In people with osteoarthritis, injections of a drug called hyaluronate sodium into the knee are as good as anti-inflammatory drugs at relieving pain at rest. For activity-related pain, the injections may be even better.
Osteoarthritis is a disease caused by the general "wear and tear" of aging. The cartilage in joints breaks down, leading to pain and stiffness. Part of the problem is that the concentration of a substance called hyaluronic acid declines in the fluid inside joints.
Hyaluronic acid "acts as a ‘lubricant‘ when movements are slow. It acts "as a ‘shock absorber‘ when movements are fast.
The theory behind injecting hyaluronate sodium into a joint, which is a relatively new osteoarthritis therapy, is that the injections will restore joint levels of hyaluronic acid, resulting in pain relief and improved function. Some of the earliest research into joint injections for osteoarthritis was actually done in racehorses. A number of studies of hyaluronate injections in humans have been conducted, but none have examined their effect on activity-related pain.
The researchers conclude that hyaluronate injections are as effective as anti-inflammatory drugs at treating arthritis pain at rest, and may even be superior to exercise alone or anti-inflammatory drugs alone for relieving pain with physical activity and boosting daily function, such as walking and stair climbing.
Other experts, point out in an editorial that while the study showed improvement within groups, it did not provide statistical data supporting their conclusion that hyaluronate sodium might be more effective than placebo.
There is considerable evidence that the reverse is true, that hyaluronic acid is no more effective than salt water injections for the treatment of knee osteoarthritis.
Furthermore, when others reanalyzed the data by a method they consider more appropriate, they determined that the effect of anti-inflammatory drugs in the study was 48 times greater than the effect of hyaluronate injections.
They found no evidence to suggest that hyaluronate sodium in this trial is more effective than placebo.
Archives of Internal Medicine February 11, 2002;162:292-298
Does hyaluronic acid work for knee pain or doesn't it?
Who are you going to believe?
It doesn't really matter from my perspective. From the evidence in the study it appears that funding may have influenced the study results to compile the data in a way that showed hyaluronic acid was indeed effective.
However, even if it worked like gangbusters, would you really want someone to inject your knees with a medication when there are less expensive and non-invasive alternatives?
The first one would be exercise. Even the study above showed that exercise worked fabulously well. However, it is clear that if you have had previous knee injuries, jogging would not be a good option for you.
However, there are many other exercise programs that will not stress the knee and still provide excellent benefits.
Additionally, one will want to follow a good eating plan to optimize the body' biochemistry for healing.
Once these two legs of healing are implemented you will want to consider NST which works so effectively for most knee problems. We have been able to help dozens of people avoid knee surgery with this technique.
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