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Viscosupplement (Hyaluronic Acid) Injection

Hyaluronic acid (HA) is a natural element present in joints. Injection of HA can improve mobility, acting as a natural lubricant and reducing pain. Injections are performed under X-ray guidance to ensure the solution is delivered exactly into the joint.

We use HA injections to help relieve pain from osteoarthritis or mechanical difficulties in joints. Hips, knees, and ankles are the most commonly treated, and relief can last up to 12 months. We provide all HA products (Durolane, Monovisc, Synvisc, and others) onsite to patients at cost*, including newer generation products containing a combination of HA and steroid (Cingal). A prescription is required. Your doctor may request an initial diagnostic steroid injection before HA injections (except Cingal).

For more information on osteoarthritis and these injections, read the article New Guidelines for Treatment of Knee Osteoarthritis.

*Medications are provided at cost, but prices vary depending on dosage and manufacturer. Please contact our pain management department for the most current price.

HOW DO I PREPARE FOR MY PROCEDURE?

  • You’ll need a prescription and requisition from your practitioner. Many insurance plans cover HA products as “medical devices.” Your booking coordinator will discuss this with you when they call to give you details about your appointment. We provide most products onsite at cost. Otherwise, you will need to bring your medication to your appointment.
  • If you are on anticoagulation drugs (Plavix, Coumadin, Warfarin etc.) you may need to have an international normalized ratio (INR) test and stop your medication prior to the procedure. Please inform our booking coordinators of any blood thinners you may be taking, so that they can discuss further instructions with you.
  • If you take insulin to manage your diabetes, please let your booking coordinator know. You may have some juice and a small snack after taking your insulin.
  • In case you have any discomfort, please have someone accompany you on the day of your test. It may be more convenient to have someone else drive you home.
  • Please arrive 15 minutes before your appointment to allow enough time to fill out a consent form.
  • Bring photo identification and your provincial health card.
  • Take all prescribed medications as directed.
  • Wear comfortable clothes.
  • Please do not bring children who require supervision.

WHAT HAPPENS DURING MY PROCEDURE?

  • We may provide you with a comfortable clinic gown to change into (depending on the area being treated).
  • A team member will review the consent form and procedure details, and answer any questions.
  • We will then escort you to our treatment suite where you will meet the radiologist who will clean the skin and inject a local anesthetic, similar to the freezing you get at the dentist.
  • The radiologist will typically use X-ray guidance to perform the treatment and inject the solution using a sterile needle.
  • You will be assessed post-injection by our team and, if there are no concerns, you will be free to leave.

POST-PROCEDURE INSTRUCTIONS

  • First 24 hours: Keep the treatment area clean. Leave the Band-Aid on. Do not shower.
  • First 48 hours: Avoid bathtubs, hot tubs, and pools. Avoid strenuous activity and lifting.
  • After one week: You may resume physiotherapy. Be mindful of your pain and stop if it hurts too much. Notify your physiotherapist that you have had this injection so they can modify your exercises if necessary.
  • Watch for infection: If you develop worsening pain, skin redness at the site of injection, or a temperature greater than 38.5°C, please proceed to an urgent care or emergency centre.
  • If you have pain or other symptoms beyond 48 hours after your injection, please call our office at 403-568-3890 or email us at paintherapy@radiology.ca during business hours. You may apply heat and ice to the treatment area.
  • Diabetics: Note that cortisone can cause a temporary increase in blood sugar. Please monitor your blood sugar closely and, if you have any concerns, consult with your doctor.
  • This product may take time to distribute in the joint. We encourage you to move the joint and massage the area.
  • Rarely, patients may experience a temporary “flare” of the joint – pain and stiffness – after these injections. This typically occurs between 12-48 hours after the injection and can be managed by Tylenol or aspirin. Please notify us if this happens at 403-568-3890 or email us at paintherapy@radiology.ca.

WHEN WILL I SEE RESULTS?

  • After your injection, the freezing may last for a few hours. Your symptoms may return until the injection takes effect in 1-2 weeks. Please track your symptom response to share with your physician.
  • An injection typically provides up to 12 months of symptom relief. If it does not help relieve your symptoms, then you may need further evaluation by your referring doctor for another cause of your symptoms.

HOW MUCH WILL IT COST?

Medications are provided at cost, but prices vary depending on dosage and manufacturer. Please contact our pain management department at 403-777-3122 for the most current price.

FOR YOUR APPOINTMENT

Please ensure that you bring your requisition with you to your appointment.

DURATION

15-20 minutes

How long does the injection take to work?
After your injection, the freezing may last for a few hours. Your symptoms may return until the steroid takes effect in 1-2 weeks. Please track your symptom response to share with your physician.
How long will the injection last?
An injection typically provides up to 12 months of symptom relief. If it does not help relieve your symptoms, then you may need further evaluation by your referring doctor for another cause of your symptoms.
How many injections can I have and how often?
You can have an HA injection every three months, but if you aren't getting 6-12 months relief from each injection that product may not be right for you. You may need to discuss further treatment options with your physican. 
What are the side effects?
These are very safe procedures. The most common side effect of an injection is mild pain or bruising around the area. Over-the-counter pain medications or icing the area can help. As all our procedures are performed in a sterile manner according to provincial guidelines, only in very rare circumstances will a patient develop an infection or an allergy to a substance in the product. The booking staff will review your allergies with you prior to your appointment.