Knee Pain Injections

Surgery isn’t always appropriate or practical for early to moderate wear and tear of the knee there are therefore a number of different types of injections that can be given into the knee that may improve the pain and dysfunction that is felt by the patient. These do not cure or change the underlying cause.

Steroid injection

Steroid is a potent anti-inflammatory and pain killer. I t can provide pain relief for between 6 and 12 weeks after injection. It is particularly useful when there is an effusion (fluid) within the knee. It can be beneficial to get someone through a holiday or important event or through a flare of symptoms. It is not appropriate for long term management of arthritis or pain. A steroid injection given close to the time of surgery particularly joint replacement can increase the risk of complications particularly infection. It is therefore advised to delay joint replacement for at least 4 months after injection.It is the cheapest injection option and is usually covered by the insurers and NHS.

Hyaluronic injection (Hyalgan or Synvisc)

Hyaluronic Acid is a derivative of animal cartilage. The exact mechanism of action in terms of pain relief is  unknown. It dan provide pain relief for up to 6 months in patients with early arthritis. However it doesn’t give pain relief in all patients and because of this isn’t covered by the NHS. Some insurance companies however will cover its cost.


The N-Stride APS injection has been developed to provide pain relief for knee osteoarthritis avoiding the need for surgery.

When a patient has osteoarthritis Cartilage lining the joint breaks down releasing proteins that promote inflammation and leads to further breakdown of the joint surface.

N-stride APS is an injection created from the patients own blood. A sample of blood is taken from the patient. This is then spun in a special centrifuge that separates out the different constituents of the blood. Some of the proteins found in the blood are concentrated and and then injected back into the affected joint. The protein concentrate is anti inflammatory and contains growth factors that reverses the inflammatory response caused by the arthritis.

Studies have shown That N-Stride can provide long lasting pain relief (beyond  1 year) in a large percentage of patients. There is some evidence that it slows down the degenerative process.

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