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Knee pain and degenerative knee conditions can occur at any age, and what is concerning is that they significantly impact daily life. Therefore, it is important to see a specialist promptly for proper diagnosis and treatment.

Currently, there are both surgical and non-surgical treatment options. For non-surgical treatments, aside from oral medications or topical applications, there are also treatments involving injections into the knee joint, including steroid injections, hyaluronic acid injections, and platelet-rich plasma PRP injections that help reduce pain and inflammation, allowing the knee to function well again. It is important to understand the differences to choose the most appropriate treatment.

Non-surgical Knee Treatment Methods

	Steroid Injections (Steroid)	Hyaluronic Acid Injections (Hyaluronic Acid)	Platelet Injections PRP (Platelet Rich Plasma)
Treatment Methods	– The doctor will inject a steroid mixed with an anesthetic into the knee joint. You may feel a squeezing or burning sensation, which acts quickly to reduce pain and inflammation within 24 – 48 hours and can last up to 12 weeks. It should not be injected more than 4 times per year.	– The doctor will inject synthetic joint fluid or hyaluronic acid directly into the knee joint space, which acts as a lubricant and helps absorb shock, preventing the cartilage surfaces from rubbing against each other. It can last for 3 – 6 months and can be repeated as appropriate and recommended by the doctor.	– The doctor will inject plasma with a high concentration of the patient’s own platelets (PRP) which has been processed to remove red and white blood cells, leaving a high concentration of platelets and growth factors suitable for treatment. This is injected back into the injured area needing treatment. There may be minor pain and swelling after the injection, and the number of injections depends on the doctor’s discretion.
Treatment Highlights	– Steroids have anti-inflammatory effects on body tissues, reducing localized inflammation and acting quickly to alleviate pain and inflammation within 24 – 48 hours.	– Hyaluronic acid injections help reduce pain and inflammation, improve mobility, and allow for a better quality of life.	– The patient’s own concentrated platelets (PRP) stimulate the release of substances that repair and regenerate tissues faster than normal mechanisms, increasing lubricating fluid that helps reduce friction and aids in pain relief and the restoration of bones, joints, tendons, and muscles .
Recommended for	– Those with knee pain from inflammation – Patients who do not improve with medication – Patients who cannot take anti-inflammatory drugs	– Patients with early to moderate knee degeneration – Patients who do not improve with painkillers and anti-inflammatory drugs along with physical therapy – Patients whose knees are not clearly inflamed to the point of needing steroid injections – Patients waiting for knee replacement surgery or those not ready for it – Patients who cannot undergo knee replacement surgery	– Younger patients in the early stages of the disease with minimal cartilage damage – Patients with mild to moderate knee degeneration – Patients who do not improve with painkillers and anti-inflammatory drugs along with physical therapy – Patients sensitive to non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen – Patients who cannot receive steroid injections
Possible Side Effects	– Damage to knee joint tissues from steroids – Thinning and discoloration of the skin at the injection site – Increased risk of infection, so the doctor will thoroughly check for internal or skin infections around the knee and review the patient’s history of steroid allergies before treatment.	– Knee swelling and pain from inflammation during treatment	– Knee swelling and pain after injection for about 3 days. If multiple injections are required, the patient must space them out by weeks or months as recommended by the doctor.
Precautions	– The patient must not have an internal or skin infection around the knee – The patient must not be allergic to steroids	– Since hyaluronic acid is mostly extracted from poultry or poultry combs, it is not recommended for patients with a history of allergies to eggs or poultry. Patients should inform the doctor before treatment.	– Before treatment, patients should avoid using or receiving steroid injections for 2 – 3 weeks and stop using various non-steroidal anti-inflammatory drugs (NSAIDs) for at least 1 week – Patients must not take blood-thinning medications 5 days before treatment
Treatment Limitations	– Steroid injections are most effective in the first few treatments and are not suitable for long-term treatment as they may interfere with the body’s natural repair processes. Therefore, if there is no improvement after a while, it is advisable to change the treatment method.	– Hyaluronic acid injections provide slower pain relief than steroid injections – Not recommended for elderly patients or those with severe knee degeneration, significant joint damage, or deformity to receive hyaluronic acid injections	– Not recommended for patients with severe knee degeneration, those with active inflammation and infection, those with blood diseases or abnormal bleeding conditions requiring blood thinners, patients with anemia, or pregnant women to receive platelet-rich plasma PRP injections.

Preventing Knee Degeneration

Control body weight to prevent excess strain on the knees, which can accelerate degeneration.
Adjust behavior to avoid overusing the knees, such as lifting heavy objects, squatting, sitting cross-legged, kneeling frequently or for long periods, etc.
Do not exercise too strenuously or with excessive impact, and avoid frequent bending and straightening of the knees.
Be careful not to injure the knee joints. If injured, seek treatment immediately and do not leave it untreated for long .
Regularly strengthen the muscles around the knees to support and absorb shock effectively.

Information: Dr..Sarit Hongvilai
Specialist in Hip and Knee Joints Bangkok International Hospital

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