Osteoarthritis can cause debilitating pain, stiffness, reduced ability to participate in your activities, and difficulty moving around freely. There are various treatments for knee osteoarthritis, such as pain relief medications or steroid injections. If you have tried all the conservative treatments without much success and want to avoid the implications of surgery, you might want to try hyaluronic acid injections.  

Here at Susan A. Baker, M.D, we offer effective pain management solutions for various conditions or injuries resulting from knee pain, such as hyaluronic acid injections. We expertly diagnose and offer personalized treatments to effectively reduce pain while addressing the underlying condition for lasting relief. Read on to learn more about hyaluronic acid injections and how they work. 

What Are Hyaluronic Acid Injections?

Hyaluronic acid injections are primarily used to treat knee pain caused by osteoarthritis in patients who have tried other treatment options and did not find sufficient relief. Hyaluronic injections are available in gel/jelly and solution form. The injection should only be administered under the supervision of a doctor or nurse. 

The injection contains sodium hyaluronate and is usually injected directly into the joint space where the synovial fluid is. It reduces friction and improves the worn-out cartilage’s oxygen and nutrient supply. Hyaluronic acid injections are also known as viscosupplementation, which means supplementing the joint with viscosity. 

Hyaluronic acid is similar to the naturally occurring substance in the body that lubricates (synovial fluid) joints. It is a humectant, meaning it traps moisture inside cells and tissues for hydration throughout the body and joints. High concentrations of hyaluronic acid are found in joints and eyes (protects eye lenses). Naturally occurring hyaluronic acid has several functions in the joints, including:

Lubricates joints: It binds well to water to produce a viscous, jelly-like fluid. The fluid lubricates and absorbs shock within the joints and helps them work smoothly as they move.

Reduces inflammation: Hyaluronic acid helps reduce joint pain and control inflammation and synovitis in the foot and ankle joints caused by tissue degeneration or injuries.

Bone and cartilage growth: Hyaluronic acid plays an essential part in the growth and development of bone and cartilage in the joints by assisting in the growth of new tissues and cells. 

If you have osteoarthritis, the hyaluronic acid in your joints thins, and they have difficulty gliding smoothly because of cartilage degeneration. This can lead to inflammation, pain, and swelling. The hyaluronic acid injections deliver hyaluronic acid directly into your joints, increasing your joint’s diminishing natural supply. This helps decrease symptoms of osteoarthritis by reducing friction, stiffness, and pain in your joints, allowing them to function smoothly. 

Currently, hyaluronic acid injections have only been FDA-approved for treating knee osteoarthritis, but doctors use it for other joints like the shoulder, hip, thumb, and ankles. It has also been approved for use in certain dermal fillers and during certain eye surgeries.

Hyaluronic acid treatments are most effective in individuals with mild to moderate osteoarthritis and may not be as effective for those with more severe symptoms.

Hyaluronic Acid Effectiveness

According to research, hyaluronic acid effectively manages osteoarthritis, with 30% of patients finding pain relief after treatment. Other studies show that hyaluronic acid injections are more effective than painkillers for some patients with osteoarthritis. Additionally, hyaluronic acid injections have been shown to work as well as corticosteroid knee injections. The treatments work well for some patients more than others. The injections may be less effective in older adults and patients with severe osteoarthritis. It is not entirely clear why some people feel better than others after the treatment.

While the injections offer pain relief and improved function, they do not stop the progression of osteoarthritis and cannot change the underlying cause of the disease. Hyaluronic acid does not cure osteoarthritis. For those who benefit from hyaluronic injections, results appear between 4 to 12 weeks after the initial injection, with symptom relief lasting anywhere from six months to a year or more in some cases. To maintain results, you may require a series of hyaluronic injections one week apart for three to four injections. The injections may restore joint lining but do not repair tissues.

Those who seem to respond to hyaluronate knee injections have normal weight with mild to moderate symptoms of osteoarthritis. For people with obesity or excess weight, and advanced osteoarthritis, the injections may not be as effective. The injections may offer more relief to people younger than 65.

Suitable Candidates for Hyaluronic Injections for Osteoarthritis

Hyaluronic injections are not suitable for everyone. You may benefit from hyaluronic acid injections if you do not respond well to nonsteroidal anti-inflammatory drugs (NSAIDs). If you have diabetes and do not want to take corticosteroids because they increase blood sugar levels, you can also benefit from hyaluronic acid injections. Corticosteroids are drugs used to reduce inflammation. 

Hyaluronic injections are not recommended for:

  • Pregnant and lactating mothers
  • Children 
  • Those who are allergic to hyaluronic acid or allergy to bacterial proteins
  • Those who have infections in the treatment area or on the skin
  • People with cancer or a history of cancer
  • Patients with too much liquid in the knees (joint effusion). They should first seek treatment before receiving a hyaluronic acid injection
  • Those having a bleeding or blood clotting disorder, such as hemophilia

Inform your doctor if you are taking any medications before starting hyaluronic acid injections. Don’t use complementary treatments such as herbal remedies. Please inform your doctor since some may react with the hyaluronic acid injections. Additionally, discuss with your doctor about vaccination before going for the injections. 

What to Expect 

Dr. Susan A. Baker begins with a consultation and a thorough examination to determine the root cause of your knee pain and recommend the best treatment. 

Suppose you are suffering from osteoarthritis, and Dr. Susan thinks you can benefit from the injection based on her assessment. In that case, she can provide hyaluronic acid injections to relieve your pain. 

During the procedure, the treatment area will be cleansed, and a local anesthetic will be injected. If your knee is swollen due to excess fluid buildup, a needle will be inserted into the joint to extract the excess fluid (this is known as joint aspiration). With the help of an X-ray to guide the needle, hyaluronic acid will be injected into your knee joint. 

Once the procedure is complete, you can resume normal activities and avoid lifting heavy objects for at least one or two days. Additionally, avoid straining your knee, activities such as soccer, tennis, jogging, or standing for long periods.

After the injection, you may experience temporary pain, warmth, and slight swelling in the knee. You can apply some ice to relieve the symptoms. These symptoms diminish after a short time as your body adjusts to the medicine. If the pain and swelling persist or become severe, contact your doctor. Your doctor will monitor your progress closely to see whether the injection works well and to assess whether you should continue receiving the injection. 

Some patients may rarely develop an allergic reaction in the knee, which may turn red, warm, full of fluid, and painful. If this happens, contact your doctor immediately.

Call Susan A. Baker, M.D. today for more information on how we can help treat your knee pain with hyaluronic acid injections and learn about other treatments we have.