For osteoarthritis, a hyaluronic acid injection is generally considered a better choice than a corticosteroid injection if you're looking for longer-term pain relief. Hyaluronic acid acts as a joint lubricant and protector, while a corticosteroid provides faster but shorter-lasting pain relief by reducing inflammation. However, depending on the severity of inflammation and your specific situation, your doctor may recommend one over the other or even a combination of both injections.
Conflicting results have been reported on the efficacy and safety of HA. Guidelines are controversial and in most of the cases “uncertain” recommendations are provided due to inconclusive evidence in literature. However, HA does not seem to have significantly higher side effects when compared to saline or CSs injections, and provides better medium-term control of symptoms in patients with mild to moderate knee osteoarthritis.
Corticosteroids are potent, injectable, anti-inflammatory medications which have been used as effective painkillers in musculoskeletal healthcare for decades. When injected, corticosteroid has the potential to rapidly reduce pain and swelling. The effects of corticosteroids can be felt as early as 6 hours after injection, although most people experience the maximum benefits within the first 2 weeks.
How long the beneficial effects of a corticosteroid injection will last is less predictable. Consensus in the research suggests significant pain relief lasting up to 3 months. However, many people experience a much longer period of pain relief after an injection, while others find corticosteroids provide very short-term pain relief or none at all.
Many patients are concerned about how many corticosteroid injections they can safely have. The consensus states that up to 3 injections can be carried out in one area each year. For best outcomes, it is essential that after receiving a steroid injection the underlying cause of your pain is treated. A course of pyysiotherapy after an injection for a musculoskeletal problem is essential to ensure you achieve maximum benefit.