What is Hyaluronic Acid?

As we get older, the concentration and quality of the Hyaluronic Acid within joints diminishes. It becomes more watery and less effective at protecting the joint. It is thought that this is a contributory factor in the development of joint pain and stiffness associated with arthritis. Hyaluronic Acid can be produced synthetically and injected into arthritic joints to reduce pain and stiffness. As well as the immediate boost in the concentration of good quality Hyaluronic Acid following the injection, the injection also stimulates the joint to start producing more good quality Hyaluronic Acid of its own.

What Conditions can be treated with Hyaluronic Acid Injections?

Most of the research has focused on the effectiveness of Hyaluronic Acid in the treatment of arthritic joints - predominantly knee arthritis. Studies show that it is can be very effective in the management of mild to moderate knee arthritis. Hyaluronic Acid Injections are an effective alternative to Cortisone Injections in the treatment of pain associated with mild to moderate knee joint arthritis. Research has shown that Hyaluronic Acid Injections are as effective as taking regular strong anti-inflammatory medication and Cortisone injections, but they do not have the same potential risk factors associated with these other options.

Unlike a Cortisone Injection, the effect of a Hyaluronic Acid Injection is often not immediate. It can take 3-4 weeks to notice a significant reduction in knee pain. However, the duration of pain relief following a Hyaluronic Acid Injection is generally longer than a Cortisone Injection in patients with Mild-moderate knee arthritis. Cortisone works very quickly, but on average only lasts around 4 months, whereas Hyaluronic Acid Injections are slower to work, but often provide relief for 6-9 months.

Combining Cortisone Injections and Hyaluronic Acid injections can be a very effective method of managing a flare-up of mild to moderate knee arthritis. The Cortisone Injection provides immediate relief of pain and stiffness and the Hyaluronic Acid Injection extends the period of pain relief and improved function. Hyaluronic Acid Injections can also be combined with PRP Injections. There is some research which suggests that a combination is also better than either in isolation.

Injection Therapist

Gareth Tremain

Our specialist physiotherapist Gareth Tremain completed a Masters degree module in 'Joint & Soft Tissue Injections' at Keele University in 2013 and has undertaken extensive training with specialist doctors, sonographers and consultant physiotherapists to hone his skills in Ultrasound-Guided Injections. He offers a range of Ultrasound-Guided Injections, including Cortisone, Hyaluronic Acid, High Volume and Hydrodilatation to treat a wide range of persistent injuries and chronic pain. Gareth will also advise you regarding the most appropriate exercise programme to complement your injection.

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How many Hyaluronic Acid Injections do I need?

At iPS we use Ostenil Plus which has been developed for single injection use. Some patients opt to have 2 Ostenil Plus Injections (1 week apart) if they are in severe pain and want to maximise the effect of the treatment. From our clinical experience, 2 injections of Ostenil Plus (1 week apart) seem is more effective than 1, but there is no research to back this up, just our own clinical observations.

How often can I have a Hyaluronic Acid Injection?

There is no limit on the number of Hyaluronic Acid / Ostenil Plus Injections you can have. Research has shown that there are no significant side effects from repeated use - This is a major advantage over Cortisone Injections. When you feel the benefit of the Hyaluronic Acid Injection is wearing off, you can simply book in for a repeat injection.

What do I need to do after a Hyaluronic Acid Injection?

It is not uncommon to experience some post injection pain and stiffness for a few days after a Hyaluronic Acid Injection. Therefore we recommend that you limit your activities for a few days. Following this you should gradually increase your activity and work on exercises recommended by your physiotherapist.

What does the Research Say?

Research on the use of Hyaluronic Acid Injections to treat tendon pain is promising for several chronic conditions such as Tennis Elbow, Patellar Tendinopathy and Achilles Tendinopathy. It is thought to help by blocking pain receptors, modulating inflammation, facilitating local tendon nutrition and reduces friction between the tendon and other local structures. Hyaluronic Acid Injections may be a useful alternative to Cortisone Injections for some tendon conditions that are unresponsive to more conservative treatments.