Pain Management

Pain Management at a Glance

Pain is an unpleasant feeling triggered in the nervous system which indicates that something has gone wrong. Actually, it protects our bodies from harm by causing us to perform certain actions and avoid others.

All of us may have experienced pain at one point or another. The severity of the pain can only be determined by the sufferer, not observers. Pain can be mild or severe, acute or chronic. If pain lasts for more than three months, it is said to be chronic. Arthritis is the most common cause of chronic pain.

Arthritis affects almost all joints in the body such as knees and hips. Usually, arthritic pain is managed conservatively by over-the-counter pain relievers called non-steroidal anti-inflammatory drugs, or NSAIDs. In severe cases, COX-2 inhibitors and corticosteroids can be prescribed. Physical therapy is also useful in the initial stages.


The knee osteoarthritis is very common condition for patients to see their physicians. A major drawback of above mentioned traditional methods of pain management is that they provide only temporary relief. In addition, some people have a reaction to NSAIDs. Viscosupplementation is the best therapeutic option for all those people who do not respond well to other treatment methods or are not candidates for surgery.

Viscosupplementation injection is a procedure that involves injecting hyaluronic acid directly in the knee joint. Hyaluronic acid is a natural substance found in synovial fluid. According to some researchers, hyaluronic acid seems to increase joint lubrication, has an anti-inflammatory effect and may encourage the production of cartilage. Hyaluronic acid is now approved by US FDA for treating osteoarthritis of the knee.

These formulations of hyaluronic acid are available:

  • Euflexxa (1 % sodium hyaluronate)
  • Supartz (sodium hyaluronate)
  • Synvisc (Hylan G-F 20)
  • Synvisc One (Hylan G-F 20)
  • Orthovisc (high molecular weight form of hyaluronic acid)
  • Hyalgan (sodium hyaluronate)

According to the product being used, three to five shots are recommended with an interval of 1–3 weeks. Sometimes, an allergic reaction may occur due to injection in the joint which may cause temporary pain and swelling. The injection does not provide immediate pain relief. By the time, the course is completed, you will feel better and the effect may last from 6 to 12 months.

Discuss about viscosupplementation therapy with your orthopedic surgeons, if you want to delay your surgery or are not responding to other treatment modalities.


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