Euflexxa Injections: The Non-Surgical Solution to Relieving Knee Pain

Knee Treatments


Last Updated On: 2024-01-12

Learn what Euflexxa injection is, how it works, how it’s administered, its benefits, side effects, contraindications, and restrictions.

Doctor Medica team

Sometimes, patients don’t respond well to non-invasive treatments, so a different approach is necessary. In the case of knee osteoarthritis, this doesn’t always have to be surgery. It has been found that many patients can benefit from viscosupplementation.

Viscosupplementation involves injecting hyaluronic acid (HA), also known as hyaluronan or hyaluronate, into the knee joint. There are various brands of these kinds of injections. The one we will touch upon in this article is the popular Euflexxa injection. Read on to learn more about what it is, how it works, how it’s administered, its benefits, side effects, contraindications, and restrictions.

What Is Euflexxa?

Euflexxa is a brand of injections used to treat knee osteoarthritis. Osteoarthritis (OA) is a condition that causes damage to the joints. This happens when the cartilage, a connective tissue that cushions the joints so they don’t rub together, becomes too thin.

Inside the cavities of synovial joints, we can find synovial fluid, which is there to help lubricate them. Euflexxa contains synthetic hyaluronan extracted from bacterial cells, which mimics the natural hyaluronan, a gel-like substance found in the synovial fluid. 

How Does Euflexxa Work?

The hyaluronic acid contained in Euflexxa is meant to supplement the hyaluronan found in our knees, which should ideally help with the pain. The idea is to increase the concentration of HA and help stimulate our natural production of it.   

OA is a progressive disease, which means that it gets worse with time. There are indications that viscosupplementation can slow down the progression. It should be noted that Euflexxa doesn’t cure OA because it isn’t possible to restore an already deteriorated cartilage, but it does help ease the pain associated with it.

What Does the Procedure Look Like?

Euflexxa is administered by a qualified healthcare professional after it has been prescribed to the patient. If there is effusion in the joint, which means there is extra fluid, the doctor will first remove this fluid by means of a syringe. Once the liquid is aspirated, the patient will receive cortisone treatment.

Sometimes, the doctor will also inject a local anesthetic to numb the area before starting the procedure. Two to four weeks after being injected with cortisone, the patient will receive the Euflexxa injection. There should be three doses in total, one per week.

A study was conducted to test whether it is safe to repeat the procedure after six months. The results showed no negative consequences from additional treatment.

Benefits & Side Effects

The main advantage of Euflexxa is that it offers pain relief without the need for a surgical procedure in cases where oral medications, exercise, and physical therapy aren’t viable treatment options. Those suffering from OA can be pain-free for six months or more after just three injections.

Despite its major benefits, you should be aware of the possible side effects before opting for this injectable medication. Some of the most common ones you may encounter include :

  • nausea;
  • headache;
  • itchiness;
  • loss of appetite;
  • stomach pain;
  • diarrhea;
  • dizziness;
  • difficulty walking;
  • pain, stiffness, or bruising around the injection site;
  • back pain.

Other less common issues that may arise include difficulties swallowing and breathing, severe dizziness, coughing, and skin rashes.

Apart from these adverse reactions, there have been occasional instances of other severe complications as a result of using Euflexxa. For instance, an infection could occur, resulting in symptoms such as a fever, redness, and swelling. This side effect of Euflexxa is extremely rare, but it’s essential for patients to understand all the risks before agreeing to the treatment.

If you notice any side effects, you should consult with your doctor. Some of them may not need medical intervention and will disappear on their own, but other side effects may persist.

Contraindications & Restrictions

Euflexxa is not to be used by patients who are allergic to hyaluronic acid or other ingredients found in the solution. Furthermore, those with an infection or skin disease around the area where Euflexxa is supposed to be injected should also avoid this type of treatment.  This medication is not recommended for those who are pregnant, nursing, or under the age of 18 because it hasn’t been tested on these groups.

The patient shouldn’t do any strenuous physical activity within the first two days of receiving each dose. This includes sports, jogging, and standing for more than an hour at a time.


All things considered, Euflexxa can be quite beneficial for those suffering from osteoarthritis. While this injectable can’t cure the condition, the positive effects can sometimes last six months or even longer. Keep in mind that it is not a solution suitable for everyone, so patients need to be open with their doctors about any allergies to the ingredients or other circumstances that might make receiving the injections risky or even outright dangerous. 


How long does it take for Euflexxa to work?

The time it takes for Euflexxa to take effect may vary from individual to individual. It’s been reported that patients usually start noticing improvements two weeks after being injected with the final dose.

What is the success rate of Euflexxa injections?

If we look into studies conducted to test the efficacy of Euflexxa knee injections, we may be able to determine how successful this injectable medication is in helping patients with pain caused by knee OA. For example, in the study conducted by Altman et al. (2009), 47% of participants who received a three-week-long treatment with Euflexxa injections ended up being entirely pain-free. This effect persisted for six months.

Is the Euflexxa injection a steroid?

No, the Euflexxa injection is not a steroid. It’s a hyaluronic acid injection, which can be an alternative for those with medical conditions that prevent them from taking steroid injections. It has been suggested that there is a small risk of steroid injections actually worsening knee OA, which is not the case with Euflexxa.


Altman, R. D., Rosen, J. M., Bloch, D., Hatoum, H. T., & Korner, P. I. (2009). A Double-Blind, Randomized, Saline-Controlled Study of the Efficacy and Safety of EUFLEXXA® for Treatment of Painful Osteoarthritis of the Knee, With an Open-Label Safety Extension (The FLEXX Trial). Seminars in Arthritis and Rheumatism, 39(1), 1–9.

Frequently Asked Questions. Euflexxa.

Hyaluronic Acid (HA) Injections. Twin Cities Orthopedics.

Hyaluronic Acid (Injection Route). Mayo Clinic.

Interventional Pain Management in Osteoarthritis. Fowler Simons Radiology.

Konstantakos E. What Is Cartilage? May 2016.

Multum C. Euflexxa (injection). March 2023.

Orchard, J. (2020). Is there a place for intra-articular corticosteroid injections in the treatment of knee osteoarthritis? BMJ, l6923.

Osteoarthritis (OA). Centers for Disease Control and Prevention. July 2020.,underlying%20bone%20begins%20to%20change

Osteoarthritis. Mayo Clinic. June 2021.

Osteoarthritis. National Institute of Arthritis and Musculoskeletal and Skin Diseases. October 2019.

Rassouli S. What Is Euflexxa and How Does It Work? March 2023.,the%20joint%20to%20function%20properly.

Viscosupplementation Treatment for Knee Arthritis. OrthoInfo. February 2021.

What Is Euflexxa. Euflexxa.

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