April 20, 2022

How Hyaluronic Acid Can Help Those Living with Joint Pain

Written by: Omnia Tantawi, MSc

To many — Joint pain can be a little bit too much to handle. 

Whether it's the swelling, stiffness, inflammation, or unbearable pain; living with joint pain can be one of the most challenging ailments to continue living with, so scientists and researchers are always on the hunt to test for the efficacy and safety of new therapeutic contenders. 

One new promising candidate showing potential in easing this suffering is 'Hyaluronic acid'.


What is Hyaluronic Acid?

According to the American College of Rheumatology, Hyaluronic acid, also known as Hyaluronan, is a naturally occurring fluid inside joints.1

Generally, it functions in lubricating and loosening the joints to move easily and freely.

On the occasion that the amount of naturally occurring Hyaluronan surrounding the joint is reduced below the normal range, joint diseases will start to arise.

Building on this information, scientists started researching the competence of externally injected Hyaluronic acid to treat patients with joint diseases.


Real-World Evidence of Hyaluronic Acid and Joint Pain

The verdict on the efficacy and safety of Hyaluronic acid use as a therapeutic tool for joint diseases is in —and it's a favorable one— This was evident in a study conducted on 72 patients who were given Hyaluronic acid orally every day. Outcomes of this study were presented in pain reduction, improved joint state, and better sleep.2

Another study was done on 20 patients suffering from osteoarthritis. They were given 80mg/day of Hyaluronic acid extract. After 4 to 8 weeks of treatment, they reported enhanced physical and social capacity.3

As for injection, it was clear that even though it's quicker in showing results. It can pose a greater threat of side effects and inferior efficacy as compared to supplements.4


Hyaluronic Acid Treatment Product Forms

There are several product forms when it comes to Hyaluronic acid: 

  • Topical Form
  • Injectable Form
  • Supplement Form

The method of application differs according to your intended use. But bone health supplements and injections are the most used forms.

Presumably, this is something you can discuss with your care physician before deciding on a specific product to choose what's best suitable for you.


Dosage Form of Hyaluronic Acid

There have been no general guideline criteria to follow when taking Hyaluronic acid supplements. Supplement dosages range from 200-to 1000 mg/day, and most clinical studies presented in the literature advised an average of 200 mg/day. 

So, it's best to consult your doctor, read the information on the bottle carefully and take them in moderation. 

Remember, increasing the dose will not improve your results. 

It's less subtle when it comes to injections as these can only be prescribed and administered by your care physician, so they will provide you with the dose that best suits you.


Side Effects of Hyaluronic acid

Given that Hyaluronic acid is naturally produced in the body, there is no evidence supporting its components' side effects either in supplements or injectable forms. 

This was evident in a study on 60 Osteoarthritic patients who were given Hyaluronic acid supplements for one year. The results revealed improvements in their mobility and no mentions of any side effects, further proving their safety.5

However, there may be some risks and complications associated with the injection procedure manifested in symptoms like:1

  • Pain
  • Warmth
  • Swelling
  • Rash
  • Redness
  • Burning or coldness
  • Tenderness
  • Tingling
  • Ulceration
  • Inability to move joints immediately after injection

These side effects should subside after some time following the injection procedure. 

Thus, multiple studies have advocated for the favorable use of supplements rather than injection.6,7

Nevertheless, it would be best if you were keen on consulting and following up with your health care professional before starting any treatment.


Who Shouldn't Use Hyaluronic Acid Treatment?

Although seemingly safe, there are a few categories of individuals who should be excluded from taking Hyaluronic acid as a treatment: pregnant women, breastfeeding women, and cancer patients.

The reason behind excluding pregnant and breastfeeding women is that there isn't any evidence of the outcomes of medication intake for both these categories —and this is true for most medications, not just in the case of Hyaluronic acid.

The reason for excluding cancer patients is the reports linking Hyaluronic acid to increasing cancerous cell growth. This association was evident in the literature through some studies that advised against using Hyaluronic acid as a treatment tool for cancer patients and cancer survivors.8

Additionally, people who have allergies may exhibit some unwanted side effects, and thus, they are advised to test first before commencing the treatment plan.


Future Directions for Hyaluronic Acid and Bone Health

There have been efforts in investigating Hyaluronic acid and how it can further benefit bone health by increasing the rate of bone growth and repair and reducing the loss of bones that are caused by Osteoporosis-like diseases. 

So far, the results are very promising but still limited to animal studies and testing in the lab.9,10


To Sum Up

Even though Hyaluronic acid has been most famous for treating skin-related problems and reducing wrinkles, there have been valid studies and real-world evidence proving its efficacy and safety in treating patients with joint pain.

Thus, it is a promising candidate who works on improving the burdensome symptoms of bone disease and enhancing patients' quality of life struck with chronic diseases and mobility issues.

Following the advent of scientific research, Hyaluronic will probably have a meaningful impact in reducing or even preventing deteriorating bone diseases.



  1. American College of Rheumatology. Hyaluronic Acid [Internet]. 2022 [cited 2022 Apr 11]. Available from: https://www.rheumatology.org/I-Am-A/Patient-Caregiver/Treatments/Hyaluronic-Acid
  2. Jensen GS, Attridge VL, Lenninger MR, Benson KF. Oral Intake of a Liquid High-Molecular-Weight Hyaluronan Associated with Relief of Chronic Pain and Reduced Use of Pain Medication: Results of a Randomized, Placebo-Controlled Double-Blind Pilot Study.
  3. Kalman DS, Heimer M, Valdeon A, Schwartz H, Sheldon E. Effect of a natural extract of chicken combs with a high content of hyaluronic acid (Hyal-Joint ® ) on pain relief and quality of life in subjects with knee osteoarthritis: a pilot randomized double-blind placebo-controlled trial. 2008; Available from: http://www.nutritionj.com/content/7/1/3
  4. Rutjes AWS, Jüni P, da Costa BR, Trelle S, Nüesch E, Reichenbach S. Viscosupplementation for osteoarthritis of the knee: A systematic review and meta-analysis. Annals of Internal Medicine. 2012;157(3):180–91.
  5. Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N. The cientificWorldJOURNAL Clinical Study Oral Administration of Polymer Hyaluronic Acid Alleviates Symptoms of Knee Osteoarthritis: A Double-Blind, Placebo-Controlled Study over a 12-Month Period. The Scientific World Journal. 2012;2012.
  6. Lafaille P, Benedetto A. Fillers: Contraindications, Side Effects and Precautions. Journal of Cutaneous and Aesthetic Surgery [Internet]. 2010 [cited 2022 Apr 11];3(1):16. Available from: /pmc/articles/PMC2890129/
  7. Adams ME, Lussier AJ, Peyron JG. A Risk-Benefit Assessment of Injections of Hyaluronan and its Derivatives in the Treatment of Osteoarthritis of the Knee. Drug Safety 2000 23:2 [Internet]. 2012 Nov 21 [cited 2022 Apr 11];23(2):115–30. Available from: https://link.springer.com/article/10.2165/00002018-200023020-00003
  8. Publishing Asia B, Itano N, Zhuo L, Kimata K. Impact of the hyaluronan-rich tumor microenvironment on cancer initiation and progression. Cancer Sci. 2008;99(9):1720–5.
  9. Kippo K, Hannuniemi R, Pa¨ivi Isaksson PP, Lauré N L, Sterman TO¨, Peng Z, et al. Clodronate Prevents Osteopenia and Loss of Trabecular Connectivity in Estrogen-Deficient Rats*. 1998.
  10. Lajeunesse D, Delalandre A, Martel-Pelletier J, Pelletier JP. Hyaluronic acid reverses the abnormal synthetic activity of human osteoarthritic subchondral bone osteoblasts. Bone [Internet]. 2003 Oct 1 [cited 2022 Apr 11];33(4):703–10. Available from: https://pubmed.ncbi.nlm.nih.gov/14555276/


Article written by Omnia Tantawi, MSc
Omnia is an Assistant Lecturer and Medical Researcher from Egypt. She’s an integral part in many research projects that proved promising in revolutionizing the future of Medicine. As a Research Scholar, she’s particularly interested in Personalized & Molecular Medicine because she believes that this is the prospect of the healthcare industry and can be applied to all medical and pharmaceutical specializations. But at heart she remains a wordsmith, so she currently works as a Medical Writer. This transition was fairly easy with an Academic Medical background, ability to adapt to different audiences and passion for research and creation. She always takes the most complex or mundane topics and turn it into a must-read with an unparalleled style. In her free time, she likes to read books, tunes in Netflix or enjoys the outdoors.

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