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Arthritis

Human Body x-ray with zoom spotlight on brain, wrist joints, shoulder, pelvis, ankle, and knee.

Osteoarthritis Managed with Hyaluronic Gel Injections

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Treatment for Knee, Back, Shoulder, and Elbow Pain

Osteoarthritis affects about 1 in 4 US adults (23.7%) or about 58.5 million people have had a doctor-diagnosed arthritis. As you can see this is an extremely common problem that unfortunately for many leads to disability and or surgery. This article aims to educate the public about alternatives to surgery so they will be able to explore all options.

Gel Hyaluron or Viscous knee joint supplementation is a wonderful alternative that has helped even advanced arthritis sufferers with Kellgren stage 3-4 Osteoarthritis. Joint injected Gel viscous supplementation, also called hyaluron or hyaluronic gel can enhance chondrocyte [cartilage] hyaluronic gel synthesis [production of hyaluronic gel – a natural joint lubricant], prevent the degradation [breakdown] of cartilage and promote its regeneration [growth of cartilage]. Some patients will report reduced pain in other arthritic joints when their knees are injected. Moreover, gel hyaluron viscous injections can reduce the production of proinflammatory mediators and matrix metalloproteinases involved in OA Osteoarthritis pathogenesis [joint destruction].

A mini-review highlights the evidence of hyaluronic gel in reducing osteoarthritis symptoms and structural damage, as well as its ability to delay joint replacement surgery. Visco-supplementation with gel hyaluronic joint injections should be considered as a long-term therapy.

What is Osteoarthritis?

Osteoarthritis (OA) is a chronic degenerative joint disease that demonstrates progressive damage of articular cartilage and underlying bone. It is a common rheumatic [arthritic] disease that affects both genders and the majority of older people, but also younger people with consequent loss of workdays (1).

The most important symptom is pain in joints, accompanied by morning stiffness, usually of short duration, aggravated by movements, and reduced or relieved by rest. In addition, joint damage causes a progressive functional limitation from the pain and associated dysfunction (2).

As part of the overall management of patients with osteoarthritis, it is important to use a therapeutic strategy including physical therapy and rehabilitation, analgesics [not including NSAIDS, steroids or prednisone], chondroprotective agents and intra-articular treatment with infiltrative substances such as hyaluronates, Prolotherapy- Prolozone, PRP-Platelet Rich Plasma or Bone Marrow Messenger Signaling Cell Injections. (3).

Viscosupplementation (VS) with intra-articular hyaluronic gel (IA-HA) is a well-established treatment option in Knee Osteoarthritis and is included in the professional guidelines for the treatment of the disease in KNEE joints, but it should apply to all synovial joints in order to reduce pain, improve joint function and counter the joint damage that occurs in arthritic joints. (4).

Unfortunately, currently insurance, only covers hyaluronic gel injection to arthritis knees, even though it is clear that all joints have the potential to benefit. At Kentuckiana Integrative Medicine- Kentuckiana Medicine all of the above treatment modalities are available to patients.

HA – Hyaluronic Gel Mechanism of Action:

HA is a non-sulfated glycosaminoglycan consisting of alternately repeating D-glucuronic acid and N-acetylglucosamine units. HA exists naturally in various animal tissues, including rooster combs, shark skin, bovine eyeballs, bovine nasal cartilage, rabbit brain, and heart, and in various human tissues, including the umbilical cord, serum, vitreous body, dermis, epidermis, thoracic lymph, urine, and synovial fluid (SF). However, the highest amounts of HA in the human body are found in the ECM of soft connective tissues (5).

HA can bind to specific receptors expressed in many cells. This binding triggers various intracellular signal events such as cytokine release and stimulation of cell cycle proteins. The consequence of these interactions is to stimulate cell functional activities such as cell migration and proliferation (8).

In osteoarthritic joints, synovial fluid contains a lower concentration of HA than in healthy joints, so intra-articular therapy with exogenous [external hyaluronic gel] injected into a joint can restore the joint viscoelastic and functional properties helping one to move pain-free or at least with less pain and friction. The reality is that hyaluronic gel injections can enhance chondrocyte [cartilaginous regeneration] or synthesis of endogenous [from one’s own body] HA and proteoglycans, prevent the degradation of cartilage and promote its regeneration. Hyaluronic gel injections can reduce the production of proinflammatory mediators and matrix metalloproteinases, and reduce nerve impulses and nerve sensitivity associated with Osteoarthritis pain (9).

Patient Improvements with a variety of arthritic joints:

Globally, data indicate that intra-articular hyaluronan preparations provide Osteoarthritis OA pain relief that is comparable to or greater than that observed with conventional treatment, NSAID medications, intra-articular corticosteroids, arthroscopic lavage, physical therapy, and exercise (10).

Remarkable that these simple injections can perform better than Physical Therapy and or surgery. Our experience at Kentuckiana Medicine is that best outcomes are achieved with Fluoroscopic Guided injections weekly x 5, and Physical Therapy [Note; Not many cinics offer fluoroscopic guidance which means their injections miss the joint 33% of the time. A recent systematic review showed that Hylan GF-20 is a safe and effective treatment for decreasing pain and improving function in patients suffering from knee but also HIP Osteoarthritis. More evidence is emerging for the use of hyaluronic gel injections in other joints (19).

In patients with osteoarthritis, non-steroidal anti-inflammatory drugs (NSAIDs) consumption to reduce pain is often inappropriate and related to both high gastrointestinal and cardiovascular morbidity and increasing mortality rate. On the other hand, HA intra-articular joint injection treatment is well tolerated and is associated with a low incidence of adverse effects. A multicentric, open, and retrospective study, that enrolled more than two thousand patients, has investigated if NSAID consumption may be reduced by the use of ultrasound-guided intra-articular injection of several hyaluronic gel (HA) products in hip joint administered in patients affected by symptomatic hip OA.

The use of NSAIDs was reduced by 48.2% in the third month when compared with baseline values. This sparing effect increased in the 12th and 24th months with a reduction respectively of 50% and 61% in comparison to baseline values. These data point out that intraarticular hyaluronan preparations provide OA pain relief and reduce NSAID consumption in a large cohort of patients for a long period of follow-up (20). This tremendous reduction in the dangerous long-term use of NSAIDs is a breakthrough in that patients are protected from the risks of gastrointestinal bleeding and heart attacks while simultaneously experiencing less pain and more quality of life.

Hyaluronic  Gel is Useful in OA Treatment

Hyaluronic Gel is a useful tool in OA treatment, with a potential structure-modifying activity. The structural effects of HA given as 5 weekly injections were evaluated by micro arthroscopy and morphological analysis of biopsy samples taken at baseline and after 6 months in an open clinical trial on 40 patients with knee osteoarthritis. At 6 months, the micro arthroscopic evaluation indicated that the majority of the patients (60%) showed no changes compared to baseline, while 32.5% of the patients showed improvement in the grading and/or extension of cartilage lesions …. And these changes were accompanied by a statistically significant reduction in the synovial inflammation.

At 6 months, compared to baseline, a statistically significant reconstitution of the superficial amorphous layer of the cartilage, an improvement in the chondrocyte [cartilage] density and vitality, and a statistically significant reduction in synovial inflammation accompanied by a significant increase in the synovial repair process were observed (21). Other prospective studies demonstrate microscopically significant joint structure and quality of life measured improvement not just in Knees but also in Hips and other joints. At 6-12 months, joint cartilage thickness is consistently improved in those patients treated with hyaluronic gel injections.

Outcomes Research in Knees and Hips Treated with Hyaluronic Gel:

The time to TKR Total Knee replacement in 75% of knees was (3.8 years) (26). In another study, 120 patients candidates for a total hip replacement, received hyaluronic gel injections and 51% of these patients did not undergo total hip arthroplasty at 3 years after HA injections (27). Avoiding the risks of surgery for 3+ years is a worthy consideration for many patients. At 24 months, 159 out of 176 (90%) patients did not undergo THR. At 48 months, 82% (N = 144) of the study population treated with intra-articular hyaluronic gel avoided THR. In the group of 93 patients considered candidates for THR, only 17 had undergone THR, with survival results of 82% at 24 months. At 48 months, this percentage reduced to 66% in this group (29).

HA as Long-term Therapy Approach:

In consideration of HA Hyaluronic Gel Joint Injections’ clinical and structural effectiveness and tolerability, therapy with hyaluronic gel gel can be regarded as a legitimate long-term therapy approach to osteoarthritis of a variety of arthritic joints. In particular, AMELIA (Osteo Arthritis Modifying Effects of Long-term Intra-articular Adant) study (30) showed the benefit of treatment with more than one course of hyaluronan. ……. Significant differences were found in favor of HA for pain, function, and patient global assessment. The results of AMELIA offer important evidence that repeated cycles of intra-articular injections of HA not only are safe and improve knee osteoarthritis symptoms during the in-between cycle period but also exert a marked carry-over effect for at least 1 year after the last cycle.

Summary:

Intra-articular hyaluronic gel is a useful therapeutic tool in the management of patients with osteoarthritis of many different joints. Literature data demonstrates hyaluronic gel’s ability to reduce pain and improve joint function. Moreover, considering its high tolerability, its ability to counter structural joint damage, and delay the use of joint replacement surgery, it can be seen as a safe and effective long-term therapy.

Kentuckiana Integrative Medicine can help treat your osteoarthritis pain. We have a team of experienced practitioners who can help you develop a treatment plan that’s right for you. Contact us today to schedule an appointment.

REFERENCES:
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Man holding Shoulder in pain

Hyaluronic Gel for Osteoarthritis Pain in Knees & Shoulders

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Cheerful active senior couple jogging in the park. Exercise toge

Hyaluronic gel, also known as hyaluronic gel injection or viscosupplementation, is a medical treatment that involves injecting a gel-like substance containing hyaluronic fluid medication into the joints, typically the knee or shoulder, to provide relief for osteoarthritis pain. Osteoarthritis is a degenerative joint disease characterized by the breakdown of cartilage, leading to pain, stiffness, and reduced joint function. Hyaluronic gel is a natural component of joint fluid and cartilage and is believed to help lubricate and cushion joints.

How It Works

Hyaluronic gel injections are intended to mimic the natural synovial fluid present in healthy joints, thereby improving joint lubrication and shock absorption. The injections may also have anti-inflammatory effects, reducing pain and swelling associated with osteoarthritis.

Benefits:

  1. Pain Relief: Hyaluronic gel injections can provide relief from joint pain associated with osteoarthritis. Some patients experience reduced pain and improved joint function, allowing them to engage in daily activities with less or no discomfort. In fact, one of our 70-year-old patients went snow skiing after completing his series of 5 injections. A 95-year-old lady with stage 3-4 osteoarthritis and a femoral condyle fracture got rid of her walker by the fourth injection and she could go down 10 steps to do laundry.
  2. Improved Joint Mobility: By lubricating and cushioning the joints, hyaluronic gel injections can help improve joint mobility and flexibility.
  3. Non-Surgical Option: Hyaluronic gel injections are a non-surgical alternative to manage osteoarthritis pain, which can be particularly appealing for patients who wish to avoid surgery or who are not candidates for surgical interventions due to poor health, especially poor heart health.
  4. Minimal Downtime: The injections are typically administered in a healthcare setting and do not require a lengthy recovery period. Patients can usually resume their regular activities shortly after the procedure.

Considerations:

  1. Variable Results: While some patients experience significant pain relief and improved joint function after hyaluronic gel injections, the results can vary from person to person. Not everyone will respond positively to the treatment; however, most patients do respond very positively to hyaluronic gel injections. Hyaluronic gel injections are especially effective when injections are performed with direct visualization using fluoroscopic X-ray or Ultrasound guidance as is the case at Kentuckiana Medicine. You and your doctor will see correct and precise needle placement within the joint with every procedure. Many clinics DO NOT use direct visualization and consequently misplace the medication 1 out of every 3 injections according to research studies. One can imagine less than ideal results if every 3rd injection is not correctly placed within the joint space.
  2. Duration of Effects: The effects of hyaluronic gel injections are not permanent. The duration of pain relief can vary, and some patients may need repeat injections to maintain the benefits. Benefits can last 6 -36 months or longer depending on each individual’s stage of arthritis. Medicare allows for 5 injections [one per week] which may be repeated every 6 months if the patient benefits from the first series of injections and if the pain and dysfunction are returning.
  3. Cost: Hyaluronic gel injections can be costly, and insurance coverage may vary. Patients should discuss the cost and potential insurance coverage with their healthcare provider. Traditional Medicare offers full and complete coverage so NO COST to the patient. Other commercial insurances offer full or partial coverage. Having little to no out-pocket cost is a tremendous advantage. Not needing to take time off work for rehabilitation is also a significant cost saver. With many deductibles ranging between $5-10,000, hyaluronic gel injections are often a more affordable and successful treatment.
  4. Medical Assessment: Not all individuals with osteoarthritis are suitable candidates for hyaluronic gel injections. A thorough medical assessment by a healthcare provider is necessary to determine if the treatment is appropriate.

Conclusion:

Hyaluronic gel injections can be a viable option for managing pain associated with osteoarthritis in the knees and shoulders. If you’re considering this treatment, it’s essential to consult with a qualified healthcare provider who can evaluate your condition, discuss potential benefits and risks, and guide you in making an informed decision about the best approach to managing your osteoarthritis pain.

Kentuckiana Integrative Medicine can help treat your osteoarthritis pain. We have a team of experienced practitioners who can help you develop a treatment plan that’s right for you. Contact us today to schedule an appointment.

AdobeStock_39050624-scaled-600x600

Prolotherapy Injection Therapy

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Young couple doing their stretches in the park

Prolotherapy, short for “proliferative therapy,” is a medical treatment that involves the injection of substances, typically an anesthetic like procaine or lidocaine, vitamins, and dextrose (a type of sugar solution), into injured or painful areas of the body, such as joints, tendons, ligaments, and soft tissues.

The goal of prolotherapy is to stimulate the body’s natural healing processes, promote tissue repair, and alleviate pain in areas that may not be healing properly on their own.

How Prolotherapy Works

Prolotherapy is based on the principle that the injection of a mild irritant solution into damaged or weakened tissue triggers a localized inflammatory response. This response encourages increased blood flow, recruitment of healing cells, and deposition of new collagen fibers, ultimately strengthening and stabilizing the injured area.

Conditions Treated:

Prolotherapy is often used to treat a variety of musculoskeletal conditions, including:

  1. Joint Pain: Prolotherapy can be used for conditions like osteoarthritis, where the injection aims to provide pain relief and improve joint function.
  2. Tendon and Ligament Injuries: Prolotherapy is used to target areas of chronic pain or instability caused by tendon and ligament injuries.
  3. Chronic Back Pain: It may be considered for chronic back pain caused by ligament laxity or instability.
  4. Sports Injuries: Prolotherapy is sometimes used to address sports-related injuries, such as sprains, strains, and overuse injuries.

Benefits and Considerations:

  1. Non-Surgical Approach: Prolotherapy offers a non-surgical option for pain relief and tissue repair, which can be appealing to individuals who want to avoid surgery.
  2. Minimally Invasive: The injections are minimally invasive and are typically performed in an outpatient setting. Recovery time is usually shorter compared to surgical procedures.
  3. Individual Response: Responses to prolotherapy can vary among individuals. Some patients experience significant pain relief and improved function, while others may experience more modest results.
  4. Multiple Sessions: Multiple prolotherapy sessions are often required to achieve optimal results. The injections are typically spaced several weeks apart. On average 4 sessions are needed.
  5. Evidence: The scientific evidence supporting the effectiveness of prolotherapy is mixed. While the majority of studies suggest benefits and most patients improve, others show limited or inconclusive results.
  6. Qualified Practitioners: Prolotherapy should be administered by qualified healthcare professionals who are trained and experienced in the technique.

Conclusion

Prolotherapy is an alternative treatment approach for musculoskeletal pain and injuries that aims to stimulate the body’s natural healing response. It may be a consideration for individuals seeking non-surgical options for pain relief and tissue repair. If you’re considering prolotherapy, it’s important to consult with a qualified healthcare provider who can assess your condition, discuss potential benefits and risks, and determine if this treatment is appropriate for your specific needs.

Kentuckiana Integrative Medicine can help you recover from conditions that cause musculoskeletal pain, such as joint injuries or tendon & ligament injuries. We have a team of experienced practitioners who can help you develop a treatment plan that’s right for you. Contact us today to schedule an appointment.

Boxer receiving treatment for a torn muscle

Prolozone Injection Therapy

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View of Skeleton with joints highlighted

Prolozone therapy is an alternative medical treatment that involves the injection of a mixture of ozone gas with or without prolotherapy into painful or injured areas of the body, such as joints, tendons, ligaments, and soft tissues. The goal of prolozone therapy is to stimulate tissue repair, reduce inflammation, and alleviate pain by increasing oxygen delivery and circulation to the treated area. This therapy is often used as a potential option for musculoskeletal pain, including conditions like osteoarthritis and joint injuries.

How Prolozone Therapy Works

Prolozone therapy combines two components: ozone gas and a mixture of nutrients, which can include vitamins, minerals, and homeopathic substances. Ozone gas is a molecule composed of three oxygen atoms (O3), and it has been proposed to have potential healing properties due to its ability to increase oxygen utilization in tissues and modulate inflammation.

During a prolozone therapy session:

  1. Preparation: The skin over the treatment area is cleansed, and the injection site is prepared.
  2. Injection: A mixture of ozone gas and nutrients is injected into the targeted area using a fine needle. The injection aims to improve oxygen delivery, stimulate healing, and potentially reduce pain and inflammation.
  3. Response: The localized introduction of ozone gas can stimulate an oxidative response, which is believed to promote tissue repair and the production of collagen, a protein that plays a crucial role in tissue strength and stability.

Potential Benefits:

  1. Pain Relief: Prolozone therapy is intended to provide relief from pain associated with musculoskeletal conditions, injuries, and inflammation.
  2. Tissue Repair: The treatment’s goal is to stimulate tissue healing and repair by promoting collagen production and increasing oxygen delivery to the area.
  3. Reduced Inflammation: Ozone has been suggested to have anti-inflammatory effects, which may contribute to pain reduction and improved function.
  4. Non-Surgical Approach: Prolozone therapy offers a non-surgical option for individuals seeking pain relief and improved joint function.

Considerations:

  1. Scientific Evidence: The scientific evidence supporting prolozone therapy is significant and supported by numerous pubmed research articles and patient’s experiences. Prolozone has been offered in Germany for over 70 years More research is needed to establish its efficacy and safety.
  2. Patient Response: Responses to prolozone therapy can vary among individuals. While some patients report positive outcomes, others may not experience significant benefits.
  3. Qualified Practitioners: Prolozone therapy should be administered by qualified healthcare professionals who are trained and experienced in the technique.
  4. Alternative Treatments: Individuals considering prolozone therapy should also explore evidence-based treatments, including conventional medical interventions and physical therapies.

Conclusion:

Prolozone therapy is an alternative treatment option that aims to stimulate tissue repair, reduce inflammation, and alleviate pain by injecting a mixture of ozone gas and nutrients into affected areas. While some individuals report positive outcomes, the scientific evidence supporting its effectiveness is limited. If you’re considering prolozone therapy for musculoskeletal pain or injuries, it’s important to consult with a qualified healthcare provider who can assess your condition, discuss potential benefits and risks, and guide you in making an informed decision about the best approach to managing your pain and promoting healing.

Kentuckiana Integrative Medicine can help you recover from conditions that cause musculoskeletal pain, such as osteoarthritis and joint injuries. We have a team of experienced practitioners who can help you develop a treatment plan that’s right for you. Contact us today to schedule an appointment.

Red Light Therapy from Kentuckiana Integrative Medicine

Low-Level Laser Therapy for Pain & Inflammation

Woman with lower back pain sitting on sofa

What Conditions Can Low-Level Laser Therapy Treat?

Low-Level Laser Therapy (LLLT) has been shown to accelerate tissue repair and reduce inflammation and pain. In addition, laser Treatment has low side effects and reports pain relief.

LLLT has been used in the treatment of several acute and chronic conditions, such as:

  • Chronic pain
  • Carpal tunnel syndrome (CTS)
  • Fibromyalgia
  • Osteoarthritis
  • Rheumatoid arthritis
  • Joint disorders
  • Wound healing
  • Chronic low back pain
  • Acute and chronic neck pain

Compromised cells and tissues respond better than healthy ones to energy transfers. Cells and tissues negatively affected by inflammation, edema, and injury have shown a significantly higher response to LLLT than healthy cells.

Does LLLT only target poor cells and tissue?

Laser therapy targets all cells. However, because damaged cells are more sensitive to laser light, LLLT strongly affects damaged cells and tissues, leaving healthy ones primarily unaffected.

Benefits of Laser Therapy for Pain

Although there is still much to learn, the effectiveness of Low-Laser Light Therapy to reduce pain has been thoroughly researched. Laser therapy has beneficial effects in treating both short and long-term inflammatory conditions. However, treatment and course of therapy vary in chronic situations. Therefore, results may differ depending on the patient, illness, and how long the chronic condition has been present.

Low-level Laser Light Therapy has been shown to improve pain at the cellular level. Studies show it can:

  1. Increase Beta-Endorphins – Your body naturally produces these pain-blocking chemicals in response to pain.
  2. Increase Nitric Oxide production. – Nitric Oxide helps the blood vessels to expand, increasing circulation and releasing beneficial hormones.
  3. Increased Neuron Action Potential – Nerve latency values have shown improvement with laser therapy.
  4. Nerve Regeneration – Studies have reported a decrease in pain due to cell regeneration after light therapy
  5. Release Acetylcholine – Acetylcholine regulates pain perception in the central nervous system.

Laser Treatment for Inflammation Through Tissue Healing

LLLT aims to build up your body’s natural healing process. Low-level laser light accelerates and enhances the body’s biological healing activities. LLLT works to reduce pain and inflammation by speeding up the healing process. Once inflammation and pain are reduced, the body’s natural ability to repair and heal itself is improved.

Some Laser Therapy is FDA Approved

The FDA has recently approved some Low-Level Laser Therapies to treat conditions such as:

  • carpal tunnel
  • cervical neck pain
  • low back pain
  • joint pain
  • generalized muscle pain
  • wound healing

Laser Therapy for pain management is becoming more common. In addition, clinical research is increasing, showing more potential for this non-invasive treatment. Kentuckiana Integrative Medicine offers Low-level laser therapies to treat some conditions.  Schedule an appointment to discuss if LLLT treatment is right for you.

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Doctor giving hyaluronic gel injection for knee pain

Can Hyaluronic Gel Injections Manage Osteoarthritis & Joint Pain?

Doctor giving hyaluronic gel injection for knee pain

What is Hyaluronic Gel, and How Does It Work in the Body?

Hyaluronic acid is a substance that occurs naturally in various animal and human tissues. It is made up of repeating units of glucuronic acid and N-acetylglucosamine. In the human body, it is found in the highest amounts in the extracellular matrix (ECM) of soft connective tissues. Hyaluronic acid can attach itself to specific receptors located on many cells.

Once the binding takes place, it sets off different chains of events within the cell, such as cytokine release and activation of cell cycle proteins. The result is the stimulation of various cellular functions like migration and growth. When there is less Hyaluronic acid in the joints, it causes osteoarthritis.

To ease pain and make movement more fluid, exogenous [external Hyaluronic Acid] is injected as a form of therapy. It acts as a lubricant and shock absorber. Hyaluronic gel injections can help to improve the cartilage in your body, as well as prevent further degradation. In other words, it can both bring pain relief and promote healing at the same time! Not to mention that these injections can also reduce inflammation throughout the body.

Currently, Medicare and Commercial Insurance will only pay for Hyaluronic gel injections to treat knee joint pain. However, Hyaluronic gel injections are still an excellent treatment option for long-term therapy for osteoarthritis and joint pain to avoid the risks of surgery. The injections help to prevent the degradation of cartilage and promote its regeneration. They also help to reduce inflammation and pain associated with Osteoarthritis.

Hyaluronic Gel Injection is a wonderful alternative that has helped even advanced arthritis sufferers with Kellgren Stage 3-4 Osteoarthritis. At Kentuckiana Integrative Medicine- Kentuckiana Medicine, all the above treatment modalities are available to patients. www.ReGenMedKy.com

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What is Osteoarthritis?

Osteoarthritis is a progressive joint disease that causes damage to articular cartilage and underlying bone. This disease affects many adults in the United States, with 1 in 4 US adults (23.7%) or about 58.5 million people affected. Joint damage from osteoarthritis can lead to progressive functional limitations due to the pain and associated dysfunction.

The Benefits of Hyaluronic Gel Injections for Osteoarthritis and Joint Pain

Cheerful active senior couple jogging in the park. Exercise togeHyaluronan injections have been shown to effectively relieve osteoarthritis pain, comparable to or better than other common treatments such as NSAIDs, corticosteroids, physical therapy, and exercise. Remarkably, these simple injections can perform better than Physical Therapy and or surgery. Our experience at Kentuckiana Medicine is that the best outcomes are achieved with Fluoroscopic Guided injections five times weekly and Physical Therapy. Not many clinics offer fluoroscopic guidance, which means their injections miss the joint 33% of the time.

More evidence is emerging that Hyaluronic gel injections can be used to treat other joints. Non-steroidal anti-inflammatory drugs (NSAIDs) are often not appropriate for people with osteoarthritis because they can cause high gastrointestinal and cardiovascular morbidity and mortality rates. On the other hand, Hyaluronic gel intra-articular joint injection treatment is well tolerated and is associated with a low incidence of adverse effects.

A study of more than 2000 patients found that ultrasound-guided intra-articular injection of Hyaluronic Gel products can reduce the need for NSAIDs. The use of NSAIDs was decreased by 48.2% in the third month, 50% in the 12th month, and 61% in the 24th month.

This tremendous reduction in the dangerous long-term use of NSAIDs is a breakthrough. Patients are protected from the risks of gastrointestinal bleeding and heart attacks while experiencing less pain and more quality of life.

What Are the Results for Patients?

What are the results of Hyaluronic gel treatment for knee and joint pain? In a study of 120 patients with hip arthritis treated with Hyaluronic gel injections, 51% did not require total knee replacement surgery within the 3-year time frame typical for conventional treatments. In a group of 148 patients considered candidates for surgery, only 17 underwent surgery. The survival rates for those who did have the surgery were 82% at 24 months and 66% at 48 months.

This suggests that many patients may be able to avoid surgery altogether or at least delay it for some time. The verdict? Hyaluronic gel injections are a legitimate long-term treatment approach for osteoarthritis of various arthritic joints.

Should I Try Hyaluronic Gel Injections for My Joint Pain or Osteoarthritis?

Intra-articular Hyaluronic gel injections can help if you are one of many living with osteoarthritis and joint pain. Data from different studies show that Hyaluronic acid gel can reduce pain and make it easier to use the joints.

Because Hyaluronic gel is so well-tolerated and can help reduce damage to joints, it is a safe and effective long-term therapy option. At Kentuckiana Integrative Medicine – Kentuckiana Medicine, all the above treatment modalities are available to patients.

Cheerful active senior couple jogging in the park. Exercise toge

Arthritis Awareness and Non-Surgical Treatment

Each year, May is recognized as National Arthritis Awareness Month. Nearly 1 in 5 adults are affected by arthritis in the United States. Arthritis is also the nation’s top cause of disability, having a profound economic, personal and societal impact in the United States.

Types of Arthritis

Arthritis is the inflammation or swelling of one or more joints. Several conditions and types of arthritis affect the joints, and symptoms often vary depending on the type of arthritis. The most common types of arthritis include:

Osteoarthritis

Osteoarthritis (OA) is the most common type of arthritis that occurs when the cartilage at the end of the joint wears down, causing bone to rub against bone. Osteoarthritis occurs most frequently in the hands, hips, and knees. The most common signs and symptoms of osteoarthritis include pain or aching, joint stiffness, decreased range of motion, and swelling.

Rheumatoid Arthritis

Rheumatoid arthritis (RA) is an autoimmune and inflammatory disease that causes joint inflammation and pain. RA occurs when the immune system doesn’t work properly and attacks the lining of the joints. RA most commonly affects the hands, knees, or ankles.

Psoriatic Arthritis

Psoriatic arthritis is a chronic inflammatory autoimmune disease of the joints where tendons and ligaments connect to bone. This disease can start at any age, although for many people, it appears between ages 30 and 50.

Psoriatic arthritis causes the following symptoms:

  • Fatigue
  • Tenderness, pain, and swelling over tendons
  • Swollen fingers and toes
  • Reduced range of motion
  • Morning stiffness and tiredness

Regenerative Medicine

Regenerative medicine can help many individuals with the above described arthritic conditions as well as torn muscles, ligaments, and tendons. In addition, stiff and achy joints can make it challenging to get through the day.

Before considering surgery, there are many conservative options that may provide significant relief.

  • Physical Therapy
  • Medications
  • Hyaluronic Gel Injections
  • Regenerative Medicine Injections
  • Supplements can be beneficial to reduce the symptoms of arthritis and ligament pain.

Safe Alternative to Arthritis Surgery

Regenerative medicine is also a non-invasive or minimally invasive option that may help patients heal faster without surgery. Messenger Signaling Cells contain the natural healing ingredients found in birth tissues, including collagens, proteins, growth factors, extracellular matrix, amino acids, and more. Regenerative medicine injections help target damaged tissue and deliver healing growth factors precisely where they will be most effective.

Our Regenerative Medicine Techniques include:

  • Prolotherapy
  • Prolozone
  • Messenger Signaling Cell injections may assist the biological processes that enable the body to regenerate itself – helping to relieve pain and repair arthritic joints and torn ligaments, tendons, and or muscles.

Additionally, some nerve injuries have improved with regenerative medicine techniques.

The above management strategies are NOT covered by insurance; however, hyaluronic gel gel “rooster comb” injections are a form of regenerative medicine covered by Medicare and most Commercial Insurances. In addition, we offer a comprehensive program with Ultrasound, X-ray Fluoroscopic Guidance when performing injection therapy [when needed], and Physical Therapy when appropriate. Schedule an appointment and find out why regenerative medicine is a safe, non-surgical alternative to surgery for arthritis.

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Knee Osteoarthritis Reversed

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Knee Osteoarthritis Reversed

Imagine Your Life WITHOUT Knee Pain

NO Surgery – NO Steroids – NO Down time

FDA Approved & Covered By Medicare and Most Major Insurances

Xray of knee with osteoarthritis reversed

Specifically Developed For Chronic Knee Pain and Osteoarthritis

Did you know that over 100 million Americans suffer from knee and joint pain? In fact, pain from osteoarthritis alone accounts for over 25% of all visits to primary care physicians and half of all anti-inflammatory drug prescriptions.

In spite of these facts and the potential complications associated with joint replacement surgery, there is some good news: Relief from your knee pain and lost function can be achieved using a promising nonsurgical technique.

Joint fluid therapy, also known as viscosupplementation, is a new type of FDA-approved treatment approach for pain associated with osteoarthritis and chronic knee pain.

An arthritic painful knee can usually be treated with insurance coverage with hyaluronic gel injections.

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Kentuckiana Medicine

405 E Court Ave #102
Jeffersonville, IN 47130

(812) 282-1575

*Results may vary due to a variety of factors.

Recent Posts

Considering Surgery?  Consider This…

People suffering from knee pain typically try supplements or pain medications before seeking help from a doctor.  When all else fails and the pain is too much, some believe that surgery is their only option.  Before you put yourself through months of immobility, pain, rehabilitation, and hefty medical bills, consider these facts:

Cost

Joint Fluid Therapy:  Covered by most insurance plans including Medicare

Surgery:  Deductible, co-pay, medications, time-off work, etc.

Risk

Joint Fluid Therapy:  No known side effects

Surgery:  Blood clots, infection, poor outcome, addiction to pain medications

Pain

Joint Fluid Therapy:  Little to none

Surgery:  Can be severe for months

Recovery

Joint Fluid Therapy:  Immediate

Surgery:  Months / Years

Frequently Asked Questions

    1.  Will Insurance or Medicare pay for this treatment?

      Our treatment program is covered by Medicare and most major insurance carriers. If you like, we can take your insurance information over the phone to perform a complimentary verification of your benefits.

    2. What is injected into the knee?

      Based on your condition, we utilize an FDA-approved product that goes by various brand names, including Genvisc, Supartz, Orthovisc, Hyalgen, or Synvisc. This substance is similar to the natural lubricant in your knee and can replace the fluids you may have lost over time or due to injury.

    3. I’ve already done this, and it did not work. How is this different?

      If you’ve had these done by an orthopedist, chances are they did the procedure blindly, meaning without x-ray guidance. We use a new technology called fluoroscopic guidance that allows us to see into your knee in real-time, which allows the doctor to see the needle travel directly where it needs to go. If your past doctor did not use this technology, how can you be sure the lubricant got to where it needed to be?

    4. How many treatments will I need?

      Although the length of our treatment plans vary based upon your condition, most patients require a series of 3-5 injections. The doctor can explain the necessary frequency of your treatment during your risk-free, no-cost consultation.

    5. How long will it take before I experience relief?

      This varies by patient, as no two cases are precisely the same. That said, many patients experience relief almost immediately after the first injection.

    6. How long will my pain relief last?

      This depends on your condition. For many patients, relief lasts years, while others may need to return periodically for additional treatments. Most insurance carriers allow for two courses of injections per year if your pain returns.

    7. Are there any side effects to the treatment?

      No known side effects or adverse drug interactions are associated with joint fluid therapy. That said, please make sure your doctor knows of any known allergies or adverse reactions to medication.

    8. If I have had joint replacement surgery, am I still a candidate for treatment?

      No. You would not be a candidate if you’ve had joint replacement surgery on both knees. If, however, you’ve only had one knee replaced, we may still be able to help you with the other knee. Patients with partial knee replacements are often candidates. Our clinician will need to evaluate you.

    9. I was told nothing could help me. Do you think this treatment can help me?

      I understand your frustration. However, there is hope. We frequently see patients that have been told their only option is “to learn to live with the pain or have surgery.” We have been able to help many patients find relief and avoid surgery. The doctor can review your particular case and determine what, if anything, we can do to help. There is no cost or obligation for this consultation.

Is Joint Gel Fluid Therapy Right For You?

If you’ve tried everything to get rid of your chronic, debilitating knee pain and you’ve been told your only other option is joint replacement surgery, then we’d like to help you get a clear picture of what your life could be without chronic and severe joint pain by scheduling a NO COST, NO OBLIGATION consultation.

In less than an hour, you’ll receive a thorough assessment of your problem and provided with our best recommendations you’ll need to recover quickly and begin enjoying a normal life again.

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To reserve your FREE personal consultation,
contact us and take the first step toward saying goodbye to joint pain. 

Request Your FREE Consultation

How to get lasting knee pain relief without drugs or surgery

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Does Messenger Signaling Cell Therapy Work for Arthritis?

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You’ve probably heard about messenger signaling cell therapy for arthritis and knee osteoarthritis, but what exactly is it?

If you suffer from arthritis or osteoarthritis, you have many options for treatment. One of the newest, most promising options today is messenger signaling cell therapy.

Messenger signaling cell therapy uses the very cells you contain in your body to rebuild joint cartilage and heal the chronic pain of arthritis. Learn more about this revolutionary treatment and what’s involved when considering messenger signaling cell therapy by our Louisville doctors for an arthritic knee or other joint.

The Benefits of Messenger Signaling Cells for Arthritis

Arthritis, also known as joint pain and joint disease, is the leading cause of disability in America, affecting more than 50 million adults and 300,000 children. There are more than 100 different types of arthritis and related arthritic conditions, the most widespread being osteoarthritis and rheumatoid arthritis.

Messenger signaling cells are basic human cells that have the ability to become several kinds of cells in the body, including muscles, ligaments, bones and even cartilage.

When applied to an arthritic joint, research has shown messenger signaling cells help develop new cartilage cells.

Do Messenger Signaling Cells Cure Osteoarthritis?

Osteoarthritis is a degenerative joint disease that causes the progressive breakdown of cartilage. The cartilage on the ends of your bones helps cushion the joints. When that cartilage starts to break down, it leads to pain and grinding sensations.

More and more research shows the effectiveness of messenger signaling cells for arthritis to help grow and repair cartilage, and even promote the formation of new tissue. With all procedures involving stem cells, recovery time is faster than conventional medicine.

Messenger Signaling Cells: A Safe, Effective Treatment Option To Avoid Surgery

Messenger signaling cells therapy has been demonstrated as a safe, effective treatment option for arthritis without the use of pain medications, steroids or surgery.

Not only is messenger signaling cell therapy effective for arthritis pain; it also works as an alternative to invasive reconstructive knee therapies, such as a total knee replacement or an arthroscopic knee surgery.

Our medical doctors and holistic wellness staff at Kentuckiana Integrative Medicine can diagnose your joint pain and provide messenger signaling cell treatment to stimulate the creation of new cartilage cells and to reduce inflammation and pain in the joint.

We may also recommend other alternative medicine therapies to complement your treatment, like PRP injections.

Schedule An Appointment At Kentuckiana Integrative Medicine in Louisville For Messenger Signaling Cell Therapy For Arthritis!

Messenger signaling cell injections at our integrated medical clinic can help you avoid joint surgery and complete joint replacement. If you want to end your arthritis pain without surgery, you may be a good candidate for messenger signaling cell therapy.

Do you want to find out more about our messenger signaling cell treatment in Louisville to help reduce your osteoarthritis pain?

To schedule an appointment with our messenger signaling cell doctors in Louisville for your knee and joint pain, call us now!

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About Us

405 E Court Ave #102, Jeffersonville, IN 47130
(812) 913-4416

DISCLAIMER NOTICE: We make NO claims that ANY of our supportive therapies can cure or heal any disease process. Our treatments and therapies can provide symptom relief and support your bodies self-healing mechanisms. Only FDA approved therapies can be declared curative of disease. All information including video testimonials are purely educational and no implied or direct claims of a patient experiencing a benefit are made. Results CANNOT be guaranteed and vary based on multiple variables especially patient’s level of health and receptiveness. Only GOD, you and FDA therapies can cure you of a disease. Additionally, educational information regarding many of the services and or commercial products discussed are NOT offered. Our focus is on Injections of Prolozone, Prolotherapy, Platelet Rich Plasma, Harvested Adipose “Fat” and Bone Marrow Messenger Signaling Cells all collected administered as within same day procedure FDA guidelines with minimal manipulation [no enzymes are used.] 

Regarding Stem Cell Injection Therapy and Regenerative Medicine Pain Relief Injections, we are one of the most experienced clinics in the USA. Our most experienced physician has been providing these services since 2010 which were the early days of Platelet Rich Plasma and Stem Cell Therapy. We are extremely experienced in the use of ultrasound and fluoroscopy guided injections offering precision needle placement when needed. We focus on FDA approved procedures and products [especially wound care that are even approved by some insurances] and FDA approved and permitted “same day procedures” that include but are not limited to Collecting [Harvesting] a patient’s Adipose “Belly Fat” Messenger Signaling Cells and Bone Marrow Messenger Signaling Cells, Platelet Rich Plasma Injections [from your blood], Prolozone and Prolotherapy. Collection of “fat” messenger signaling cells and bone marrow messenger signaling cells can be done very comfortably and with very little or no pain with proper numbing techniques. Currently, the FDA allows the above “same day procedures” or injection therapies under FDA rule 21 CFR 1271.15.  The FDA has approved a very few injectable commercial regenerative products under FDA rule 21 CFR 1271.10 mostly wound care products for homologous use with skin problems such as burns and wounds.

FDA DISCLAIMER: Our treatments are considered “off-label,” meaning they are not FDA approved to diagnose, treat, cure, or prevent any disease or condition. Individual results will vary depending on each patient’s overall health and mindset, and no outcomes are guaranteed. These therapies are intended to support the body’s natural healing response and may help improve function and quality of life. Testimonials reflect individual experiences and do not imply or guarantee that you will experience similar results.

© Kentuckiana Integrative Medicine 2025