Intra-articular injections – a possible option or a long-term solution for pain?

Intra-articular injections can be used to administer hyaluronic acid preparations, corticosteroids, and antibiotics.

Intra-articular Administration of Corticosteroids

Corticosteroids are medications that, when administered in this way, have a powerful anti-inflammatory effect.

They are administered in combination with local anaesthetics, meaning their effects begin immediately or very shortly after administration and last for approximately 4 weeks.

Patients report that the pain is reduced or disappears, joint mobility improves, and their functional status improves very quickly.

For some patients, a single administration is sufficient and, depending on the cause of the symptoms, they may disappear permanently.

This type of therapy can be repeated if symptoms recur. It is recommended in combination with physical therapy and kinesitherapy.

Intra-articular Administration of Hyaluronic Acid

Hyaluronic acid is naturally present in the synovial fluid found within the joints. Its role is to “lubricate” the joint surfaces, allowing the joint to function smoothly.

Another very important role of hyaluronic acid is to absorb forces acting on the joints, as well as to nourish the articular cartilage by supplying it with essential nutrients.

It also helps reduce the production of substances that cause inflammation and damage to the articular cartilage and the joint itself.

Hyaluronic acid injections are used to treat joint pain (e.g. shoulder, wrist, hip, knee, ankle, etc.) caused by osteoarthritis (OA) in patients who have already been treated with pain-relieving medications (e.g. NSAIDs) or other treatments that have not produced satisfactory results.

Hyaluronic acid injections may also be recommended for prevention and faster recovery following sports injuries, after orthopaedic procedures, and to help slow degenerative processes within the joints.

The aim is to reduce or eliminate pain, swelling, and stress on the joint while improving its mobility. This helps improve the patient’s functional status and reduce subjective symptoms.

A wide range of hyaluronic acid preparations is available on the market, in the form of solutions or gels, either as standalone preparations or in combination with corticosteroids.

Preference is generally given to preparations with a high concentration of high-molecular-weight hyaluronic acid, administered as a single dose and providing effects lasting between 6 and 12 months.

This approach provides greater comfort for the patient and reduces the possibility of complications affecting the joint itself.

How Is the Procedure Performed?

Under ultrasound guidance, the joint is examined for the possible presence of excess fluid.

If excess fluid is detected, it is removed, and through the same access point, hyaluronic acid or a corticosteroid preparation is injected directly into the joint (shoulder, elbow, wrist, hip, knee, ankle, etc.).

What Should Be Considered Before an Intra-articular Injection?

The patient should be asked about any allergies to medications, anaesthetics, hyaluronic acid preparations, food, or preservatives, as well as any comorbidities and the use of oral anticoagulant therapy.

It is also important to determine whether there is an infection or any other skin condition around the joint, as well as the possible presence of septic arthritis, which represents an absolute contraindication to the administration of hyaluronic acid preparations.

Advice for Patients After an Intra-articular Injection

Following an intra-articular injection, patients are advised to rest and avoid putting excessive strain on the joint for the next 48 hours. Cold compresses may be applied locally, and pain-relieving medication may be used if pain occurs at the injection site. This pain usually subsides within two days.

During this period, patients are advised to avoid training, running, and prolonged standing.

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