Simple oral pain killers (analgesics) such as paracetamol and codeine are usually helpful in managing the pain associated with acute knee injury and arthritis.  There are vast arrays of analgesics available in different forms, so if one type doesn’t help there are often alternatives available.  Stronger analgesics require a prescription so please discuss with your GP or consultant.

Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and diclofenac can often be taken with other analgesics to help reduce swelling, inflammation and pain.  These medications should be used with caution as they can cause gastrointestinal side effects if taken for a prolonged period.  NSAIDS should be avoided in people who suffer from severe asthma or chest problems and in those people with kidney problems.  Please seek advice from your GP or consultant.

Corticosteroids are powerful anti-inflammatory agents that can be injected into, or around, joints and muscles.

They can be given to help reduce the pain and swelling produced by inflamed joints and soft tissues.  Usually steroid injections are used to treat acute ‘flare-up’ pain associated with mild to moderate arthritis.  Steroid injections usually take several days before they begin to improve symptoms and some patients find that the joint may initially become more painful for a short time.  The benefit gained from steroid injections varies from patient to patient – typically symptoms are improved for a few months.

There are concerns that prolonged or excessive use of corticosteroids may actually cause harm to the joint and alter the body’s own immune system.  For these reasons their use is usually limited to 2–3 injections per year.

Viscosupplementation is an injection treatment to help relieve the pain of knee or hip osteoarthritis.  The injection contains hyaluronic acid which is a naturally occurring molecule that helps provide cushioning and lubrication within a normal joint.

The injection is given as an outpatient or day case procedure and usually takes 15 to 20 minutes.

The effects of viscosupplementation tend to be similar to corticosteroid injections, although longer-term benefit has been shown in a number of studies.  The treatment is not effective in all cases, and is not helpful in more advanced arthritis.