For patients with osteoarthritis, joint pain often stems from the loss of natural lubrication and shock absorption within the joint. Hyaluronic acid injections, also known as viscosupplementation, directly address this problem by restoring the joint’s natural fluid, reducing pain, and improving mobility.
At Joint Health Solutions in Charlotte, we offer hyaluronic acid injections as part of our comprehensive, non-surgical approach to arthritis care. Our team—led by Dr. Jeffrey Galvin and Ariel Curtis, FNP-C—uses advanced ultrasound guidance to deliver these injections with precision, ensuring optimal outcomes. Hyaluronic acid injections are most commonly used for knee osteoarthritis, but may also be considered for other joints such as the hip, shoulder, and ankle in select patients.
Medically reviewed by: Dr. Jeffrey Galvin & Ariel Curtis, FNP-C | Last reviewed: March 2026
Hyaluronic acid is a naturally occurring substance found in high concentrations in healthy joint fluid, also called synovial fluid. It acts as a lubricant and shock absorber, allowing bones to glide smoothly against each other. In osteoarthritis, the concentration and molecular weight of hyaluronic acid in the joint fluid decrease, leading to increased friction, inflammation, and pain.
Hyaluronic acid injections, also called viscosupplementation, supplement the depleted hyaluronic acid, restoring the lubricating properties of the joint fluid and providing a cushioning effect. This can reduce pain, improve function, and potentially delay the progression of osteoarthritis.
The exact mechanism of action is not fully understood, but research suggests multiple benefits:
The injected hyaluronic acid increases the viscosity of synovial fluid, reducing friction between cartilage surfaces.
Hyaluronic acid may suppress inflammatory cytokines and reduce the production of enzymes that degrade cartilage.
Some evidence suggests hyaluronic acid injections may stimulate the body’s own production of hyaluronic acid.
By improving joint mechanics and reducing inflammation, hyaluronic acid may help slow cartilage degeneration.
Unlike corticosteroid injections, which provide rapid but temporary anti-inflammatory effects, hyaluronic acid injections work more gradually but can offer longer-lasting relief.
Hyaluronic acid injections are FDA-approved for the treatment of osteoarthritis of the knee. They are indicated for patients with mild to moderate knee osteoarthritis who have not responded adequately to conservative care such as physical therapy, weight management, or oral analgesics.
While FDA-approved only for the knee, hyaluronic acid injections are often used off-label for:
At Joint Health Solutions, we evaluate each patient individually and consider hyaluronic acid injections for joints beyond the knee when clinically appropriate.
Several hyaluronic acid products are available, differing in molecular weight, number of injections required, and duration of effect. Your provider will select the product best suited to your condition.
| Product | Typical Course | Duration |
|---|---|---|
| Single-injection products (e.g., Synvisc-One, Gel-One, Durolane) | 1 injection | 6–12 months |
| 3-injection series (e.g., Euflexxa, Supartz) | 1 injection per week for 3 weeks | 6–12 months |
| 5-injection series (e.g., Hyalgan) | 1 injection per week for 5 weeks | 6–12 months |
The choice depends on the joint, severity of arthritis, patient preference, and insurance coverage.
Hyaluronic acid injections are generally very safe. Potential side effects include:
Serious complications are uncommon. We use image guidance to ensure accurate placement and minimize risks.
Most patients experience significant pain relief and functional improvement for 6 to 12 months after a complete course of hyaluronic acid injections. Some patients may benefit from a repeat course after this period. Duration varies based on the severity of arthritis, the joint treated, and individual patient factors.
Patients with advanced bone-on-bone arthritis may still benefit, although results are often less predictable. We evaluate each case individually.
| Feature | Hyaluronic Acid | Cortisone |
|---|---|---|
| Mechanism | Lubrication, shock absorption, and mild anti-inflammatory effects | Potent anti-inflammatory |
| Onset of relief | 2–4 weeks, gradual | 24–72 hours, rapid |
| Duration | 6–12 months | Weeks to months |
| Best for | Mild to moderate osteoarthritis and chronic management | Acute flare-ups and severe inflammation |
| Frequency | 1 injection or series every 6–12 months | Limited to 3–4 per year |
| Effect on cartilage | May be chondroprotective | Potential damage with excessive use |
In some cases, we combine both approaches: a cortisone injection for rapid relief of a flare-up, followed by hyaluronic acid to provide longer-term lubrication.
Derived from your own blood, PRP contains growth factors that may reduce pain and improve function in knee osteoarthritis. It is often used for mild to moderate arthritis and can be combined with physical therapy.
These treatments are not guaranteed to reverse osteoarthritis, but they can provide meaningful relief and help delay joint replacement. Candidacy is determined on a case-by-case basis.
Expert Providers
Dr. Jeffrey Galvin and Ariel Curtis, FNP-C, have extensive experience in viscosupplementation and image-guided injections.
Image Guidance
All injections are performed under ultrasound or fluoroscopy for accuracy and safety.
Personalized Care
We select the hyaluronic acid product and injection protocol best suited to your condition.
Comprehensive Approach
Hyaluronic acid is often combined with physical therapy, weight management, and regenerative medicine for optimal outcomes.
Convenient Charlotte Location
Serving patients from Charlotte, Huntersville, Concord, Matthews, and surrounding areas.
Most patients feel a brief pinch or pressure during the injection. The procedure is generally well tolerated. Mild soreness after the injection is common and usually resolves within a few days.
Unlike cortisone, hyaluronic acid works gradually. Most patients notice improvement within 2–4 weeks after completing the injection series. Full benefit is often seen at 6–8 weeks.
The effects typically last 6–12 months. Some patients may experience relief for longer. When symptoms return, a repeat course can be considered.
Yes, for knee osteoarthritis, hyaluronic acid injections are covered by most insurance plans, including Medicare, when medically indicated. For other joints such as the hip or shoulder, coverage varies and we verify benefits before the procedure.
Yes, but we typically wait at least 4–6 weeks after a cortisone injection before administering hyaluronic acid. Spacing them out allows for a more predictable response.
It depends on the product. Some require a single injection, while others are given as a series of 3 or 5 injections one week apart. Your provider will recommend the appropriate protocol.
Yes. Hyaluronic acid injections do not affect blood sugar the way cortisone can. They are a safe option for diabetic patients with osteoarthritis.
The most common side effect is temporary pain or swelling at the injection site. Rarely, a more significant inflammatory reaction can occur, but it is usually self-limited. Infection is extremely rare.
For many patients, yes. By managing pain and improving function, hyaluronic acid injections can postpone or even eliminate the need for joint replacement. They are most effective in mild to moderate arthritis.
You may be a candidate if you have mild to moderate knee or other joint osteoarthritis, pain persists despite physical therapy, weight loss, and oral medications, you want to avoid or delay joint replacement, or you want a non-surgical option with longer-lasting relief.
If you have knee or joint arthritis and want to explore hyaluronic acid injections, schedule a consultation at Joint Health Solutions in Charlotte. We will help determine if viscosupplementation is right for you and integrate it into a comprehensive care plan.
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