Knee osteoarthritis (OA) affects over 8.75 million people in the UK, making it one of the most common reasons patients visit their GP or a private joint clinic. When physiotherapy and pain relief tablets no longer provide enough relief, two highly effective injectable treatments are available: corticosteroid (steroid) injections and hyaluronic acid (HA) injections.
But which one is right for you? This article breaks down the science so you can make an informed decision with your clinician.
How Steroid Injections Work
Corticosteroid injections reduce inflammation within the joint cavity rapidly. They work by suppressing the inflammatory response — reducing swelling, heat, and pain in the knee. Most patients notice significant improvement within 3–7 days of their injection.
They are particularly effective for patients experiencing an acute flare of osteoarthritis — where the knee is noticeably swollen, warm to touch, and severely limiting daily activities. Clinical research published in the New England Journal of Medicine confirms that steroid injections provide reliable short-term pain relief, typically lasting 4–12 weeks per injection.
How Hyaluronic Acid Injections Work
Hyaluronic acid (HA) is a natural component of healthy synovial fluid — the lubricant inside your knee joint. In osteoarthritis, this fluid becomes thinner and less effective. Products such as Durolane and Ostenil Plus replenish and thicken this fluid, restoring the joint’s natural shock-absorbing and lubricating properties.
Unlike steroid injections, HA takes up to 4 weeks to reach full effect — but the benefit lasts considerably longer. Clinical evidence shows HA can provide pain relief for up to 12–15 months from a single injection. A landmark meta-analysis published in the Osteoarthritis and Cartilage journal found HA delays the need for knee replacement surgery by an average of 3 years.
Head-to-Head Comparison
- Speed of relief: Steroid injections win — relief within days vs. 4 weeks for HA
- Duration of effect: HA wins — up to 15 months vs. 4–12 weeks for steroids
- Suitability for diabetics: HA is preferred — steroids can temporarily raise blood glucose
- Repeat use: Steroids are limited to 3–4 per year; HA can be repeated annually
- Evidence for surgery delay: HA has stronger evidence for long-term structural benefit
Which Should You Choose?
The decision depends on the severity and stage of your arthritis, your lifestyle demands, and any other health conditions. At Norfolk Health & Joint Care, Jon Gardner conducts a thorough clinical assessment before recommending any treatment — ensuring the right injection is matched to your individual needs.
Many patients benefit from starting with a steroid injection for rapid relief, followed by hyaluronic acid for sustained long-term benefit. Your clinician will advise the most appropriate pathway for you.
