When it comes to chronic joint pain treatment, there are several nonsurgical or minimally invasive options to discuss with patients before recommending open surgery or joint replacement.

“Nonsurgical methods can still be very effective with pain management and improving quality of life in patients with chronic pain,” said Nathan L. McKinney, D.O., orthopedic sports medicine physician with Norton Orthopedic Institute. “Recovery time is significantly shorter compared with traditional surgery, allowing patients to return to their daily activities.”

Injections

Joint injections are an effective nonsurgical treatment option for joint pain. Corticosteroid injections can provide temporary relief by reducing joint inflammation. Hyaluronic acid injections also can be used to reduce pain and improve mobility by lubricating the joint, restoring the natural viscosity of the synovial fluid. Patients often experience rapid pain relief.

Conditions treated

• Osteoarthritis pain
• Knee pain
• Hip pain
• Shoulder pain
• Rheumatoid arthritis
• Inflammatory joint conditions

How the procedure works

1. Diagnosis and planning: Clinical evaluation and imaging are done to confirm joint degeneration or inflammation.
2. Procedure: Hyaluronic acid or corticosteroid is injected directly into the joint under local anesthesia.
3. Recovery: Patients may experience relief within a few days, with peak benefits typically observed within weeks.

Advantages over traditional surgery

• Noninvasive: No incisions required, reducing recovery time
• Quick procedure: Typically performed in an outpatient setting
• Symptom relief: Can be effective in delaying the need for joint replacement surgery

Patients with moderate to severe pain due to osteoarthritis or inflammatory conditions, especially those who have not responded to other conservative treatments, may be good candidates for joint injection treatments.

A 2022 study shows that knee osteoarthritis patients yielded positive results for joint pain relief when combining hyaluronic acid injections with additional treatments, such as corticosteroids and platelet-rich plasma (PRP) therapy.

Platelet-rich plasma therapy

Platelet-rich plasma (PRP) therapy involves injecting concentrated platelets from the patient’s own blood into the affected joint. Platelets contain growth factors that may promote tissue regeneration and repair, making PRP joint injections an effective treatment for chronic joint pain.

Conditions treated

• Osteoarthritis
• Tendon injuries
• Ligament injuries
• Chronic joint pain

How the procedure works

1. Getting started: Blood is drawn from the patient and processed to concentrate the platelets.
2. Procedure: Platelet-rich plasma is injected into the affected joint under ultrasound guidance.
3. Recovery: Patients usually experience improvement within a few weeks, with continued progress over several months.

Advantages over traditional surgery

• Nonsurgical: No need for incisions or lengthy recovery
• Lower risk: Minimal risk of adverse reactions since the treatment uses the patient’s own blood
• Long-lasting Relief: Can provide sustained pain relief and improve joint function

Patients with chronic joint pain, particularly those with osteoarthritis or tendon and ligament injuries, who have not found relief with other treatments, may be good candidates for PRP therapy. Various studies, including Efficacy and Safety of Platelet-rich Plasma Injections for the Treatment of Osteoarthritis (2023), have shown PRP to be a safe and effective treatment for most cases of osteoarthritis.

Minimally invasive tenotomy

Minimally invasive tenotomy, sometimes called TenJet treatment, is a minimally invasive procedure designed to alleviate joint pain and chronic tendon pain without the need for open surgery. This treatment uses a high-velocity stream of saline to precisely target and remove damaged tissue from the affected joint while leaving healthy tissue intact. This minimizes the impact on the joint, promoting better overall joint health and faster recovery. The procedure is guided by ultrasound to ensure accuracy.

Conditions treated

• Tendinopathies
• Plantar fasciitis
• Lateral epicondylitis
• Medial epicondylitis
• Patellar tendinopathy
• Rotator cuff tendinopathy
• Achilles tendinitis
• Calcium deposits

How the procedure works

1. Diagnosis and planning: Ultrasound imaging identifies the exact location and extent of tendon damage.
2. Procedure: Under local anesthesia, a small puncture is made, and the TenJet device is inserted. The high-velocity saline stream targets and removes diseased tissue.
3. Recovery: Patients receive specific post-procedure care instructions and usually experience significant pain relief within six weeks.

Advantages over traditional surgery

• Less painful: Minimally invasive nature results in less postoperative pain compared with open surgery.
• Lower risk of complications: Precision reduces the likelihood of damaging surrounding tissues.

Patients with chronic tendon pain that has not responded to conservative treatments such as rest, physical therapy or medication may be suitable candidates for the TenJet procedure.

Studies have shown positive long-term outcomes, including decreased pain levels, after patients underwent a TenJet procedure (Ultrasound-guided Tenotomy for Lateral Epicondylitis With TenJet Improves Physical Functional and Decreased Pain Outcomes at 1 Year).

Finding relief from chronic joint pain

Treating joint pain with injections, PRP therapy or the TenJet procedure can provide patients with significant pain relief, improve joint function and enhance quality of life with fewer risks and shorter recovery times. Before recommending surgical intervention, providers should discuss nonsurgical treatment options with patients to help determine the best treatment plan for them.