Interventional Pain Management in Osteoarthritis
Mechanisms of Action
Euflexxa is synthetic copy of hyaluronan, a viscous and elastic substance found in normal synovial joint fluid. It is injected directly into the joint to improve joint function and works in the following ways:
- Lubrication and shock absorption
- Anti-inflammatory actions
- Analgesic properties
- Stimulates production of normal, non-inflamed joint fluid
- Protects residual cartilage within the joint
Euflexxa can be used in the knee, hip, ankle and foot, as well as the shoulder, elbow, wrist and base of thumb.
Euflexxa has been shown to have improved efficacy in a non-swollen and less inflamed joint, so it is recommended to have any excess fluid in the joint aspirated and treated with cortisone 2 - 4 weeks prior to commencing Euflexxa. A referral for ultrasound and aspiration of the joint effusion can be included with your Euflexxa referral from your doctor.
- The injection is performed under CT guidance and sterile conditions by one of our doctors
- The Euflexxa treatment is a series of 3 injections performed 1 - 2 weeks apart. The length of each appointment is 10 - 15 minutes and patients are able to drive after each injection
- At the first appointment, any excess inflamed joint fluid will be aspirated from the joint via the same needle that will administer the Euflexxa
- Relative rest for 48 hours is recommended after each injection. Where possible, avoid activities that exacerbate or worsen the joint symptoms during that time
- The maximal effect of Euflexxa is seen at 8 weeks after the first injection. Beneficial effects in some patients can extend beyond 6 months and the treatment can be performed twice a year
Side Effects and Risks
- Transient joint swelling or stiffnes.
- Bruising or mild-moderate temporary pain at the injection site
- Infection is rare. If fever develops with joint pain, swelling, redness and warmth in the week following an injection, you should immediately contact your doctor and our practice
Euflexxa is recommended for use in symptomatic osteoarthritis by the International Osteoarthritis Research Society, European League Against Rheumatism, American College of Rheumatology (American Arthritis Foundation) and European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).
An epidural injection is an injection into the fluid space surrounding the spinal cord (epidural space). They are performed to treat neck, back, arm and leg pain.
Facet Joint Injection
Facet joints are small joints of the spine that provide stability and help guide motion. They are found in the neck (cervical), upper back (thoracic) and lower back (lumbar). They can become painful as a result of arthritis, injury or mechanical stress. Facet blocks are usually performed for two reasons:
1. Diagnosis, or
Ganglion Aspiration Injection
Ganglion’s are small cysts or pockets of fluid. Under ultrasound guidance we can introduce a needle to drain their contents and inject medication to help them heal.
PRP – Platelet Rich Plasma Injection
An injection of your own blood into the injured tendons. The blood is centrifuged to separate the blood components. Plasma contains growth factors that when injected incites an healing response. This can be used for the treatment of joints, tendons and muscle pathologies.
Platelets release numerous growth factors which help regenerate tissue to some extent and hence help in the repair of the injured tendon and muscle.
At FMIG we have the latest, fully automated equipment for concentrating and separating the platelets, with a completely closed system, thereby minimising the manual handling of the blood and consequently lowering the risk of infection and contamination.
Please talk to your doctor, physiotherapist or sports physician if this is the right treatment choice for your injury. Further details can be provided when you call our clinic.
PRP injections are available at our FMIG Sunshine Clinic.