Vale Health Injection Clinic

Cingal Knee Injection

Achieve swift and enduring relief from your osteoarthritis knee discomfort with Cingal® – ensuring a rapid and enduring solution for your pain and stifness



Knee Osteoarthritis 


None needed 


30 minutes


Avoid heavy impact and intense loading activities for 10-14

Cingal® is a single-injection osteoarthritis knee pain relief treatment that combines the quick relief of a cortisone with the long-lasting relief of a viscosupplement.

CINGAL®: An innovative blend of viscosupplement designed to alleviate osteoarthritis knee pain effectively.


A single intra-articular injection of Cingal® can provide rapid* osteoarthritis knee pain relief that’s felt as early as 1 week following the injection and that can last up to 6 months.

Reducing Pain Improving Mobility

The combined action of lubricant and anti-inflammatory properties is crucial in addressing osteoarthritis knee pain effectively.

As time progresses, alterations in synovial fluid and the deterioration of joint structures can contribute to the onset of osteoarthritis knee discomfort.

Hyaluronic acid, a naturally occurring substance within the knee joint’s synovial fluid, plays a pivotal role. Viscosupplementation involves injecting hyaluronic acid into the joint, aimed at lubricating the cartilage, akin to oil lubricating an engine. This process offers enduring relief with a delayed onset, targeting long-term pain reduction.

 Cortisone, possess potent anti-inflammatory properties. They are utilised to alleviate pain by mitigating swelling within the joint, providing rapid relief on a short-term basis.

London Bridge Regenerative Clinic

Cingal® stands out with its unique composition, blending hyaluronic acid (HA) viscosupplement with cortisone in the injection.

HA plays a vital role as a lubricating element in synovial joint fluid, crucial for maintaining healthy cartilage elasticity and resilience. However, individuals suffering from osteoarthritis (OA) often experience diminished HA levels in their joints. To counteract this deficiency, HA-based viscosupplementation products are developed specifically for OA, aiding in pain alleviation while lubricating and cushioning the joint.

 Purification and formulation processes are built upon naturally-sourced hyaluronic acid. These processes aim to replenish the HA lost from arthritic knee joints’ synovial fluid due to aging or injury.

Given that cortisone are insoluble in water, they are suspended in the HA gel as particles. Within Cingal, both the cortisone and HA components remain separate and unchanged, maintaining their integrity within the formulation.


During an ultrasound-guided cortisone injection, your injection practitioner will select the appropriate cortisone and dosage based on the area we are injecting, clinical history, and severity of your issue. We will begin by taking your case history, orthopedic, and neurological examination followed by a diagnostic ultrasound scan. This comprehensive approach allows for accurate diagnosis and for the best treatment modality to be used.

Assuming there are no contraindications, the practitioner will proceed to inject the cortisone directly into the inflamed area, such as a joint or the surrounding soft tissue identified during the diagnosis. Most patients find these injections to be comfortable and well tolerated.

Depending on your medical history and examination, we may need to postpone the injection if certain conditions are present, such as unstable blood pressure or fluctuating blood sugar levels due to diabetes. In such cases, specific written consent from your GP may be required before proceeding with the injection.

Following the injection, it’s common for the local anesthetic to provide immediate relief from pain. However, this initial numbing sensation typically subsides within a couple of hours. The full effects of the cortisone may take several days to start, usually resulting in a significant reduction in pain within a week post-injection. We will also advise specific rehabilitation exercises, pain and anti-inflammatory medication, ice, compression, and activity modification.

Depending on the area we are injecting, it is normally advised to avoid driving for 1 hour after the injection, as you may experience some numbness.

For joint injections, it’s recommended to refrain from strenuous exercise for approximately two days afterward. Similarly, if the injection is near a tendon, avoiding heavy impact and intense loading activities for 10-14 days post-injection is advisable. We will provide guidance on returning to normal activities on the day of treatment and may advise a course of shockwave therapy or physiotherapy.

If you experience pain relief from the injection and alternative treatments have been ineffective or unsuitable, repeat cortisone injections can typically be administered safely, but we would not normally have more than 3 per year. Some injections serve to create a ‘window of opportunity’ for engaging in exercise and rehabilitation. As your pain becomes better managed, the emphasis often shifts towards exercise and conservative management, potentially reducing the necessity for further injections. Once the pain levels have reduced to a more tolerable level, we may also advise other treatment modalities such as focused shockwave or HA injections.

  1. Have an infection
  2. Exhibit allergies to local anesthetics or cortisone
  3. Feeling unwell or have fever
  4. Have upcoming surgery planned in the same area
  5. Are unsure or hesitant about receiving the injection
At London Bridge Regeneration clinic we provide various payment options meaning you can spread the cost and enjoy a confident outlook at a price you can afford this can also include interest free options.

Please book your free initial 10 minute free telephone or face-to-face consultation to ascertain the suitability of the injection and the different treatments we offer. 

Procedure Specialists

Injection Therapist 

 Ultrasound guided Steroid Injections

Gary Edwards



Cingal emerges as a clear gel crafted from pristine, non-animal-derived, ultra-pure, high molecular weight HA expertly


UNRIVALED RAPIDITY AND DURATION Distinguished for its swift onset and prolonged efficacy surpassing that of other, Cortisone offers enduring relief for up to 21 days, far exceeding the typical 8-14 day duration of alternative cortisone


In Cingal, the hyaluronic acid (HA) undergoes a gentle cross-linking process, extending the stay of HA molecules within the knee joint space. This results in prolonged pain relief, ensuring enduring comfort for an extended period.


Cingal boasts a distinctive formulation designed for optimal water binding, creating polymers of exceptional viscosity. These polymers significantly enhance the synovial fluid's capability to cushion the knee joint effectively, absorbing shocks with unparalleled efficiency.


Cingal features an elevated concentration of HA at 22 mg/mL, delivering a total dose of 88 mg of HA. This formulation aims to replicate the abundant HA levels present in healthy synovial fluid, ensuring optimal functionality and support for the knee joint.


Hyaluronic acid (HA) plays a pivotal role in sustaining synovial fluid’s elasticity and function. Cingal steps in to supplement the diminished HA levels found in osteoarthritic knee joints, while its cortisone component swiftly addresses inflammation, offering rapid pain relief within days of administration.

Harnessing a potent blend of high HA concentration and a proven cortisone, Cingal presents a dynamic, fast-acting, high-viscosity solution. This formulation not only cushions the knee joint during routine activities like walking and biking but also swiftly alleviates discomfort.

With just one injection, Cingal delivers lubrication, cushioning, and protection to the knee joint, enabling patients to swiftly resume their active lifestyles with diminished pain.

After the procedure,  typically we dvise refraining from engaging in strenuous physical activities for several days to allow your body to recover optimally. It’s essential to prioritise hydration by drinking plenty of water to help flush out any toxins and aid in the healing process. If you experience any discomfort or pain, Paracetamol can be safely used for pain management as needed.

It is important to follow your clinician post-procedure instructions carefully and attend follow the knee rehabilitation programme.


Step 1. Free Intial consultation

London Bridge Regenerative clinic gives every patient a free consultation with one of our injecting practitioners.

There is no obligation to proceed to treatment. The consultation is an opportunity to discuss your issue in detail and the benefits and risks of the procedure.

Approximately 10 million individuals in the UK are impacted by osteoarthritis (OA), with approximately 6 million being women and 4 million men. Among them, an estimated 5.4 million people suffer from knee osteoarthritis, while 3.2 million are affected by hip osteoarthritis.


We will allow time to find out more about the procedure, understand the advantages and risks with the procedure, and to give time for you to ask questions We may need to refer you for an MRI


We  will then take your medical history, examine which may include diagnostic ultrasound then proceed with the guided injection. 


You’ll be given individual pre-injection advice to reduce your chance of bleeding or infection and support your recovery and aid healing

It’s important to let your practitioner know if you’re on any prescription or over-the-counter medications. You may be asked to stop taking aspirin or anti-inflammatory tablets, which can increase the risk of bruising. It’s also important to stop smoking cigarettes and e-cigarettes before and after the procedure because they can disrupt the healing process.

Local anesthetic is not needed for this procedure and the procedure is tolerated very well. 

STEP 4: RECOVERY & after care

Following the procedure, most individuals can return home and resume their normal activities. Our clinical team will be available to offer water and provide guidance on post-injection care.

For the next twenty-four hours, it’s advisable to refrain from strenuous activities and alcohol consumption. Don’t be alarmed if you don’t notice immediate effects; it typically takes around five days for the injection to take effect, with the full results becoming evident over the course of several weeks.

A follow-up appointment or phone consultation will be scheduled for four weeks after the procedure to review the progress. 



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