The causes of painful joints are very diverse. Arthrosis is one of the most common diagnoses. Arthrosis is a sign of wear and tear in the joints that can occur as a result of normal ageing processes or other diseases (e.g. due to an accident or a genetic condition or chronic inflammatory diseases such as rheumatoid arthritis). In osteoarthritis, the cartilage within the joints changes, which can lead to remodelling processes and finally to the destruction of bone substance. This results in severe pain in the joints, which increases under load and restricts the joint in its movement.
In principle, osteoarthritis can occur in all joints. However, some joints are affected more often than others. These are usually joints that are exposed to a particularly high load. This load can be exerted by frequent movement or by increased pressure on the joint. The joints that are classically affected include the wrist, metacarpophalangeal joint of the thumb, ankle and big toe joint. But larger joints such as the shoulder joint, the knee joint or the hip joint are also typical sites for arthrosis.
Osteoarthritis severely limits the quality of life of those affected. However, one is not helplessly exposed to the pain, because there are effective methods to treat the symptoms of arthrosis. One of these methods is the injection of hyaluronic acid into the affected joint. What hyaluronic acid is exactly and why it is so suitable for the treatment of arthrosis, you will learn in the following sections.
What is hyaluronic acid?
Hyaluronic acid is a naturally occurring substance in the body that performs different functions in different parts of the body. It is a carbohydrate (polysaccharide = multiple sugar) that is produced by numerous cells in the body. The most important function of hyaluronic acid is to bind water.
This ability is particularly important in the joints, as it allows the cartilage tissue and also the synovial fluid to maintain their physiological states. Due to the degenerative processes of arthrosis described above, the cartilage and synovial fluid are restricted in their function, which is why the injection of hyaluronic acid is particularly suitable in these cases.
How can hyaluronic acid be used to treat osteoarthritis?
The body's own hyaluronic acid production is increasingly limited, especially in advanced age, and it is no coincidence that this correlates with the degenerative joint wear that occurs at this age. In principle, it is possible to support hyaluronic acid production through a balanced diet and dietary supplements, but this is not sufficient to effectively treat osteoarthritis. The injection of the important substance directly into the affected joint is particularly suitable for this purpose. This allows the hyaluronic acid to take effect on the spot.
However, not all hyaluronic acid is the same
As described above, hyaluronic acid is a sugar that consists of chains of individual sugars strung together. There are hyaluronic acids that are of different lengths and have a different effect depending on their length. The short-chain hyaluronic acids are particularly known for their pain-relieving effect. They are also said to have an anti-inflammatory effect. The long-chain hyaluronic acid, on the other hand, is particularly suitable for restoring the gliding ability of a joint. A combination of both forms of hyaluronic acids can therefore provide significant relief from the symptoms of osteoarthritis.
Opportunities & Risks
What are the chances and risks of the treatment?
Due to the effects of hyaluronic acid described above, it has now established itself as a standard treatment method for arthrosis. A great advantage is that hyaluronic acid is normally produced by the body itself. When it is administered to the joint, allergic reactions are therefore very rare. However, not every form of arthrosis can be treated satisfactorily with hyaluronic acid.
The most important factor is the cartilage substance that must still be present in the joint. If the arthrosis has already existed for too long or is particularly rapidly progressing, then in some cases the cartilage mass falls below a critical amount, so that treatment with hyaluronic acid only leads to a limited lasting improvement in the symptoms.
As a specialist practice for joint diseases, Dr. Braune's practice is specialised in this field and performs multiple injections into almost all joints of the musculoskeletal system every day.
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Extremely high safety and hygiene measures in Dr Braune's practice
Extremely high safety and hygiene measures are used for every injection. The joint to be treated is prepared for the injection under comparable sterile operating conditions. 3 sterile disinfections and subsequent sterile covering of the injection field are standard. Sterile gloves and a mouth guard are worn during the injection. The risk of infection resulting from the treatment is thus reduced to a minimum, but cannot always be 100% excluded. Practical experience shows that the risk of infection is less than one per thousand. Since hyaluronic acid has already been used as a treatment method for several decades, there is a high level of treatment safety and it can be well assessed in which cases the treatment can be carried out with low risk and in which cases further preparations are necessary.
Versatile application possibilities of hyaluronic acid injections
Hyaluronic acid injections can be carried out in a wide range of joints in the case of arthrosis, which is also a great advantage. In general, all joint injections in Dr. Braune's practice are exclusively ultrasound-guided and controlled in order to ensure the maximum effect and safety for the patient.
Smaller joints such as the wrist, metacarpophalangeal joint of the thumb and metacarpophalangeal joint of the big toe can thus be treated just as well as the large joints of the hip, shoulder and knee. Only the amount of hyaluronic acid administered differs, of course, depending on the joint.
Preparation & Follow-up
What should be considered before and after treatment with hyaluronic acid?
Before you decide on a treatment with hyaluronic acid, it is advisable to clarify some aspects. Specifically, it is important to know that the injection of hyaluronic acid does not have to take place only once in order to achieve the desired treatment success. The exact duration of the treatment always depends on the individual case. As a rule, 3-5 injections per session are administered at weekly intervals, which ensures the amount of scientifically determined and required hyaluronic acid concentration for the respective joint. The effect then lasts for several months in most cases. Sometimes the pain may even be relieved for up to a year. After assessing the condition of the joint and especially the cartilage substance, a new treatment interval can then be started.
It is also advisable to keep the skin area around the affected joint as clean as possible before the treatment and to inform the attending doctor if you notice any inflammation of the skin in this area. In this way, the risk of infection of the joint can be minimised.
Carrying out the injections and cost absorption by the health insurance fund
It is also possible to numb the puncture site for the needle with which the hyaluronic acid is administered with a local anaesthetic or locally the skin with an ice spray. This makes the treatment more comfortable for you on the one hand, and on the other hand it allows for more stable work due to the immobilised position of the joint. An anaesthetic is not necessary for this type of treatment.
Despite the proven and scientifically proven effect of hyaluronic acid in osteoarthritis, the costs for the injections are not covered by the statutory health insurance. If you are privately insured, please talk to your health insurance company to find out whether they will cover the costs. If you are covered by statutory health insurance, you can expect to pay about €400 for one treatment.