Hyaluronic Acid Injections
Advanced joint injection therapy to restore lubrication, reduce pain and improve mobility — administered under ultrasound guidance by our specialist consultant.
What Are Hyaluronic Acid Injections?
Hyaluronic acid (HA) is a naturally occurring substance found in the synovial fluid of healthy joints. It acts as both a lubricant and a shock absorber, allowing the cartilage surfaces of your joints to glide smoothly against one another. In joints affected by osteoarthritis or chronic inflammation, the concentration and quality of hyaluronic acid deteriorates significantly — leading to increased friction, pain and stiffness.
Hyaluronic acid injection therapy (also called viscosupplementation) involves injecting a highly purified, medical-grade hyaluronic acid preparation directly into the affected joint. This restores the natural cushioning and lubrication of the joint fluid, reducing pain, improving mobility and slowing the progression of joint degeneration.
At Fenland Physio, all hyaluronic acid injections are performed by our specialist consultant Dr Imran Riaz, who holds a Doctorate specialising in spinal pain and works as an Advanced Physiotherapist at both the NHS and Harley Street, London. All injections are administered under real-time ultrasound guidance to ensure maximum precision and safety.
How Does It Work?
When hyaluronic acid is injected into a joint, it supplements the depleted natural joint fluid, restoring its viscoelastic properties. Over a series of injections, the treatment produces several beneficial effects:
Joint Lubrication
The injected hyaluronic acid immediately restores the lubricating film between cartilage surfaces, reducing friction and the grinding sensation associated with arthritis.
Shock Absorption
Restores the viscoelastic cushioning of the joint, absorbing impact forces during walking, stairs and other load-bearing activities to reduce pain.
Cartilage Protection
HA has chondroprotective properties — it helps protect remaining cartilage from further breakdown and may stimulate the production of new hyaluronic acid by the joint lining.
Anti-inflammatory Effect
High-quality HA preparations reduce pro-inflammatory mediators within the joint, helping to calm the chronic inflammatory cycle that drives arthritic pain.
Clinical Evidence & Outcomes
Hyaluronic acid injection therapy is well established in the clinical literature and is recommended by NICE and EULAR guidelines for the management of knee osteoarthritis in patients who have not responded adequately to physiotherapy and analgesics alone.
Conditions & Joints Treated
Hyaluronic acid injections are most commonly used for osteoarthritis of the large joints, but can benefit a range of chronic joint conditions where natural lubrication is compromised.
- Knee osteoarthritis (mild to moderate)
- Hip osteoarthritis
- Ankle osteoarthritis
- Shoulder osteoarthritis & rotator cuff conditions
- Thumb base (CMC joint) osteoarthritis
- First MTP joint (big toe) osteoarthritis
- Chronic joint pain from cartilage damage
- Post-traumatic joint stiffness
- Recurrent joint effusion (swelling)
- Pain delaying or avoiding joint replacement surgery
Hyaluronic Acid vs. Other Injection Therapies
There are several injection options available for joint pain. We help you choose the most appropriate treatment based on your diagnosis, symptom duration and treatment goals.
Hyaluronic Acid (Viscosupplementation)
Best suited for: mild to moderate osteoarthritis with reduced joint space and chronic stiffness. Provides mechanical lubrication and longer-lasting relief of 6–12 months.
Ideal for patients who want to delay or avoid joint replacement surgery, or who have not responded to steroid injections.
Corticosteroid Injections
Best suited for: acute inflammatory flares, bursitis and short-term pain relief. Acts quickly but effects typically last 6–12 weeks, with limited repeat use.
Often recommended before HA when rapid short-term relief is the priority, or as a complement to rehabilitation.
Dr Imran Riaz will assess your joint, review any imaging, and recommend the most appropriate injection therapy — or a combination — during your initial consultation.
What to Expect: The Procedure
The procedure is straightforward, well-tolerated by most patients and typically completed within 30–45 minutes including preparation and aftercare discussion.
Initial Assessment
A thorough consultation with Dr Imran Riaz to review your history, symptoms, relevant imaging (X-ray / MRI) and suitability for injection therapy.
Ultrasound Guidance
The injection site is identified and confirmed using real-time diagnostic ultrasound, ensuring the needle is accurately placed within the joint space.
Injection
After skin preparation, the hyaluronic acid preparation is injected precisely into the joint under continuous ultrasound visualisation. The procedure typically takes just a few minutes.
Aftercare & Follow-up
You receive clear aftercare instructions. Mild soreness for 24–48 hours is normal. A follow-up is arranged to monitor your response and plan any further injections.
Before & After Your Injection
Before Your Appointment
You may continue to take your normal medications unless advised otherwise. If you are on blood-thinning medication (e.g. warfarin, aspirin, clopidogrel), please inform us in advance.
Wear loose, comfortable clothing that gives easy access to the joint being injected. You do not need to fast before the procedure.
Bring any relevant imaging (X-rays, MRI scans) if you have them, and a list of any current medications and supplements.
After Your Injection
Rest the injected joint for 24–48 hours and avoid strenuous activity during this period. Mild swelling, warmth or discomfort at the injection site is normal and settles quickly.
Most patients begin to feel improvement within 2–4 weeks. The full benefit develops gradually as the hyaluronic acid integrates with the joint fluid — maximum effect is typically reached by week 6–8.
You can apply ice to the area for 10–15 minutes at a time if discomfort persists. Avoid hot baths or swimming for 24 hours after the procedure.
Frequently Asked Questions
Is the injection painful?
Most patients describe the injection as mild discomfort rather than pain. The skin is cleaned thoroughly beforehand. For anxious patients or sensitive joints, a local anaesthetic can be applied to the skin before the procedure. The use of ultrasound guidance allows the injection to be placed precisely, minimising discomfort.
How many injections will I need?
This depends on the hyaluronic acid product used and your individual response. Some preparations are given as a single injection, while others are administered as a course of 3 weekly injections. Dr Imran Riaz will advise you on the most appropriate protocol during your consultation.
How long does the effect last?
Most patients experience pain relief lasting between 6 and 12 months, with some reporting benefit for up to 18 months. The duration varies depending on the severity of arthritis, the joint treated and individual response. Repeat injections can be given if you respond well to treatment.
Are there any side effects or risks?
Hyaluronic acid injections have an excellent safety profile. The most common side effects are mild and temporary — localised soreness, swelling or warmth at the injection site lasting 24–72 hours. Serious adverse events are rare. Your consultant will conduct a thorough screening to identify any contraindications before proceeding.
Who is not suitable for this treatment?
HA injections are not suitable if you have an active skin infection over the injection site, a known allergy to hyaluronic acid products, or active joint infection (septic arthritis). Patients with severe end-stage arthritis (bone-on-bone) may gain limited benefit and should discuss alternative options with Dr Imran Riaz.
Does it work alongside physiotherapy?
Absolutely — and this is the recommended approach. Hyaluronic acid injections reduce pain and improve joint lubrication, which creates an optimal window for physiotherapy rehabilitation. Strengthening the muscles around the joint reduces load and maximises the long-term benefit of the injection. We can combine both treatments in your care plan.
What Our Patients Say
“I couldn’t walk for three days because of knee pain. I am back to cycling after great treatment. Thank you.”
“The injections worked wonders. My joint pain went away totally after 2 treatments. The whole experience was professional and reassuring from start to finish. Thank you sincerely.”
“I had been in pain for over two years and was dreading surgery. After two hyaluronic acid injections with Dr Riaz, I have my life back. The ultrasound guidance made it so precise — I barely felt anything.”
Ready to Relieve Your Joint Pain?
Book a consultation with Dr Imran Riaz today. We will assess your joint, review your imaging and recommend the most appropriate injection therapy for lasting relief.
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