Corticosteroid injections & hyaluronic acid

Professor David Hunter, rheumatologist 

Corticosteroid injections in the management of osteoarthritis again are widely used but it's important for people to understand that they're probably overused. For everybody who has a corticosteroid injection the mean duration of relief that they can expect to attain is usually in the order of about one to two weeks across our whole population. Individuals may attain a longer duration of benefit than one to two weeks but that's what's been found in clinical trials it's important to understand that this is a chronic disease that runs for years and that one to two weeks duration benefit is not necessarily something that should be the first line priority for the management of this disease.

Hyaluronic acid injections, use of viscous supplements or things like Synvisc again are commonly used. In the best-done trials there's no evidence to suggest that viscous supplements are more effective than saltwater injections. Suggesting that you can attain the same benefit from a placebo or a control related injection they do also run the risk in about 5 to 10% of people in them having an allergic reaction in the knee and developing a big swollen diffusion as a consequence of what you otherwise thought was a treatment or intervention and they're also reasonably expensive.