As I currently work in an interventional pain management- many of my Nurse Practitioner colleagues in Rural Family Practice ask "I have this old patient that has severe arthritic pain, the patient does not want to have replacement surgery, they have been on NSAIDS for a while but now it just not helping their pain as much as it did before. I don't want to start them on opioids right now either due to: NP wanting to avoid treating chronic pain- as in our state NPs cannot prescribe narcotics for chronic pain, potential side effects of opioids (constipation), poly pharmacy or future dependency issues. But, the patient can't drive to another city for a specialist to treat their arthritis pain."
When conservative treatment of arthritic joint pain fails (i.e. weight loss, exercise/PT, NSAIDS, etc.) the nurse practitioner should consider performing corticosteroid joint injection for symptomatic relief, usually in conjunction with previously mentioned treatments. Joint injections have longed been consider an appropriate treatment for arthritic joint pain. My personal experience with joint injections is that these simple in office procedures decrease patients' joint pain and improves their functionality and mobility.
Down and Dirty on Joint Injections:
A patient with less arthritic knee pain as a result of an injection is more likely to increase their activity of daily living- thereby, maintaining or improving lower extremity strength. Improved lower extremity means better stability and hopefully less likely to fall- we all know what happens when they fall.
As the current number of aging patients with mild to moderate OA is staggering with the number only increasing- Learning joint injections is an important skill necessary for the Nurse Practitioner treating our aging population.
Andy Austin FNP-C, FAAPM
www.injectioncourses.com
