Injection options for knee osteoarthritis

June 13, 2025

What is knee osteoarthritis?

Osteoarthritis is the most common form of arthritis and is a condition that affects joints, with the knee being one of the most affected joints.

Osteoarthritis causes the cartilage in your knee joint to thin and the surface of the joint to become rougher, which means that the knee doesn’t move as smoothly as it should and might feel painful and stiff.

Management for knee osteoarthritis

There is no cure for osteoarthritis, but there are things that you can do to manage the pain. There are also some treatments available that could help with your pain.

Exercises, weight management, modifying daily activities and medication are a few things you can do yourself to help with pain management.

If the above methods of pain relief have not helped, you could consider injection therapy. Injection therapy can be a very useful form of treatment to settle acute symptoms to allow you to engage with rehabilitation or to manage long-term symptoms.

There are three main types of injection therapy that have proven beneficial for knee osteoarthritis – Corticosteroid Injections, Ostenil injections (Hyaluronic Acid Injections) and Cingal injections (Hyaluronic Acid combined with Corticosteroid).

Corticosteroid injections

Some steroids occur naturally in the human body. Artificial steroids act like natural steroids to reduce inflammation. Corticosteroid injections, are a common treatment for knee osteoarthritis, providing temporary pain relief and reducing inflammation.

Steroid injections are often recommended for people with rheumatoid arthritis and other types of inflammatory arthritis. They may also be recommended for osteoarthritis if your joints are very painful and swollen. The injection can reduce inflammation, which in turn should reduce pain and swelling.

Steroid injections often provide patients significant pain relief allowing them to engage with exercise and the chance to progress their rehabilitation and strengthen the surrounding areas to create longer term gains.

Ostenil injections

Ostenil is a solution containing hyaluronic acid (HA injections) which is a natural substance found within synovial joints such as the knee. Hyaluronic acid acts as a lubricant and shock absorber used specifically to help ease joint pain and stiffness associated with osteoarthritis, by helping to preserve joint health.

There are 2 different Ostenil injection options available for knee osteoarthritis:

1. The Ostenil Standard is 2 ml of 1% Sodium Hyaluronate. It is a course of 3 injections once a week over 3 weeks.
2. Ostenil Plus 2ml of 2% Sodium Hyaluronate. It is a single injection that is usually used as top up / follow up injection but can be delivered in place of the recommended course of 3 Ostenil Standard in certain circumstances.

Cingal injections

Cingal® is a single combination injection of Hyaluronic Acid (HA) and Corticosteroid for the management of Osteoarthritis of the knee joint. Hyaluronic Acid helps restore the natural lubrication in the knee joint. The Corticosteroid is Triamcinolone Hexacetonide which is an anti-inflammatory medication.

Due to the HA component of the Cingal injections being the major component they have been approved as a medical device so does not require a prescription and has been deemed safe and effective for its intended use within knee joints in the UK.

The combination is designed to treat pain in knee osteoarthritis and offers both quick and long-lasting pain relief.

Is injection therapy for me?

While injection therapy can provide significant relief for many, it is not always right for everyone. A clinical specialist physiotherapist will complete a full assessment to ensure that an injection is the most appropriate option for you, considering:

• What your pain is caused by.
• Whether you need fast, short-term relief, or slower, longer-term relief.
• What other medical conditions you have.
• What other treatment you have had so far or are currently undergoing.
• Whether you are aware of the risks and side effects and are still happy to go ahead with the injection.

Injections are performed within our clinics using safe methods and you will be able to go home shortly after the procedure. You will also be given an individualised rehabilitation programme to enable the most effective and longer lasting recovery. While you may need to rest the joint for a few days following the injection, you will be able to do all normal activities of daily living.

For more information please visit or contact our clinic at 0191 285 8701 if you would like to talk to one of our clinical specialist physiotherapist.