A frequent comment from knee pain sufferers is “I went to my doc and got a shot for my knee pain.” In an attempt to get relief, a cortisone shot combined with a local anesthetic is injected into the joint. For some, relief occurs quickly only to find that the knee pain returns after a while and is then followed by another injection. Then the process continues over the next couple of years with a return of knee pain, more injections, and eventual worsening of the condition with the discussion of joint replacement surgery.
Aging and wear and tear are implicated for the decline in joint health. However, there is an issue that may not be presented to patients as they seek care for joint pain. Ongoing research exposes the truth that local anesthetics used to help joint pain actually contribute to cartilage cell damage and worsening of arthritis.
Cartilage Cells Killed by Anesthetic Injection
The journal Knee Surgery, Sports Traumatology, Arthroscopy, official sponsor of the European Society of Sports Traumatology, Knee Surgery, and Arthroscopy published a systematic review study in March 2018 on the detriment of a single-dose anesthetic on knee cartilage. Results of this meta-analysis study dealt a blow to western medicine’s approach to management of cartilage health. It showed that the treatment approach of single-dose local anesthetics injected into knee joints caused cartilage cell death.
The study looked at many different aspects and statistics across several studies. Results showed that when arthritic cartilage cells were exposed to local anesthetics bupivacaine and lidocaine, the cartilage cells experienced injury and damage. Anesthetic injection caused more disease and destruction. Cartilage breakdown occurred first in the outer layers and was then followed by progressive mitochondrial damage inside the cells. As the damage snowballed, it then caused damage to the deeper inner portions or nucleus of the cartilage. The most toxic and harmful anesthetic was lidocaine, whereas bupivacaine, mepivacaine and rivacaine were less toxic.
Cellular toxicity worsened with higher dose, repetitive exposure and type or combinations of anesthetics. The authors stated “single-dose intra-articular administration of local anesthetics impede chondrocyte (cartilage cell) metabolism and should be performed only with low concentrations for selected diagnostic purposes and painful joints. The use of lidocaine should be avoided.”
Lidocaine patches, a topical pain patch also prescribed for chronic musculoskeletal and joint pain was not included in the review study. Lidocaine use as an anesthetic and topical application, however, has a lengthy list of adverse effects including mitochondrial dysfunction and injury. The drug class which lidocaine belongs to has publications starting in the 1950’s and earlier demonstrating its toxicity.
Living with daily knee pain and severe osteoarthritis is without question difficult. If you reach the point of knee replacement surgery, it leaves other challenges in the wake of recovery. Ask anyone who has had knee replacement surgery. They will tell you that flexibility, balance, strength, and walking are very different after surgery. This often leads to the recognition that the “original parts” in good working condition are better than the replacement parts.
The goal of maintaining healthy, durable, strong joints is something we all need to focus on. If your joints have deteriorated substantially and you are on the medical path of steroid and anesthesia injections, then use the least amount of medication possible. Have a thorough discussion with your medical provider regarding the damage that lidocaine and other anesthetics do to cartilage cells. Do not let them dismiss the toxicity and adverse effects of the drug. Use other tools as much as you can to help balance adverse effects and support daily wear and tear if you must use the injections or lidocaine patches. Even if you have had knee replacement surgery, you still want to work on support for the replacement joint structure and to keep other joints in good shape.
Drug Injury or Thinking Outside the Box?
We spend more on health care in this country than many other countries, yet health levels decline. The information presented here hopefully makes you think about several things such as “Why is there such a high need for joint replacement surgery now more than ever? What is driving the need? What can we do to stop this trend? How can I help myself or family member with aging joints?”
Here are some resources to answer these questions.
Help Keep Your Joints Healthy
Cartilage cells require several things for health. Our body needs movement to get nutrients in and waste products out of joints due to limited blood supply to cartilage cells. Strong muscles balanced throughout the body are required to help take the strain off joints. This makes physical activity and regular structural care integral to keeping joints healthy for a lifetime.
Cartilage cells require a variety of nutrients to maintain function and structure. Omega-3 fats like DHA and EPA along with hyaluronic acid help maintain cartilage make-up, internal hydration, and slipperiness. These nutrients are also needed to buffer daily wear and tear from mechanical and biochemical stress. Hyaluronic acid is the substance used by the body to make synovial fluid that baths and hydrates cartilage cells (and skin too!).
Low molecular weight hyaluronic acid, grapeseed extract, and curcumin with black pepper extract absorb into tissues and help preserve and protect mitochondria in cartilage cells. Chondroitin, glucosamine, MSM sulfur, and collagen peptides provide critical structural components of cartilage cells. Other herbs like boswellia serrata, ginger, and feverfew help support joint comfort and daily wear and tear. Magnesium, just like in the brain and muscles, helps buffer cartilage cells from stress, helps improve omega-3 oil functionality and mitochondria working in cartilage cells. Magnesium is essential to cartilage cells.
If your joints feel stiff after sitting for a period of time or when you get out of bed in the morning, your cartilage cells and connective tissues are in need of attention. Protect, support, and nourish your cartilage cells no matter what age or healthcare approach you take to manage your knee or other joint pain. Life is easier when you have healthy original body parts.