At this step, we consider weight loss, relative rest, physical care, exercises, orthotics, diet and prevention. In patients with excess weight, even modest weight loss can produce a significant improvement in joint pain and a gain in function.
For patients suffering from temporary over-use, rest for a short time, typically 12 to 24 hours can provide relief. Resting for more than 72 hours can lead to muscle atrophy and loss of function.
The manual treatments of your physiotherapy or your chiropractic professional improves function and relieves pain by increasing flexibility and strengthening your musculature. Professional supervision will motivate you to continue your exercises while making sure your technique is safe. They will also be able to give your counselors low-impact exercises, warm-up and proper stretching, and orthotics if needed.
If these interventions are not enough, consider the next step:
At this level, there is an approach with oral medication or an injection approach.
Acetaminophen is the first line at this stage, but anti-inflammatory drugs (by mouth or topical application) and analgesics can also be considered more potent. It will be important to discuss with your doctor the pros and cons of each according to your personal condition.
The injection approach relies mainly on the injection of cortisone, viscosupplementation or platelet-rich plasma.
At the Chiromedic Center, all the injections are done under ultrasound guidance to ensure the accuracy, efficiency and safety of the injection.
Cortisone is a potent anti-inflammatory drug, injected directly into the pain site, which comes into action quickly and can relieve several months. Do not exceed 3 cortisone injections per site per year.
Here are the joints we can treat: shoulder, elbow, wrist, finger, hip, knee, ankle and toe.
Viscosupplementation consists of intra-articular injection of hyaluronic acid. This product is similar to the synovial fluid that naturally lubricates our joints. As we age, our normal joint fluid becomes depleted and loses its elasticity and lubricity. The injection of viscosupplementation aims to restore a damping power and lubricate the joint. A well-lubricated joint will be less painful and should deteriorate less quickly. In addition to protecting cartilage, studies report relief up to a year.
Viscosupplementation is possible in the following joints: Knee, hip, shoulder, ankle, elbow, finger and toe
If pain persists and you need help, our multidisciplinary team will be able to get you back on track quickly.
Although the PRP was initialy used to treat tendon injuries, multiple studies since 2010 support the use of PRP for osteoarthritis, particularly for the knee and hip. There are several types of PRP preparation and we now have a better understanding of the type of PRP that is indicated for osteoarthritis, a platelet-rich plasma that is low in leukocytes. A December 2018 publication even suggests that the PRP would now be the first choice for treatment of osteoarthritis by injection.
This new treatment, which is similar to a treatment of platelet-rich plasma, is produced from a blood sample taken from the patient. It makes it possible to concentrate two plasma proteins which are involved in blocking the production of substances that are toxic to the cartilage inside the joint. It has been available in Canada since the spring of 2019 and would provide relief for up to 2 years after a single injection in certain patients. The Sports Medicine Clinic of L’Avenir is proud to have been one of the first clinics in Canada to offer it as an option to its patients who had failed initial treatments.