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 a 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 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.
• IMPORTANT: Please schedule your injection either two weeks before or one week after any vaccination appointment.
• If you are currently taking antibiotics, you will need to wait two days after your last dose before having your injection.
• Take all prescribed medications as directed.
• 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.
• 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, explain 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, this is a normal reaction. You may apply heat and ice to the treatment area. If you have any questions, please email us at paintherapy@radiology.ca during business hours.
• 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. If you have questions or concerns, please 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. This procedure is only available in Alberta.