Intraarticular Hyaluronic Acid Injections for the Treatment of Shoulder Pain

Shoulder Pain

Shoulder pain refers to any form of pain felt in the shoulder or around the shoulder joint. The shoulder joint is the most mobile joint in the human body, including four tendons that have the function of holding the muscle to the bone. Any swelling, inflammation, tearing or bony changes around the tendons in the shoulder causes pain when a person tries to move the arm upwards, backwards, straight out or in front.

Common causes include bursitis, rotator cuff tendonitis and tears or ruptures to any of the four tendons. Shoulder instability and dislocation is very common, leading to a host of conditions in this complex area of the body. As with any of the major joints of the body, osteoarthritis can become prevalent with age.



Intra-Articular Hyaluronic Acid Injections

Intra-articular hyaluronic acid injections are a prescribed line of treatment for relief from joint-pain caused by osteoarthritis. The body naturally creates hyaluronic acid to lubricate the joints and keep them functioning smoothly. It also acts as a natural shock absorber, keeping the bones from bearing the full force of impact when putting stress on the joint.

Osteoarthritis is a condition where the hyaluronic acid in the affected joint thins. Intra-articular hyaluronic acid injections therefore add to your body’s natural supply, replenishing the joint’s ability to lubricate itself and absorb shocks.




A local anaesthetic (lidocaine 1%) is administered and the hyaluronic acid is then injected into the joint. Once completed, an iodinated contrast is injected to observe immediate distribution of the hyaluronic acid and local anaesthetic and confirm which joints are being treated.

Specialists dealing with intra-articular injections generally instruct their patients to maintain a simple diary of pain for at least a week’s duration after the injection. The commonly recommended entry in the diary is pain vs. previously expected pain or same physical workload.




The intra-articular hyaluronic acid injections are administered with the aim of providing two to six weeks of pain relief. The most common short-term side effects are minor pain at the injection site and minor build-up of joint fluid. These get better within a few days.