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Hyaluronic Acid Injections

What is Hyaluronic Acid (HA)?

We’ve been using Hyaluronic Acid injections at the practice for a number of years to assist in the treatment of arthritis and yet many people don’t know too much about it. It is a treatment used for arthritis and other joint conditions affecting the knee, hip, ankle, big toe, thumb and shoulder. With all new treatments come a degree of scepticism but HA has been around for well over 20 years and there is now substantial evidence in support of its use for a wide range of conditions. The treatment is sometimes referred to as ‘synovial fluid replacement therapy’ or viscosupplementation and has been used to keep many high profile sporting stars playing as well as being used extensively in treating the older active adult.

How does Hyaluronic Acid work?

Hyaluronic acid is a naturally occurring molecule found in all synovial joints. It has viscoelastic properties which means it plays a role in normal joint function in absorbing load within the joint (elasticity) and assisting with easy, free movement (viscosity). You could consider HA much the same as hydraulic fluid which not only lubricates but also accepts pressure and load. In the arthritic joint, the composition of synovial fluid changes. Swelling invades the joint and viscoelastic properties are reduced. Not only that, but it is thought that the HA provides a barrier to the inflammatory process which is the main feature of osteoarthritis.

How will Hyaluronic Acid injections help my arthritis and are there any side effects?

The Hyaluronic Acid injections that we use are synthetically produced in laboratories but has the same properties as the real stuff produced in our own joints. What we invariably see is a consistent reduction in pain which leads to progressive increases in function and mobility. The beauty of the treatment is that there are no harmful side effects and at a time when the medical profession have become more cautious about the use of repeated steroid injections (rightly so) or long term use of anti inflammatory medication, this treatment provides an effective, safe and repeatable solution for joint conditions including arthritis. The only downside is that HA is not readily available on the NHS but, for comparatively little cost, the prospect of reduced pain, improved function and a return to normal activities are all within reach.

Physio Paul Hattam is our principal injection therapist and a tutor on post-graduate courses for Physiotherapists & Medical Practitioners learning injection therapy. He has been using injection therapy within his practice for over 30 years. He remarks:

I’ve seen the impact that hyaluronic acid injections have had with many people – especially when the injection is combined with physiotherapy and exercise. The evidence supports its use mainly in early arthritis but I have also had notable successes with people who have more advanced arthritis unwilling or unable to consider joint replacement. It is certainly a treatment option we didn’t have at the beginning of my career and has provided a much better solution for anyone with osteoarthritis.

Jane’s story

Jane was really worried that their long planned walking expedition would have to be cancelled because of a painful arthritic knee. After the HA injection and physio treatment, the plans went ahead and this was the email I received at the end of their adventure (reproduced with permission):

Hi Paul, we had an exciting summer – where quite a bit of physical activity wasn’t held up by my leg issues. We walked 600 miles from Land’s End to Hadrian’s Wall and cycled 600 miles up the west coast of France (and camped in a very small tent!). Thanks again for all your help with understanding what was and is going on with my knee, encouragement and wisdom, and the (possibly magic) Hyaluronic mixture. In that order.