A doctor inject hyaluronic acid into a person's knee.
Hyaluronic acid injections are a new treatment option for OA, and can help prevent joint pain and friction.

Hyaluronic Acid Injections and Treating Osteoarthritis

Osteoarthritis is the most common form of arthritis and a leading cause of disability. Hyaluronic acid injections are among the newest treatment options, but are they actually effective?

This article explains hyaluronic acid injections for osteoarthritis: how they work and what is involved in the treatment process. Here’s everything you need to know.

What Are Hyaluronic Acid Injections?

Hyaluronic acid is a chemical that the body produces naturally. It is a component of the skin, eyes, bone marrow, cartilage and synovial fluid.

Synovial fluid is a substance that acts as a lubricant and shock absorber for the joints. It keeps the joint space open and prevents the bones from rubbing together and causing friction. In conditions like osteoarthritis, synovial fluid breaks down more rapidly than usual, leading to inflammation and pain.

Because hyaluronic acid is a crucial component of synovial fluid, injections can help supplement the body’s innate supply. Therefore, they may be useful for treating osteoarthritis. However, they are currently only licensed for osteoarthritis of the knee.

What is Osteoarthritis?

Osteoarthritis is a common inflammatory condition of the joints. It occurs due to wear and tear, either as a result of overuse or old age. It tends to affect the weight-bearing joints, such as the knees and hips.

In osteoarthritis, synovial fluid breaks down and the joint space becomes narrowed. This allows the bones to rub together with movement, causing friction. Over time, the cartilage that protects the bones can begin to deteriorate, leading to inflammation and pain.

The most common symptoms of osteoarthritis are:

  • Joint pain, especially in the knees and hips.
  • Heat, redness and swelling around the joint (inflammation).
  • Stiffness and reduced mobility.

Osteoarthritis is a debilitating condition and can significantly affect one’s quality of life. Therefore, scientists are constantly trying to develop more effective treatments, like hyaluronic injections.

Here’s how they could help.

How Are Hyaluronic Acid Injections Used to Treat Osteoarthritis?

Doctors usually treat osteoarthritis by prescribing painkillers, like acetaminophen, or anti-inflammatory drugs, like ibuprofen, diclofenac, or naproxen. However, these medications are not always effective and some patients can experience side effects when taking them long-term.

Another option is corticosteroid injections. Doctors administer these injections into the arthritic area and they can reduce inflammation for several months at a time. However, repeated corticosteroid injections can cause complications and they are not suitable for everyone.

Total joint replacement is usually seen as a last resort due to the risks associated with surgery.

Hyaluronic acid injections could provide a solution for people who have found other treatments ineffective, or who cannot use them due to side effects. They are suitable for individuals who cannot gain relief from painkillers, but who are not yet ready for surgery.

They may provide a similar level of relief to corticosteroid injections, although multiple injections may be required to achieve this.

How Do Hyaluronic Acid Injections Help Osteoarthritis?

Hyaluronic acid injections have several potential benefits for people with osteoarthritis. They include:

  • Supplementing the body’s natural hyaluronic acid supply.
  • Improving lubrication and shock absorption.
  • Keeping the joint space open.
  • Preventing friction.
  • Protecting cartilage and bone.

Some experts also believe that injections may stimulate the body to start making more of its own hyaluronic acid. They could also stimulate the growth of cartilage-producing cells called chondrocytes, assisting the formation of new tissue.

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The Hyaluronic Acid Injection Treatment Process

The hyaluronic acid injection treatment process is straightforward and should only take a few minutes. The procedure is carried out at a doctor’s office by a physician, nurse, or other healthcare provider.

They will disinfect the injection site and inject the hyaluronic acid directly into the affected joint. This can be done with the patient sitting up or lying down. It is essential that the hyaluronic acid enters the joint space and not the surrounding area. Therefore, some doctors use an ultrasound to increase accuracy.

If the knee is very swollen, it may be necessary to remove excess fluid using a needle and syringe. This can be done while using a local anesthetic to numb the area. It may be possible to keep the same needle in place to inject the hyaluronic acid.

After the procedure, the doctor will usually ask the patient to straighten and bend their knee a few times. This helps the hyaluronic acid to distribute evenly throughout the joint. The patient can then go home, although they should rest for a day or two and avoid any strenuous activity. This includes high-impact sports like jogging or tennis, heavy lifting and standing for long periods.

Depending on the brand of the injection, treatment may need to be repeated weekly for three to five weeks. However, some brands only require a single injection.

Possible side effects include:

  • Pain at the injection site.
  • Minor swelling.
  • Increased inflammation.
  • Allergic reactions.

Tell your doctor if you have ever had an allergic reaction to any foods, drugs, dyes, or preservatives. Also, let them know if you are taking any other medications to reduce the risk of interactions.

Are Hyaluronic Injections Effective for Osteoarthritis?

Hyaluronic acid injections are more effective in some people than others. A number of different factors can determine how well the treatment works.

For example, they are less effective in older people and those with severe osteoarthritis. They may also be less effective for people who are overweight as they tend to have a narrower joint space.

Furthermore, some people have higher-than-average levels of an enzyme that breaks down hyaluronic acid. This could mean that any relief from the injections is short-lived.

With that said, many people do find these injections effective. They can provide relief for two to six months, peaking between 5 to 13 weeks. However, the effects may not be noticeable until four weeks after the first injection.