If you suffer from osteoarthritis, especially of the knees, you may be interested in learning about rooster comb injections.

Viscosupplementation is the process of injecting hyaluronic acid, a natural occurring substance found in normal joint fluid, as a lubricant into the joint to improve pain, prevent bones from rubbing against each other, and provide cushioning. Originally the drug was manufactured from rooster combs, the red, fleshy growth on the top of the rooster’s head, but today much of the supply is synthetically manufactured.

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How it works

Viscosupplementation — sometimes called rooster comb injections — has become a popular arthritis treatment especially for people who cannot take or don’t respond well to NSAIDs (non-steroidal anti-inflammatory drugs) . The theory, according to the American Academy of Orthopaedic Surgeons (AAOS), is that adding hyaluronic acid to the joint will make movement easier and ease pain. It has been used for knees, hips and ankles in cases of mild to moderate arthritis.

Treatment might range from a one-time injection to weekly shots for three to five weeks, reports WebMD . Pain relief is not instantaneous but for those who find the shots helpful, improvement comes within several weeks and can last for several months.

Benefits of rooster comb

Results are mixed over rooster comb as an arthritis treatment. Studies show that some people find relief, while others show no improvement for their arthritis.

Researchers from the University of Queensland in Brisbane reviewed 76 studies examining the use of hyaluronic acid for treating knee osteoarthritis and found pain levels in the average patient were reduced by 28 to 54 percent. That's similar to what an arthritis patient might expect from taking NSAIDs, points out the Arthritis Foundation .

Researchers found that injecting fluid into the joint also improved the ability to move and perform daily activities by 9 to 32 percent.

Studies indicate that injecting supplemental hyaluronic acid may coax the joint into increasing its own production of this important fluid, which may in turn help preserve cartilage. “There’s a lot of data to suggest that it can slow the disease down,” said Dr. Roland W. Moskowitz, Case Western Reserve University rheumatologist and coauthor of the Osteoarthritis Research Society International.

A study in the Journal of the Federation of American Societies for Experimental Biology (FASEB) found that the injections can help maintain joint health and function.

However, the AAOS points out that "the procedure has never been shown to reverse the arthritic process or re-grow cartilage."

The rub

It can take several weeks for patients to get pain relief from rooster comb injections. By contrast, corticosteroid injections, another popular treatment for osteoarthritis, provide significant relief within days. It’s not uncommon for someone looking for pain relief to get both corticosteroid injections and rooster comb injections during the same doctor visit. The latter in seeking long-term relief, while steroids provide quick results. Many insurance policies cover both treatments.

Also, overuse of corticosteroids has been found to break down cartilage in the joint leading to further problems. The most common side effect of hyaluronic acid is pain and swelling at the site. “Hyaluronic acid is not a magic pill,” says Moskowitz. But it may play a helpful role in treatment.