- Hyaluronic acid is found in all the tissues of the body with higher concentrations in the skin, joints and eye sockets.
- In terms of joint health, its essential biological function is to retain water and provide nutrients for optimal cartilage performance.
- Certain types of HA also possess anti-inflammatory properties and may help reverse cartilage loss.
- Injections with hyaluronic acid are administered as an alternative treatment for patients with aggravated osteoarthritis.
- Also found in supplements for osteoarthritis, hyaluronic acid is also considered a safe pain reliever with minimal side effects.
Hyaluronic acid is a naturally occurring substance in the body. It is a clear, lubricating substance that is present in high concentrations in the skin, inside joints and within eye sockets. More specifically, in terms of joint health, hyaluronic acid is present in all the bones, joints, connecting tissue, cartilage and tendons all through the body.
Hyaluronic is present in significant amounts in a type of cartilage known as hyaline cartilage. This cartilage covers the bones’ ends and offers cushioning in the area. In this sense hyaluronic acid is beneficial for reducing pain and tenderness typically linked with degenerative diseases of the joints.
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The same is also present in another part of the joints known as synovial membrane. This membrane forms a covering over bones and produces the synovial fluid. This is a clear, viscous fluid which aids the joints in absorbing shock, retain its elasticity and transports nutrients to the cartilage.
In individuals with osteoarthritis, the hyaluronic acid found in the synovial fluid breaks down and contributes to the associated joint pain and stiffness. 1
How Hyaluronic Acid works
The most significant advantage of hyaluronic acid for joint health is its capacity to retain water within the soft tissue. It is also considered a glucosaminoglycan, or an extended chain of disaccharide molecules linked together.
The size of these molecules is directly related to hyaluronic acid’s different functions. For instance, larger molecules present in healthy tissue regulate inflammation and minimize damage by free radicals. Smaller molecules, on the other hand, communicate with the immune system by transmitting distress signals and raising inflammation to assist with wound healing or other injuries.
Hyaluronic acid benefits for joints
Prevents erosion of joint cartilage
Joint cartilage is a smooth, glistening, translucent living tissue found on the ends of the bones. This cartilage caps the ends of the bones and yields a low friction environment for easy movement.
Healthy cartilage with adequate amounts of synovial fluid prevents bone erosion. And the health of the cartilage depends on the presence of hyaluronic acid in the synovial fluid.
Regulates inflammatory cells
In osteoarthritis patients, synovial inflammation is an important factor in the condition. In these patients the concentration of hyaluronic acid decreases as the condition progresses. Treatment with hyaluronic acid in these instances has been shown to help restore synovial fluid properties leading to reduced inflammation, less pain and improved clinical outcomes. 2
Improves joint lubrication
Perhaps the most researched benefit of hyaluronic acid is its potential to lubricate achy joints. 3 It is no wonder then, that hyaluronic acid is present in greater concentrations in the hips, knees and other joints.
Serves as shock absorber
It is a significant part of both cartilage and synovial fluid, both of which have shock absorbing properties and can stand a tremendous amount of wear and tear. 4
Its water retaining properties allows fluid movement in the area and pressure absorption in joints which helps reduce pain associated with many degenerative conditions. Hyaluronic acid also serves as a safe alternative to NSAIDS in pain management. 5
How to use Hyaluronic Acid for joint pain
The high prevalence of arthritis and osteoarthritis has also led to an increased awareness and increased research efforts. At the moment, hyaluronic acid treatment in available in the following forms to seek relief from joint pain and discomfort:
Hyaluronic acid is now a popular substance used in supplements for treating osteoarthritis pain and injuries. Some research indicates that lower doses may be effective for reducing joint stiffness and chronic pain. 6
Further research also indicates that when taken orally, hyaluronic acid can increase the body’s natural production of this protective substance, making it an excellent non-invasive therapy for arthritis and other joint related issues. 7
When taken in supplemental form, the recommended dosage for adults over 18 is 50 mg by mouth once or twice a day daily with meals.
Osteoarthritis patients are advised to take 80mg containing 60-70% Hyaluronic acid daily for 8 weeks.
Injectable hyaluronic acid is a prescription product that needs to be administered by a physician.
The same has also been approved by the FDA for treatment of osteoarthritis when administered in relatively high doses through injections given by a healthcare provider. The types of joint pain most commonly treated with hyaluronic acid injections include those of the elbows and knees. 8
Injections are only offered as a treatment option when the patient is no longer able to control the pain with ibuprofen or other NSAIDS. Another scenario could be an individual’s intolerance to these drugs.
The recommended dosage for hyaluronic injections is 20mg into the affected joint once every week for three to five weeks.
Possible side effects
Oral hyaluronic acid is a non-prescription product that is sold as a dietary supplement. The benefits of the oral formulation over injections include lower cost, lower risk, no pain and improved convenience. Injections, on the other hand, provide longer lasting relief.
However, while generally considered safe to use, hyaluronic supplements may present some side effects for certain demographics. For instance, hyaluronic injections and supplements should not be used by expectant women or breast feeding moms. This is because the acid may stick around in breast milk and may have some negative effects for the developing baby or fetus.
Another group of people who need to be careful while using hyaluronic acid supplements or injections are those with specific allergies. Since hyaluronic acid in prescription and commercially manufactured products is typically sourced from bird protein or cartilage, individuals with allergies may experience reactions.
In addition, hyaluronic acid may interact with certain blood thinning medications, so should not be used by people on such medication.
Finally, using the injectable form of hyaluronic acid is an invasive procedure and may present a small chance of introducing an infection in the joint.
Hyaluronic acid and Glucosamine
Hyaluronic acid and glucosamine are both crucial for optimal joint health with the former being an integral part of the synovial fluid and the latter working as the building block for cartilage.
While both may have varying functions to perform, collectively they do improve joint and cartilage elasticity. Hyaluronic acid yields higher lubrication given its water retention features while glucosamine yields greater strength and structure.
Being an integral part of the synovial fluid hyaluronic acid is crucial for shock absorption whereas glucosamine prevents cartilage loss.
When both are used together, glucosamine can actually promotes the production of hyaluronic acid. 9 At the same time, when used with other substances that support joint health, both can lower the pain associated with osteoarthritis.
Hyaluronic Acid Foods
Also known as the poor man’s joint supplement, bone broth may well be one of the most beneficial sources of hyaluronic acid. Derived from the joints and carcasses of poultry, cattle and fish not only yields hyaluronic acid into the diet but also a host of other nutrients and compounds essential for optimal joint health.
You may also up the nutritional value of bone broth by adding in meat and vegetables and preparing it into a hearty soup or stew.
High levels of hyaluronic acid are present in most organ meats. However, organ meats also contain a fair amount of fat, so care should be taken when consuming these. Eating small amounts of organ meats may help increase levels of hyaluronic acid in the body.
Starchy root vegetables are another option to consider. These foods already contain some hyaluronic acid and also boost its production. Root vegetables are easy to include into meals and you can choose from options like potatoes, sweet potatoes and jicama.
Eggs are another convenient source of hyaluronic acid. Most of the hyaluronic acid content found in eggs is present in the membrane separating the white from the shell.
You can further fortify bone broth with additional hyaluronic acid by throwing in leftover eggshells into the broth and straining them out once the broth has cooked. You may also look for supplements with eggshell membrane to supplement hyaluronic acid.
Leafy greens contain magnesium which is a required catalyst to assist hyaluronic production in the body. In the absence of adequate magnesium, the levels of hyaluronic acid may also decrease. So stock up on leafy greens in salads, smoothies and stir-fries to keep hyaluronic levels up. Leafy greens also provide a host of other nutrients beneficial for overall health.
Hyaluronic acid provides the necessary lubrication to joints without which debilitating conditions like osteoarthritis set in. However, oral supplementation or treatment via injections can both help alleviate the discomfort associated with the condition. In addition, supplemental hyaluronic acid can also stimulate the body’s own generation of fresh hyaluronic acid and help abate the pain and inflammation. 10
Arrich J, Piribauer F, Mad P, Schmid D, Klaushofer K, Mullner M. Intra-articular hyaluronic acid for the treatment of osteoarthritis of the knee: systematic review and meta-analysis. Canadian Medical Association Journal. 2005;172(8):1039-1043. doi:10.1503/cmaj.1041203.↩
Altman R, Manjoo A, Fierlinger A, Niazi F, Nicholls M. The mechanism of action for hyaluronic acid treatment in the osteoarthritic knee: a systematic review. BMC Musculoskelet Disord. 2015;16(1). doi:10.1186/s12891-015-0775-z.↩
Masuko K, Murata M, Yudoh K, Kato T, Nakamura H. Anti-inflammatory effects of hyaluronan in arthritis therapy: Not just for viscosity. International Journal of General Medicine. 2009:77. doi:10.2147/ijgm.s5495.↩
Tamer T. Hyaluronan and synovial joint: function, distribution and healing. Interdisciplinary Toxicology. 2013;6(3). doi:10.2478/intox-2013-0019.↩
McIntyre L, Beach W, Bhattacharya S, Yadalam S, Bisson B, Kim M. Impact of Hyaluronic Acid Injections on Pain Management Medications Utilization. The American Journal of Pharmacy Benefits 2017. Accessed December 28, 2017.↩
Tashiro T, Seino S, Sato T, Matsuoka R, Masuda Y, Fukui N. 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;2012:1-8. doi:10.1100/2012/167928.↩
Wang C, Lin J, Chang C, Lin Y, Hou S. Therapeutic Effects of Hyaluronic Acid on Osteoarthritis of the Knee. The Journal of Bone & Joint Surgery. 2004;86(3):538-545. doi:10.2106/00004623-200403000-00012.↩
Uitterlinden E, Koevoet J, Verkoelen C et al. Glucosamine increases hyaluronic acid production in human osteoarthritic synovium explants. BMC Musculoskeletal Disorders. 2008; 9(1). doi:10.1186/1471-2474-9-120.↩