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‘What is the difference between a cortisone (steroid) injection and a Hyaluronic acid injection?’ An

One of the questions we often get asked is: ‘What is the difference between a cortisone (steroid) injection and a Hyaluronic acid injection?’ And then the important question ‘what is more effective’? 

We feel it is very important to clear up a few of these questions as we are at the front foot of delivering both of these treatment injections both at an NHS Level and in private practice. Basically, a simplified answer is these 2 injection treatments are NOT the same and offer different levels of care. So first off they should not be put in comparison to each other. Steroid injections are primary anti-inflammatory drug-based injections that are best offered for acute pain and acute flares to combat inflammation examples being - acute injury, rheumatoid arthritis flare, gout etc... These injections can and are often also used for chronic cases but are not great at dealing with chronic conditions and furthermore have been shown to be detrimental to soft tissues and cartilage. Hyaluronic acid on the other hand is a non-drug based viscosupplementation with far less side effects than steroid and is a better option for managing and treating chronic conditions long term. This is because this acts to protect cartilage and slow the progression of degenerative changes. Studies have also shown this also then has positive impacts on pain reduction. Think of Hyaluronic acid as a joint lubricant that nourishes cartilage. Both treatments have very crucial benefits but aimed at different levels. Patients then ask ‘but why is steroid most prescribed within the NHS and Hyaluronic acid is very minimally offered. This is simple answer to this is steroid is cheaper and has more research ‘to date’ and Hyaluronic acid is more expensive. Further information can be found on this at NICE (national institute of clinical excellence). Basic comparison below that concludes: The most important difference between the two intervention groups is the duration of effectiveness. HA is suggested to be superior in the duration of pain relief when compared to CS. We can propose that HA can be administered every 3 months intra-articular for knee joint OA. Therefore, when CS has to be injected every 2 months, it will be more convenient to use HA. For further information please don’t hesitate to get in touch at

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