Analgesic anti-inflammatory knee block: what is it?

How is a knee block performed?

All procedures are performed only in a medical facility by a qualified physician. The injection is administered at the doctor's discretion - in the inner part of the knee or in the outer part. It depends on the nature of the pathological process. After the procedure, you should limit physical activity and minimize joint stress for half an hour. Thanks to this technique, the quality of human life significantly improves.

The use of a therapeutic blockade is advisable in order to relieve pain and get rid of other neurological symptoms. This is an effective method that works within a short period of time. The advantage of this technique is its safety for the body and a minimum of side effects.

With the help of a therapeutic blockade, three-phase relief of pain occurs:

Initially, the pain worsens as the pain receptors are irritated by the needle.
Further, the pain syndrome is reduced to a minimum.
In the third phase, a therapeutic effect occurs, the unpleasant sensations completely disappear. After the effect of the drug wears off, the discomfort returns, but it is not so intense.

Doctors recommend following certain rules after such a procedure - reduce physical activity, immobilize the sore joint. In advanced situations, the patient needs to immobilize the damaged area for a while.

According to rheumatologists, orthopedists and traumatologists, this technique of directly introducing drugs into the joint cavity or periarticular tissue helps to quickly restore a person’s ability to work. It is considered the most effective, especially if you need to provide quick assistance.

The main advantages of this method include:

the ability to perform repeated exposure to the damaged area;
quick relief from painful sensations;
minimal risk of developing consequences;
direct effect on the desired area, drugs are not absorbed into the systemic bloodstream or digestive system;
rapid pain relief;
the ability to get rid of vascular and muscle spasms, the inflammatory process;
The procedure can be performed multiple times for each exacerbation;
the ability to restore trophism in tissues and get rid of swelling.

The main indications for injections are the following pathological processes:

synovitis - accompanied by inflammation of the periarticular bursa;
arthritis - reactive, rheumatoid, ankylosing spondylitis;
serous arthritis - is a consequence of injury, surgery or any other type of damage to the joint;
bursitis;
tenosynovitis;
periarthritis.

Who is indicated for injections of hyaluronic acid into the joint?

Special injections into the knee joint make it possible to quickly deliver medications to damaged tissues. Such injections help in the following cases:

sharp pain;
bursitis;
synovitis and tendonitis.

Hyaluronic acid injections are used as an adjuvant therapy. With their help, you can quickly and effectively relieve pain. In addition, injections of hyaluronic acid allow you to reduce the doses of drugs that are taken orally and, thus, avoid complications and disturbances in the gastrointestinal tract. How and when exactly to give injections for arthrosis of the knee joint is decided solely by the doctor. To administer injections, a special syringe with a long needle is used, which must accurately fit into the gap of the affected joint. To ensure the most accurate hit, these injections are usually performed under ultrasound guidance. In some cases, before the injection, doctors pump out fluid from the knee joint. After the joint cavity is completely drained, a special drug is injected into them.

Rice. 2. Hyaluronic acid restores the structure of cartilage in the knee joint

Drugs used to block the knee joint

In order to carry out the procedure, doctors use local anesthetics. Let's look at each medicine in more detail.

Novocaine

It is injected into nerve fibers or tissues. It has analgesic and antispasmodic effects. Severe irritation occurs at the site of the disease after administration of the drug, thus innervation in peripheral tissues is significantly reduced. Thanks to this drug, the permeability of vascular walls decreases, trophism in tissues improves, antiseptic and bacteriostatic effects are achieved, vascular tone and trophism of nerve fibers improves. This remedy is considered one of the safest. It relieves pain and does not provoke the development of negative reactions.

Lidocaine

This is a local anesthetic. After administration, a long-lasting and intense effect is ensured. After the injection, sodium channels are blocked, as a result, the generation of neural impulses stops and their conductivity decreases. The pain syndrome is eliminated, the vessels dilate without irritation. Already 5 minutes after the injection, the severity of unpleasant sensations decreases, and the muscle system relaxes.

Bupivacaine

The drug belongs to amides. It acts slowly, much longer than other drugs. At the same time, the effect of its use is longer lasting. This prolonged effect is due to a longer half-life, since the active substances are transformed and synthesized not in the blood plasma, but in hepatocytes. The first result can be felt 10-15 minutes after administration.

Hydrocortisone

This is a drug that has a long-lasting effect. It contains synthetic hormonal substances; their structure is similar to those substances produced by the adrenal glands. After administration of the drug, its active substances accumulate in the tissues, and the inflammatory process is stopped. This is an inexpensive remedy. It is usually used in parallel with lidocaine. The result is felt within 24 hours after the procedure. Negative consequences after administration include increased blood pressure. The drug is used in the treatment of neurological diseases.

Dexamethasone

This is a long-acting drug that belongs to the group of glucocorticosteroid drugs. This is a very strong medicine that has a pronounced anti-inflammatory, antihistamine, and immunosuppressive effect. Recommended for use with anesthetics. The action comes quickly.

Depo-Medrol

Has a pronounced prolonged effect. The drug is injected into the synovial cavity of the joint. The procedure should only be performed by a qualified specialist to avoid the risk of the needle getting into large vessels. If there is no effect from the injection, the procedure is not repeated.

Diprospan

The key active substance is betamethasone. After the injection, pain and inflammation are quickly relieved, and allergic reactions are eliminated. The disadvantage of the drug is its negative effect on the tissues of the adrenal glands and pituitary gland.

Safety

PRP therapy for the knee joint is one of the safest treatment methods. There is no risk of complications. The exception is the human factor. The doctor may miss the needle into the joint or cause an infection if he does not follow the rules of asepsis and antisepsis.

But if you turn to a highly qualified specialist who has extensive experience in performing this type of medical manipulation, the procedure will go smoothly. If a joint is deformed, if it is difficult for a doctor to get into its cavity, ultrasound can be used. Therefore, there is no risk of damage to healthy tissue during PRP therapy.

The drug itself for injection into the joint cavity is prepared from the patient’s blood. Therefore, the risk of transmission of infection or allergic reactions is eliminated. Your own blood does not carry an antigenic load. It is completely safe.

Complex treatment of joints with drugs

Treatment of joint diseases is carried out using the following drugs:

painkillers. These medications have a pronounced analgesic effect, but the result after administration is short-lived;
corticosteroids – Prednisolone, Kenalog, Diprospan. Medicines have a pronounced anti-inflammatory effect, but they cannot be used too often, since there is a danger of developing dystrophic-degenerative processes in the joint;
chondroprotectors – Fermatron, Alflutop, Ostenil, in combination with hyaluronic acid, help replenish the lack of joint fluid;
vitamin preparations – Milgamma. The medicine improves tissue nutrition and helps them recover.

Painkillers

Among the painkillers that are most often used to block joints are Novocaine, Lidocaine, Trimeacaine. After their administration, the pain syndrome is quickly relieved and the severity of the inflammatory process is reduced.

The advantage of such drugs is that they directly affect the focus of the pathological process. Negative reactions practically do not develop, since the drugs are not absorbed into the systemic bloodstream and into the digestive system. In addition to eliminating pain, such remedies reduce the severity of muscle tension, relieve vascular spasm and swelling.

Block of the knee joint with Diprospan

The key active ingredient in the drug is betamethasone. This drug is used in the treatment of many joint pathologies. After administration, the result is felt within 3-4 hours. The duration of action is one month. When injecting, it is not necessary to numb the injection area.

Diprospan is not only a powerful, effective analgesic and anti-inflammatory agent, it is also a safe drug that can rarely provoke adverse reactions. When used correctly, the medicine is safe for the body.

Novocaine blockade of the knee

Novocaine blockade is an innovative method that is used to treat various pathological processes in the joint apparatus. The mechanism of action is that the active substances of the drug temporarily stop the innervation processes in the diseased joint. The medicine is given by injection directly into the affected tissue that surrounds the joint or nerve.

This is a local anesthetic, its effect is manifested only when administered locally. The result comes within a short period of time. The pain is eliminated for an hour.

Novocaine works according to the following principle:

the drug is an antiseptic and bacteriostatic, inhibits the growth and development of pathogens;
increases the body's resistance to allergens;
reduces the permeability of vascular walls;
evens out vascular tone;
quickly relieves spasms in smooth muscles;
improves trophism in nerve fibers.

Novocaine actively affects the autonomic nervous system. Adverse reactions after administration of the drug are minimal. This is a safe remedy that quickly relieves pain and reduces the likelihood of developing negative consequences of the inflammatory process.

The key indications for novocaine blockade are:

painful sensations, regardless of nature and location, that cannot be relieved by other means;
acute inflammatory processes in soft tissues;
injuries or damage to various groups of joints;
burns, frostbite, snake bites;
decreased tone of internal organs.

What drugs are injected into the joint and for what purpose?

Corticosteroids.

If the pain is severe and accompanied by inflammation, the joint is treated with hormonal drugs based on corticosteroids. Medicines eliminate pain and swelling, improve joint mobility for a period of up to 2-3 months. Such injections cannot be performed often, so they are considered as a first aid remedy.

Chondroprotectors.

Chondroitin and glucosamine as part of chondroprotectors are involved in the regeneration of cartilage tissue, which always suffers with arthrosis. To avoid taking pills for months, you can take a course of five injections and get faster results. Metabolism will improve, the production of your own collagen and the healing of microtraumas will accelerate.

"Alflutop" is the most popular chondroprotector in the form of injections

Synovial fluid prostheses.

With arthrosis in the joint, the amount of synovial fluid, which performs shock-absorbing and lubricating functions, is reduced. It also becomes less viscous and less elastic, and does not cope with its tasks, so the cartilaginous surfaces begin to rub and become damaged.

Synovial fluid prostheses restore its deficiency. There are medications based on hyaluronic acid that are quickly broken down by enzymes and eliminated within a few months. There are also synthetic drugs, for example Noltrexin, with a very high molecular weight and tightly cross-linked molecules, which remains in the joint for up to two years. What kind of drug it will be - “Synvisc”, “Fermatron” or “Noltrexin” - the choice is up to the patient.

Noltrexin lasts longer than other synovial fluid prostheses

Gas injections.

The carboxytherapy technique is used quite rarely. A course of such procedures can be offered at famous medical resorts that specialize in the treatment of arthrosis of the hip, knee, elbow or shoulder. Carbon dioxide is injected into the joint, the body regards this as a lack of oxygen. The joint receives additional blood flow, and its metabolism is activated. Carbon dioxide is easily removed after a few minutes, but it has already served its purpose!

Plasma therapy.

This method is quite expensive, but also cannot completely cure arthrosis. Blood is taken from the patient and platelet-rich plasma is separated from it. Own plasma injected into the joint is well accepted by the body and does not cause rejection reactions or allergies. The course of treatment includes 5-7 injections at intervals of 3-7 days, then preventive injections are given.

Plasma therapy is an expensive injection that is inferior in effectiveness to synovial fluid prostheses.

Knee block with lidocaine

Lidocaine is a local anesthetic. It provides a longer and more intense effect than other types of painkillers. Used in the form of hydrochloride. After administration, voltage-gated sodium channels are blocked. As a result, the generation of impulses in neurons stops and innervation is blocked.

With the help of Lidocaine, pain is eliminated and the walls of blood vessels dilate. 5 minutes after the blockade, the pain stops and the muscles relax. This is a low-toxic drug, so the likelihood of developing negative reactions in the body is minimal.

Periarticular block of the knee joint

This is a treatment method that is used to relieve acute pain during the development of joint diseases. The main indications for the procedure are:

neuritis;
bursitis;
osteoarthritis;
periatrosis;
arthritis;
gonarthrosis;
sprain.

With the help of this procedure, pain is eliminated, the local inflammatory reaction is relieved, and joint mobility is restored. The technique is that the injection is injected into the soft tissues without penetrating into the joint cavity.

Indications, contraindications

The indication for blockade is severe pain in the following diseases:

non-infectious forms of arthritis - rheumatoid, psoriatic, reactive, post-traumatic/postoperative serous, ankylosing spondylitis;
synovitis as a consequence of osteoarthritis;
limited inflammation of periarticular structures (without arthritis) - tenosynovitis, bursitis, periarthritis.

Since corticosteroids activate slow-onset degenerative processes, knee blockade is contraindicated in cases of severe destruction of bone tissue (chronic deforming arthritis).

For deforming osteoarthritis, only periatricular administration of drugs is allowed. It makes no sense to do new blockades if the previous 2-3 procedures did not bring the desired result.

Contraindications

A knee joint block is not prescribed in the following cases:

blood fluid clotting disorder;
epilepsy;
individual intolerance to the constituent substances in the drugs;
neuropsychiatric disorders;
children under 12 years old;
cellulitis or abscesses in the damaged area;
peritonitis in the abdominal cavity;
stable arterial hypertension;
period of bearing a child;
allergic reactions to injected drugs.

It is very important to consider the conditions under which the blockade cannot be carried out. Otherwise, the procedure is fraught with the development of negative reactions. When used correctly, this technique can reduce the risk of complications.