Is Viscosupplementation Better than Cortisone for Knee Arthritis Pain?

Arthritis anywhere in your body hurts, but when it’s in your knee, it seems like life comes to a halt. Standing, sitting, picking up that thing you dropped on the floor, walking to the car, getting in and out of the car — it’s all an exercise in patience and endurance. 

That's why so many arthritis sufferers swear by injections to help them stride through life without excruciating pain. But how do you know if they’re right for you, and if they are, which one do you choose for your knee pain? 

That’s our job at Northern Virginia Orthopaedic Specialists, with offices in Manassas and Haymarket, Virgina. Our team of expert orthopaedists (Dr. Megan Friend, Dr. Christopher Highfill, Dr. William Bartley Hosick, Dr. John Kim, and Dr. Kevin Peltier) understands the pain and frustration of arthritis and the immobility issues it can cause. While we can’t cure your arthritis, we can help you manage the symptoms so you can lead the most active life possible. 

Two of the most effective treatment options are viscosupplementation and cortisone. Here’s how they compare.

First — a word about knee arthritis

Knee arthritis happens when the cartilage in your joint wears down due to friction over time (osteoarthritis) or an autoimmune disease called rheumatoid arthritis attacks the synovial fluid in your joints. Either way, the result is inflammation and pain. 

In both cases, you lose essential fluid and cartilage, so you no longer have the shock-absorbing, lubricating environment that once protected your joint, and your bones begin to rub on one another. If only you could replace the fluid and add some lubrication back into your knee joint.

Cortisone injections

Knee arthritis is painful and debilitating. It not only makes everyday life challenging, but it often makes the best treatments — like physical therapy and exercise to lose weight — equally difficult or impossible. 

One of the most effective ways of helping patients with knee arthritis overcome that pain is with cortisone, a chemical that mirrors the cortisol naturally produced in your adrenal glands. Adding this to your joint reduces the inflammation and your pain. 

But the effects of cortisone injections are temporary; they only last about a month or two. During that pain-free period, you can make a lot of progress and increase your range of motion through physical therapy, but you may feel the pain return before you reach your goal. 

Too many cortisone injections may damage your knee joint, so you shouldn’t receive more than 2-3 a year, but that might be enough to give you a much-needed reprieve from the pain.

Viscosupplementation injections

The synovial fluid in your knee joints contains hyaluronic acid. But osteoarthritis robs you of one-third to one-half of the normal amount of hyaluronic acid. Our team at Northern Virginia Orthopaedic Specialists can replace that critical missing element through viscosupplementation injections. 

Introducing a fresh supply of hyaluronic acid to the synovial fluid re-establishes the correct viscosity so that the fluid can resume its job of protecting and lubricating your joint. It may also reduce inflammation, which means pain relief. 

We recommend viscosupplementation injections for our patients who haven’t found relief from more conservative treatments like over-the-counter pain medications, heat and cold therapy, and cortisone injections. Those who get pain relief from viscosupplementation injections often report effectiveness for several months. This allows you to participate in other rehabilitative therapies, including aerobic exercises, strength training, and weight loss, if necessary. 

So which is better?

The best treatment is the one that works for you. Some patients have more success with one treatment over the other, so we may try cortisone injections first and see how you respond, then move to viscosupplementation if you didn’t get relief. 

In general, viscosupplementation may last longer and be safer to use if multiple injections are needed. But not all bodies react in the same way to the same treatments.

If you have knee arthritis and are interested in cortisone or viscosupplementation injections for pain relief, call us for a consultation with one of our orthopaedic specialists to find out which treatment is right for you. Or you can get the process started by using our online booking tool.