If you are suffering from knee pain, are you no longer feeling the effects even after receiving hyaluronic acid injections?
Hyaluronic acid is an extremely effective ingredient that not only acts as a lubricant for joints, but also calms inflammation and protects cartilage. Since it is an ingredient that originally exists in joints, many people may feel comfortable choosing it as a way to deal with knee pain.
However, even if you feel the effects at first, the effects often fade over time. Many people may be worried about whether they should continue with the injections or whether there are any other options.
In this article, we will explain the causes and remedies when the effectiveness of hyaluronic acid injections decreases. We will also give you specific information on when to review your approach using hyaluronic acid and the next steps, so please take a look.
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Reasons why hyaluronic acid injections are not effective
Hyaluronic acid injections are a widely used treatment to relieve knee pain caused by conditions such as knee osteoarthritis. However, there are many cases where the effect becomes less noticeable as time passes or the number of times the therapy is repeated. Let's take a closer look at some of the reasons why.
Progression of knee osteoarthritis
As the condition of the joints worsens over the years, the strain on bones and soft tissues due to deformation becomes stronger, which can lead to the inflammatory symptoms listed below, making it difficult to obtain the effects of hyaluronic acid alone.
Exacerbation of inflammation
Research has shown that hyaluronic acid not only acts as a lubricant for joints, but also has anti-inflammatory properties. This is because it plays a role in suppressing the function of cells that cause inflammation. However, if the inflammation within the joint becomes more severe, the effect of hyaluronic acid may become relatively weak.
The stronger the degree of inflammation, the more difficult it becomes to treat the pain with hyaluronic acid alone.
weight gain
As you gain weight, the stress on your knees increases, and your knees may become weaker than when you were lighter.
Increase in activity
Excessive exercise or work may change the burden on your knees, making it difficult to feel the effects.
Can antibodies against hyaluronic acid be produced?
In addition to the above, there is also the theory that, just as medicine becomes less effective if you use it for a long time, you may develop a tolerance to hyaluronic acid.
However, hyaluronic acid is a component that naturally exists in all kinds of parts of the human body, including the skin, eyes, and joints, and is completely different from medicine. Additionally, there is no clear basis for the theory that ``long-term use of hyaluronic acid will develop tolerance.''
It would be more natural to think that the condition of the knee is getting worse or that too much stress is being placed on the knee.
When to reconsider hyaluronic acid injections
If the effect is no longer felt, the following symptoms may begin to appear.
flare-up of pain
Previously, the pain was relieved by hyaluronic acid injections, but I feel like the pain is not getting much better. Or you may not feel any effect at all.
Decline in motor function
Hyaluronic acid injections no longer have a positive effect on walking distance or durability. Activities of daily living began to be affected, such as walking distance becoming shorter and difficulty going up and down stairs.
The duration of the effect is shorter
``Previously, a single injection would last a month, but now the pain returns within a week.''
If you experience these symptoms, the effectiveness of hyaluronic acid injections may be decreasing. There are various factors involved, such as the function of the joint itself, the level of muscle strength, and the amount of activity, but it is better to think of it as a sign that the condition of the knee is deteriorating.
Of course, whether or not to continue hyaluronic acid treatment depends on the doctor's judgment, so it cannot be decided by the individual alone. ” Be sure to let them know.
Injecting into a joint comes with certain risks, such as infection. Continuing to give injections even though the pain has barely decreased is not useful, even if it provides temporary relief.
After comprehensively assessing the actual condition of the knee joint, the degree of improvement in pain, and the person's complaints, should we add additional treatments, change to a different approach, or proceed with open treatment (surgery, etc.) They should be able to give you some suggestions.
Other approaches
The following treatment methods are performed by continuing hyaluronic acid treatment and additionally performing another approach in parallel, or by discontinuing hyaluronic acid treatment.
drug therapy
Treatment is with painkillers and anti-inflammatory drugs.
The use of oral or topical nonsteroidal anti-inflammatory drugs (NSAIDs) may be considered, or analgesics tailored to the level of pain may be prescribed.
steroid injection
If the inflammation is severe, steroid injections may be given for short-term effects.
Its ability to suppress inflammation is stronger than hyaluronic acid, so it often works immediately even when the pain is severe.
However, it is important to note that, like hyaluronic acid injections, it cannot be done frequently, and it does not provide a fundamental solution.
rehabilitation
Even if you are not hospitalized, you may be able to receive outpatient rehabilitation while attending the hospital.
Institutions offering outpatient rehabilitation may also choose rehabilitation as an approach.
We aim to reduce pain by strengthening the muscles around the knee and improving joint movement, and by using physical therapy (heat/cold therapy and electrical therapy).
Surgery (artificial knee replacement)
If the condition of the knee joint is poor and it is difficult to improve movement function or reduce pain even with the above approaches, surgery may be recommended.
Depending on the condition, there are various surgical methods such as osteotomy, but in most cases, knee replacement surgery is selected.
When an artificial knee joint is created through surgery, the narrowed gaps in the knee and bone protrusions (bone spurs) are replaced with artificial bone, so the knee joint itself is in good condition.
The disadvantages are that it is a surgical procedure, so you will need to be hospitalized, and you will have to endure the pain of the surgery for a certain period of time. Since rehabilitation must continue, this treatment may be difficult to choose if hospitalization is not possible due to work or family commitments.
It is also not an option if you are unable to undergo surgery due to your medical history.
New treatment method “Regenerative medicine”
Regenerative medicine is an innovative treatment that harnesses the body's natural repair abilities to repair and regenerate damaged tissue. In recent years, it has attracted attention as a new knee treatment method.
Although hyaluronic acid has become less effective, it would be a problem to just wait for the knee to worsen. However, if you do not want to undergo surgery, it is good to remember that regenerative medicine is one option.
PRP (platelet rich plasma) therapy
Platelets extracted from blood are concentrated and plasma rich in growth factors is injected. It is effective in repairing damaged areas and suppressing knee pain and inflammation.
stem cell therapy
Using "stem cells" collected from adipose tissue and bone marrow, it promotes the regeneration of cartilage and ligaments.
Regenerative medicine uses your own blood and tissue to harness your body's natural repair mechanisms. By using your own ingredients, the risk of allergic reactions is lower. Another big advantage is that knee joints can be treated without hospitalization or surgery.
In particular, stem cell therapy has the effect of regenerating cartilage and ligaments, so it can be said to be a fundamental treatment option for the knee other than surgery.
summary
Each of these alternative treatments has advantages and disadvantages. It is important to consult with a specialist organization to decide on the most suitable option.
Additionally, new treatments are constantly being researched and developed. For knee health, let's expand the range of knee care while getting the latest information.