Knee Pain Treatment

Osteoarthritis of the knee develops slowly and the pain it causes worsens over time. Although there is no cure for osteoarthritis, there are many treatment options available to help people manage pain and stay active.

Ultrasound Guided Knee Injections

In its early stages, arthritis of the knee can be treated with nonsurgical methods. It is not always necessary to have knee surgery. Dr. Allegra provides ultrasound-guided Knee Injections, an outpatient procedure designed to provide relief for patients with arthritis of the knee. The injection is given using ultrasound guidance for improved accuracy.

He also may recommend a range of treatments, including:

  • Changes in activity level
  • Weight loss
  • Pain relievers, such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) like
  • Physical therapy
  • Corticosteroid injections



If you have tried all other nonsurgical treatment methods and your pain continues to limit your activities, viscosupplementation may be an option. In this procedure, a gel-like fluid called hyaluronic acid is injected into the knee joint. Hyaluronic acid is a naturally occurring substance found in the synovial fluid surrounding joints. It acts as a lubricant to enable bones to move smoothly over each other and as a shock absorber for joint loads. People with osteoarthritis have a lower-than-normal concentration of hyaluronic acid in their joints. The theory is that adding hyaluronic acid to the arthritic joint will facilitate movement and reduce pain. The use of ultrasound improves the accuracy of the injection, whether it is corticosteroids, hyaluronic acid, or other therapies such as Platelet Rich Plasma, Prolotherapy, or Stem Cells. Ultrasound-guided injections allow Dr. Allegra to visualize the needle in real-time as it enters the body and traverses to the desired location. This assures that the medication is accurately injected at the intended site.



Depending on the product used, you will receive one to five shots over several weeks. During the procedure, if there is any swelling in your knee, Dr Allegra will remove (aspirate) the excess fluids before injecting the hyaluronic acid. Usually, the aspiration and the injection are done using only one needle injected into the joint.

For the first 48 hours after the shot, you should avoid excessive weight bearing on the leg, such as standing for long periods, jogging or heavy lifting.

Side Effects

You may notice a local reaction, such as pain, warmth, and slight swelling immediately after the shot. These symptoms generally do not last long. You may want to apply an ice pack to help ease them.


Rarely, patients may develop a local allergy-like reaction in the knee. In these cases, the knee may become full of fluid, red, warm, and painful. If this occurs, contact Dr. Allegra immediately. Infection and bleeding are also very rare complications of this procedure.


For those who report pain relief with the procedure, it may take several weeks to notice an improvement. How long the effects last varies and could be up to 8 weeks. Some patients report pain-relieving effects for several months following the injections.

If the injections are effective they may be repeated after a period of time, usually 6 months. Although some patients report relief of arthritis symptoms with viscosupplementation, the procedure has never been shown to reverse the arthritic process or re grow cartilage.

The effectiveness of viscosupplementation in treating arthritis is not clear. It has been proposed that viscosupplementation is most effective if the arthritis is in its early stages (mild to moderate), but more research is needed to support this. Research in viscosupplementation and its long-term effects continues.

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