If you are like most people, you probably haven’t heard of hyaluronic acid (HA), yet it is vital for all of us to move and function normally. HA is a major substance in all joint fluid and is essential to maintain joint health and function.

If you are like most people, you probably haven’t heard of hyaluronic acid (HA), yet it is vital for all of us to move and function normally. HA is a major substance in all joint fluid and is essential to maintain joint health and function.
HA serves three important functions:
- HA lubricates our joints to keep them working and moving smoothly.
- HA functions as a shock absorber to disperse the impact that results from standing, walking, running, and other activities.
- HA directly impacts cartilage health — cartilage is bathed in HA and derives all of its nutrition from the surrounding joint fluid.
When people have osteoarthritis, HA becomes dysfunctional and progressively thins out, which results in a decreased cushioning effect. With loss of this protection, the cartilage (a protective covering which overlies bone) becomes subject to repetitive micro-injury and is damaged. With repeated insult, large fissures begin to appear and pieces of cartilage begin to fragment and break off. Eventually, there is significant cartilage loss (which becomes complete in advanced cases of OA) and the joint function rapidly deteriorates. As more cartilage is lost, it kicks off a vicious cycle:
decreased cushion —> increased trauma —> cartilage loss —> decreased cushion
Additionally, the recurring micro-trauma induces an inflammation of the joint lining (synovium) which eventually causes chronic pain.

There is good news — HA can be injected into joints, and several studies have demonstrated benefit from this minimally-invasive treatment. Hyaluronic acid injections, also known as viscosupplementation, can be very beneficial in treating osteoarthritis. Like most other medical treatments, HA injections produce variable results. Although doctors can’t always predict who will receive the most benefit from HA treatment, it is a viable option for people seeking alternatives to surgery.
Here are the top five reasons HA injections may be right for you.
- Pain Reduction & Improved Joint Function – Anyone with joint pain knows it can be agonizing, frustrating, and debilitating. While HA injections won’t cure osteoarthritis, they can reduce pain, swelling, and stiffness – especially in the knee. Injecting HA directly into the joint reduces inflammation, which will promote cartilage health and helps to keep the vicious cycle of OA in check.
- Frequency – While everyone responds differently to the treatment, and results vary across the different brands of HA, benefits can be realized after a series of injections (generally 3 or 4) and can last anywhere from six months to a year.
- Good Alternative – There are those of us who can’t take the conventional route for joint pain and try over counter medications like Ibuprophen (Advil), naproxen sodium (Aleve), or acetaminophen (Tylenol) for a myriad of reasons. There are also those of us who don’t like the side effects of treatments like cortisol, so HA injections are a great alternative. The injections are also an option for those who’ve tried the previously mentioned treatments but not received enough relief. HA treatments may slow the progression of cartilage loss and have been demonstrated to effectively postpone the need for knee replacement surgery.
- Low Risk – Unlike steroidal therapy for joint pain, HA injections pose little to no risk for any adverse reactions. In fact, in a recent risk-benefit assessment of the injections to sufferers of osteoarthritis of the knee, only two to four percent saw any adverse events, which were almost always just local swelling. The only serious risk with HA injections is joint infection, which is very rare and usually caused during the injection process. At Reflex, all injections are performed under ultrasound or Xray guidance, and our board-certified physicians are careful that sterile technique is used during the procedure. We are proud of the fact that in our entire history of over 4500 injections, we have not had a single joint infection. Joint fluid therapy is a very safe procedure.
- Cost – Like any alternative treatment, costs are always something to consider. Fortunately, HA injections are inexpensive considering how long they provide relief, especially when compared to the costs of knee surgery. Most major insurance companies and even Medicare cover the costs of the injections. You can call your insurance provider to see if the procedure is covered under your plan.
If you’re not sure if you’re a candidate you can take this short assessment to find out, talk to your doctor to see if viscosupplementation might be right for you, or schedule and evaluation with one of our board certified physicians who are experts in osteoarthritis.