Hyaluronic Acid Joint Injection | Joint Supplement Injection

What is Hyaluronic Acid (HA)?

Hyaluronic acid (HA) is a natural substance found in the fluid that surrounds a healthy knee. The fluid in which hyaluronic acid is present is called synovial fluid, and it helps cushion, lubricate, and protect the knee. Osteoarthritis (OA), commonly known as ‘wear-and-tear arthritis’, is a condition in which the natural cartilage wears away over time. The pain associated with osteoarthritis is caused by the synovial fluid becoming thin and less able to do its job.

How Hyaluronic Acid (HA) Joint Injections Work

Injecting Hyaluronic acid into the knee joint has been proven to ease mild to moderate pain caused by osteoarthritis (OA). It’s a safe, effective treatment option that can provide pain relief for several months. Unlike oral medications, this injection is localized therapy. This means it targets the source of pain and is not distributed throughout your entire body. When injected into the knee, it replenishes the natural HA and helps to restore the ability of the synovial fluid to cushion, lubricate and protect the joint.

About OA of the Knee

If you have been diagnosed with OA of the knee, you are not alone–more than 10 million Americans have OA of the knee. Although there is no cure for OA of the knee, there are treatments available that can reduce pain and help you stay active.

Signs & Symptoms

The main symptoms commonly associated with osteoarthritis (OA) of the knee are:

  • Knee pain that worsens when you are active and improves when you rest
  • Stiffness, with reduced ability to move the knee
  • Swelling around the knee
  • Cracking (crepitus) when moving the knee

Other possible symptoms of OA of the knee include:

  • Buckling or instability of the knee
  • Bony enlargement of the knee
  • Deformity of the knee

If you have any of these symptoms or signs, see your doctor and talk with him or her about your symptoms — where the pain is, how long you’ve had it, and what types of things make it better or worse. Your doctor will perform tests to determine the cause of your knee pain or may refer you to a specialist for further evaluation. If the cause of your pain is OA of the knee, there are numerous treatment options available.


Although doctors are not completely certain what causes OA of the knee, some possible contributors are:

  • Advancing age
  • Wear and tear on the knee over many years
  • Previous injury
  • Excessive weight
  • Genetics: It may “run in the family”
  • Gender: Women are more likely than men to have OA of the knee

Diagnosis and progression

Diagnosing osteoarthritis (OA) of the knee

The first thing your doctor will do is talk with you about your symptoms. He or she will ask you where the pain is, how long you’ve had it, and what types of things make it better or worse. He or she will also probably perform a physical exam of your knee. Following that, there are several tests that can aid your doctor in making a final diagnosis:

  • X-ray: An x-ray can give your doctor a good view of the bones and cartilage in your joint–if the space between the bones is narrower than usual, it may indicate damage to the cartilage, a sign of OA
  • MRI: An MRI may be used if an x-ray is not providing a clear indication of the cause of your knee pain
  • Blood test: A blood test can rule out rheumatoid arthritis (RA) and other possible causes of joint pain

Other, less common tests include:

  • Joint fluid analysis: A needle is used to draw fluid from your joint; the fluid is then checked for signs of infection or other conditions
  • Arthroscopy: A tiny camera is inserted through small incisions around your knee to look directly at the joint


OA of the knee is a chronic condition that gradually worsens over time.

Normal knee: Cartilage covers the ends of the bones and keeps them from rubbing together. A small space between the bones contains synovial fluid, which lubricates and protects the joint.

Mild OA: Tiny cracks and pits may begin to form in the cartilage as its surface begins to break down.

Moderate OA: Large sections of cartilage lose their flexibility and start to wear down, making the cartilage even more likely to be damaged by daily wear and tear or injury. Bone spurs may form on the edges of the bones. The synovial fluid also starts to break down, losing its effectiveness.

Severe OA: Sections of cartilage completely wear away, leaving the bones unprotected so that they rub against each other. Tiny bits of cartilage may also float freely in the joint, causing further damage and pain.

The good news: OA of the knee is manageable, especially if detected early, and there are many treatment options. So, if you experience pain, stiffness, or any of the symptoms listed above, see your doctor. Only your doctor can diagnose OA of the knee. If it is OA, you and your doctor will work together to find a treatment that is right for you.

Please Note: This information should not be used for self-diagnosis.

Treatment Options

Although osteoarthritis (OA) of the knee is not curable, there are many treatment options available that can help you to control pain and maintain an active lifestyle. OA is usually managed with a combination of approaches, including medications, lifestyle changes, and sometimes surgery.

Lifestyle changes

There are changes you can make to your lifestyle that may help with the management of OA of the knee:

  • Exercise/physical therapy: Your doctor can help you design an exercise plan that is right for you or recommend a physical therapist
  • Weight loss (if you are overweight)
  • Physical therapy

Oral and topical medications

If you suspect that you have OA of the knee, you will probably first see your primary care doctor. He or she may then refer you to a specialist. Specialists who have expertise in OA include:

  • Over-the-counter pain relievers, such as:
    • Aspirin
    • Acetaminophen (Tylenol®)
    • Ibuprofen (Motrin® or Advil®)
    • Naproxen (Aleve®)
  • Topical pain relievers (creams, rubs, sprays)
  • Prescription pain medications, such as:
    • Celecoxib® (Celebrex)
    • Mild narcotic pain relievers (usually for short-term use only, as they may become addictive)


There are two types of injections commonly used in the treatment of OA knee pain:

  • Corticosteroid injections: Anti-inflammatory hormones that can decrease pain
  • Hyaluronic acid (HA) injections: Similar to the natural HA found in the fluid that surrounds a healthy knee


Surgery may also be an option in treating OA of the knee. A surgeon can remove loose bone and cartilage, and reposition or smooth out bones. In addition, a surgeon can perform a total or partial knee replacement, in which all or some of a joint is replaced with an artificial one.

The best thing to do is to talk with your doctor. Together, you will be able to work out a plan that can help you manage the symptoms of OA of the knee.


1. Data on file. Ferring Pharmaceuticals Inc. 2 Kirchner M, Marshall D. A double-blind randomized controlled trial comparing alternate forms of high molecular weight hyaluronan for the treatment of osteoarthritis of the knee. Osteoarthr Cartil. 2006;14:154-162.