Knee Gel Injections: Types, work & Side effects.

Do your knees scream for ease at the end of the day? Do you wake up with knee pain that grows as you move around throughout the day? Do you struggle to do basic movements like walking or climbing stairs without immense knee pain? Chronic knee pain affects one in four Americans, totaling over 100 million people.

While several issues can cause knee pain, one thing unites them is the immense pain and inability to do everyday tasks. It is natural to want to contact your doctor directly and find a fast-acting answer. One such quick relief resolution growing in popularity is knee gel injections. A Hyaluronic Acid Injection for Knee Pain can significantly help relieve arthritic pain and discomfort caused by advanced osteoarthritis and other joint conditions.

However, there are a few things you need to understand about knee injections before moving forward with a treatment. This blog will shed some light on what these injections are, how they work, their side effects, and other essential factors you should consider before opting for gel injections for knee pain.

Types of Injections for Knee Pain

Cortisone Injections

Typically, Cortisone injections are recommended for patients with knee arthritis who suffer from pain and swelling. They can be very adequate for knee pain and osteoarthritis symptoms. The infusion can fast relieve these symptoms, usually within 1-3 days. Symptom improvement and improvements in VAS (visual analog scores), which measures pain numbers on a scale of 1-10, typically improve even more significantly within the first six weeks after these injections but may manage to decrease around the 12-week mark post-injection.  

If symptoms recur, these injections can be given frequently every 3 to 4 months. However, we typically suggest waiting until pain/swelling symptoms have returned. Prophylactic injections and more frequent administration of the cortisone injections tend to lead to their becoming less effective over time and won’t end up working as well.

Gel Injections

You may have also heard of “Gel” injections. These viscoelastic supplement injections are a hyaluronic acid derivative, a naturally occurring chemical in the normal synovial (joint) fluid.

In the arthritic knee, the quantity of hyaluronic acid inherently diminishes. This sense typically binds to the chondral (cartilage) surface of the joint and allows it to cushion the joint. Less of this and less cartilage in the knee leads to increased pain. The idea behind the Gel injections is that re-introducing this substance will help cushion the joint surface and improve pain.

These injections are generally suggested as an option to cortisone injections and can be given every six months. Medicare covers them every six months, and various insurance companies protect them at different intervals. These are typically not shown on the same day as cortisone injections but can be spaced out a few weeks afterward to help prolong the effects.

How Do Knee Gel Injections Work?

There are a few causes of knee pain, and these gel injections’ functions may differ slightly depending on the grounds. Research indicates that injecting HA for knee pain can alleviate discomfort and improve mobility in multiple ways.

For instance, hyaluronic acid injections can alleviate joint inflammation and reduce friction. Additionally, they can slow down bone and cartilage degeneration.

Also, knee injections help keep the water content within the joints by improving synovial fluid viscosity. This fluid is a cushion for the bone ends in the knees, facilitating smooth movement with less muscle force.

Knee Gel Injections Side Effects

Both types of injections have minimal side effects. Patients can expect some initial soreness and pain at the injection site, which should subside in 24-48 hours. Patients with diabetes may note a quick rise in blood sugar levels for 48-72 hours after cortisone injections. Any injection has a small (<1%) risk of infection. With gel injections, there is a reported 5% risk of a “pseudo-sepsis” reaction where they can develop a red, hot, swollen knee that mimics infection. This typically improves with ice and NSAIDs after infection is ruled out. Long-term use of cortisone can be damaging to healthy cartilage. Still, for most patients, cortisone injections are recommended for already damaged cartilage arthritis.

The good news is that patients can almost always expect relief from at least one of these injections. The real question will be which works best for them and how long the effects last. Cortisone injections tend to work quickly and provide relief, but this can be as short as a few weeks or as long as several months. The gel injections are effective for about 50% of patients, but for those that it works well, patients see improvement in VAS scores for at least 4-6 months.

What if knee gel injections Don’t Work?

Knee replacement would be the last step in treating a patient with knee arthritis. However, this should only come after the patient has tried and failed with injections, bracing, NSAIDs, using a cane/walker, and, most importantly, a formal physical therapy program to maximize strength, motion, and weight loss if necessary. When these treatments don’t work or stop, patients can live with their current symptoms or proceed with knee replacement.

Knee replacement is the only thing that changes what the X-ray looks like and truly gets rid of the arthritis. All of the other treatments control the symptoms. The knee replacement is an open surgery where the ends of the femur and tibia, where the damaged cartilage is, are removed, and metal caps are placed on the ends of the bone with a polyethylene spacer in between. This becomes the new knee joint. 

Patients nowadays typically go home the same day and walk, with assistance, on the day of surgery. Physical therapy ensues, and patients usually recover in about three months. Knee replacement is a beneficial operation in the right candidate with typically 85-90% excellent outcomes. 


 Knee gel injections, also known as viscosupplementation, offer a promising therapeutic option for individuals suffering from knee osteoarthritis. Supplementing the natural joint lubricant with a synthetic gel, these injections help alleviate pain, improve mobility, and enhance overall quality of life. 

 However, it’s crucial for individuals considering this treatment to consult their healthcare provider to determine if it’s the most suitable option for their condition.