to strict indications, the most common being the accumulation of effusion in the joint or synovitis and severe pain that cannot be relieved by other means. With frequent injections, this drug can actually do more harm than good. We recommend that you see a doctor before the injection.

Joint fluid examination

• Outside of the inflammatory process, the aspirated fluid will be clear, light, and non-inflammatory.
• Infected joint fluid resembles pus and can often have a foul odor. The inflammatory fluid is cloudy, thick and relatively non-viscous.
• First, you need to shake the liquid in the syringe to create some air bubbles. If the bubbles rise slowly, then the liquid is of high viscosity and, therefore, it is highly doubtful that it is of an inflammatory nature.
• The presence of blood in the synovial fluid suggests injury, malignancy, or hemophilia. Joint injury caused by rheumatoid arthritis or osteoarthritis, with the presence of blood in the intra-articular fluid, is a contraindication for injection therapy. Sometimes minor bleeding occurs during joint puncture. In such cases, the blood is always mixed unevenly with the clear liquid.

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Risk factors

• Physical factors associated with occupation, including repetitive motion and vibration from machines.
• Work-related psychosocial factors may also be risk factors for shoulder pain, including stress, social support, and job satisfaction.
• Athletes who have overhead arm movements or high-impact contact sports are prone to shoulder pain.
• Occupations in which people are particularly susceptible to shoulder pain include: cashiers, clothing manufacturers, masons/construction workers, air tool operators, welders, food workers, hairdressers, plasterers, painters and decorators, assembly and production line workers and laborers people who use the keyboard for a long time - for example, IT specialists.

Indications for injection

• Injections into the glenohumeral joint are indicated for diseases such as osteoarthritis, adhesive capsulitis, RA, and rotator cuff injuries.
• Acromioclavicular joint blocks are recommended for osteoarthritis (a common cause of shoulder pain in people over 50) and distal clavicular osteolysis.
• Subacromial injections may be prescribed for conditions such as adhesive capsulitis, subacromial bursitis (can occur with gout, reactive arthritis, trauma or RA), impingement syndrome, and rotator cuff tendonitis. Subacromial corticosteroid injections can reduce subacromial pain for up to nine months. They are also likely to be more effective than NSAID medications.
• Bicipital groove: bicipital tendonitis.

Treatment

Depending on the problem that is causing your shoulder pain, medical intervention may be required, and home remedies and treatments may also be used and may have a positive effect.

• Eliminate loads. Sometimes all that is needed to reduce pain is to eliminate stress and allow the body to heal on its own. This is especially true if the pain is caused by repetitive motion or other muscle injury. Unloading can be combined with the use of heat or cold locally.
• Maintain correct posture. Poor posture can lead to serious shoulder pain. In addition, it is advisable to use an orthopedic pillow and an orthopedic mattress.
• Practice scapular retraction exercises. The right exercises will help the patient overcome discomfort and get on the path to healing. Many exercises stretch the area, which promotes flexibility, and most can be done anywhere.
• Massage can provide significant relief from any problems associated with muscle pain, including shoulder pain. Many people report rapid relief after just a few massage sessions.
• Medicines. For minor pain, over-the-counter medications can be used. For severe pain, stronger medications such as steroids are prescribed.
• Treatment of major diseases. If shoulder blade pain is caused by arthritis, herpes zoster, or another condition, your doctor may prescribe medications, exercises, etc. If the problem is nerve compression or a fracture, more serious medical intervention may be required.

Side effects

This is often the result of poor technique, too much or too little dosage, or improper mixing or dissolution of medications.

Local effects:

• Infection (1/10000).
• Post-injection increase in pain (2-5%).
• Skin discoloration that goes away over time.
• Atrophy of subcutaneous fat.
• Bleeding (rare).
• Soft tissue calcification with repeated injections in one area.
• Damage to the joint or cartilage, osteoporosis (it is advisable to avoid repeated injections, no more than four injections in each location per year).
• Tendon atrophy and rupture (
• Pericapsular calcification (>40%).
• Avascular necrosis.

Does intra-articular block eliminate the cause of the disease?

If the disease is caused by muscle spasm, for example, due to osteochondrosis, back pain, then the blockade will help relax the muscles and eliminate the source of inflammation. If the joints are affected, then usually chondoprotectors and anti-inflammatory drugs are added to painkillers; simple pain relief will not be enough.

Which treatment method to choose is determined by the attending physician during the initial appointment. As a rule, blockades are only one type of complex treatment. In addition to the blockade, physiotherapeutic treatments and other medications are effective.

Chondroprotectors

Dystrophic changes in joints due to arthrosis and arthritis lead to the destruction of cartilage. The synovial fluid loses its lubricating properties, and instead of sliding between the bones, friction occurs. The cartilage tissue is subjected to additional trauma, which causes pain to intensify.

Chondroprotectors can correct the situation. They speed up metabolism and activate the synthesis of their own collagen, which makes up cartilage. A noticeable effect from their use does not occur immediately, but after several weeks and even months. But it lasts a long time. After a course of procedures, walking becomes easier, movements cause much less discomfort. Chondroprotectors can relieve unpleasant symptoms only in the first three stages of arthrosis, when the cartilage has not yet been completely destroyed. For stage 4 deforming arthrosis, such drugs are useless.