How do I know which to choose between hyaluronic acid and cortisone injection?

Many patients who contact us are unsure about treatment options. Whether hyaluronic acid or cortisone injection would be best for their pain. Both hyaluronic acid and corticosteroid can be used as pain-relieving injections. Used in a range of peripheral joints, which we perform under ultrasound guidance to ensure accuracy.
When deciding which is likely to be the best treatment, there are a number of different factors that you should take into consideration.
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Hyaluronic Acid

Hyaluronic acid generally works best for osteoarthritis where there is little or no inflammation. Treatment generally works best for people who are active. Generally have pain in a joint where there is very little swelling. Most have a goal to return to activities e.g. running or walking long distances in the example of a knee. The typical example of a patient suitable for hyaluronic acid would be an active 40-50-year-old. Generally involved in regular sport or exercise.
Equally, hyaluronic acid can prove a good alternative for people who cannot have cortisone injection. Normally because they are either allergic to cortisone or have been advised to avoid cortisone injections for medical reasons.

Cortisone Injection

Cortisone works best for quicker pain relief. It is a very potent anti-inflammatory and is very useful in joints that are inflamed. Additionally where there is swelling or effusion. Cortisone gives very fast-acting pain relief that usually will last for at least a few months. Some patients choose to have hyaluronic acid injected after the steroid. Usually, after around four weeks, to try to prolong the effect of the steroid.
Whilst both injections give pain relief the below points might be useful. Helping to decide which would be the most suitable choice

Indications for hyaluronic acid injections

1. Joint pain

2. Little or no inflammation or swelling

3. Patient wishing to remain very active with early osteoarthritis


Indications for steroid injections

1. Acute pain relief.

2. Evidence of swelling or inflammation.


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You do not require a doctor or consultants referral for either injection.
We will carry out a medical screening as well as a physical assessment.
An ultrasound scan is also provided on the day to ensure the suitability of injection selection.