Hyaluronic acid (HA) is a naturally occurring substance found in the synovial fluid of your joints. It acts as a lubricant and shock absorber, helping your joints move smoothly. In joints affected by osteoarthritis, levels of hyaluronic acid are reduced — contributing to pain, stiffness, and inflammation.
A hyaluronic acid injection — sometimes called viscosupplementation — replenishes this natural lubricant by injecting a synthetic version of HA directly into the joint. This can reduce friction, cushion the joint, and relieve pain.
What is Durolane?
Durolane is one of the most commonly used hyaluronic acid products in the UK. It is a single-injection, non-animal stabilised hyaluronic acid (NASHA) gel. Unlike some older HA products that required a course of three to five injections, Durolane is given as a single dose and has been shown to provide relief for up to six months in clinical studies.
At Alton Pain Clinic, we use Durolane as our standard HA product. Its safety and efficacy profile makes it a reliable choice for patients with mild to moderate osteoarthritis.
What is Biolevox?
Biolevox is a premium hyaluronic acid product that we also offer at Alton Pain Clinic. It is a highly purified, cross-linked HA gel designed for intra-articular injection — meaning it is injected directly into the joint space. Biolevox has a high molecular weight formulation which closely mimics the natural synovial fluid of a healthy joint, giving it excellent cushioning and lubricating properties.
Like Durolane, Biolevox is administered as a single injection and is suitable for patients with mild to moderate osteoarthritis of the knee and other joints. It has a well-established safety profile and is used across Europe in musculoskeletal injection clinics. Your clinician will discuss whether Durolane or Biolevox is the more appropriate choice for your individual situation
What conditions are treated with hyaluronic acid injections?
HA injections are most commonly used for:
- Knee osteoarthritis — the most common indication
- Hip osteoarthritis
- Ankle osteoarthritis
- Shoulder osteoarthritis
- Other joints where osteoarthritis is causing pain and limiting function
Hyaluronic acid injection vs cortisone injection — which is better?
Both treatments have their place, and the right choice depends on your individual situation.
Cortisone injections work faster — many patients notice improvement within a few days — but the effect typically lasts two to four months and repeated injections are limited. They are particularly effective for acute flare-ups of joint pain.
Hyaluronic acid injections tend to work more slowly — most patients notice improvement at four to six weeks — but the effect can last longer, often four to six months.
Your clinician at Alton Pain Clinic will help you decide which option best suits your symptoms, lifestyle, and medical history. Read more about cortisone injections here.
What to expect during the procedure
- A consultation to review your symptoms and confirm HA is the right treatment for you
- Ultrasound assessment to visualise the joint and identify the optimal injection site
- The injection — typically completed in five minutes or less
- Aftercare advice, including guidance on activity levels and when to expect results
Some mild swelling or discomfort around the joint is normal for 24–48 hours after the injection. Most patients are able to return to light activity the same day.
This article is intended for informational purposes only and should not replace professional medical advice. If you are experiencing persistent symptoms, please consult a qualified clinician.
Frequently Asked Questions
How long do hyaluronic acid injections last?
Most patients experience benefit for four to six months from a Durolane or Biolevox injection. Some patients report longer-lasting effects. The duration can vary depending on the severity of osteoarthritis, activity levels, and individual biology.
How many hyaluronic acid injections can you have?
HA injections can be repeated. There is no firm limit in the way there is for cortisone injections, though we would typically wait at least six months between treatments. Your consultant will advise on the most appropriate frequency for your situation.
Do hyaluronic acid injections hurt?
The procedure is generally well tolerated. Using ultrasound guidance means we can use a very precise approach, minimising discomfort. Any soreness afterwards usually settles within a day or two.