Viscosupplementation - Treatment of Knee Arthritis

Dr. Dan Kendall is an interventional Pain Management Specialist at National Spine and Pain Centers in McLean, Virginia. Recognized by Washingtonian Magazine as a Top Doctor in 2015, 2016 and 2017, Dr. Daniel (Dan) Kendall is experienced in non-surgical pain management treatments including viscosupplementation.

An inadequate amount of the lubricating fluid in the knees and other joints can lead to significant pain and swelling over time. Viscosupplementation involves the injection of hyaluronic acid into the joints to replenish the joint’s normal lubricating fluid. The treatment helps reduce pain by easing the stress that aging and repetitive physical tasks put on the body's cartilage and joints. 

Depending on the patient, the injections may vary from a one-time treatment to a course of treatment over three to five weeks. After each injection, patients need to avoid physical activity for two days before resuming their normal routine. After the treatment, patients report less pain and stiffness for periods of up to six months and reduced reliance on pain medications.

An Introduction to Intradiscal Electrothermal Therapy

With more than 10 years of medical experience, Dr. Daniel (“Dan”) Kendall focuses on interventional pain management at National Spine & Pain Centers. Over the years, Dr. Dan Kendall has familiarized himself with a wide range of pain-relieving therapies, including intradiscal electrothermal annuloplasty (IDEA), also known as intradiscal electrothermal therapy (IDET).

A minimally invasive technique for treating low back pain related to spinal discs, IDET was created in 1997 and is still relatively new compared to some other pain management therapies. However, when performed successfully, it can help patients enjoy good to excellent pain relief without needing to undergo major spinal surgery to remove or replace the damaged disc.

When IDET is performed, patients often receive a local anesthetic or sedative. Physicians then use fluoroscopy to guide them as they insert a hollow needle with a flexible catheter into the spinal disc. This catheter also contains a heating element, and once it’s positioned in the disc’s outer layer, it’s slowly heated to roughly 194 degrees Fahrenheit.

As the catheter is heated, it destroys the nerve fibers in the area and toughens the disc tissue. It also seals small tears. Antibiotics are then administered via the vein or by being injected directly into the disc. Within the next couple of days, patients may experience a temporary increase in pain. By one month, patients can walk and do easy exercises, and by five to six months, they can enjoy strenuous sports such as tennis.