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Cingal® knee injections in Tunbridge Wells: quick relief and longer support in one
Cingal® puts a fast-acting steroid and long-acting hyaluronic acid into one injection for an arthritic knee. At Vale it’s given under ultrasound guidance, after a free consultation.
An arthritic knee often has two things going on. The joint lining can be inflamed, which drives pain and swelling. And the joint fluid has thinned, so the knee moves less smoothly.
A steroid injection calms inflammation quickly, but its effect often fades within weeks. Hyaluronic acid works on the joint fluid and lasts longer, but can take weeks to help.
Cingal® was designed to deal with both in one visit.
The two ingredients work on different timescales. Together they aim to cover the gap between the quick but short-lived effect of a steroid and the slower effect of hyaluronic acid.
01
The steroid
Triamcinolone hexacetonide damps down inflammation in the joint lining, often within days.
02
The hyaluronic acid
Cross-linked hyaluronic acid thickens the joint fluid and is cleared slowly.
03
Together
Early relief from the steroid, with the hyaluronic acid aiming to carry it on for months.
Who it suits
Who may benefit from Cingal®?
Cingal® is used for mild to moderate osteoarthritis of the knee.
It may suit you if your knee is painful and swollen now, and you’d like relief sooner than hyaluronic acid alone would usually give. It can also suit people who have had a short-lived benefit from a steroid injection before.
It’s less likely to help a badly worn knee. In that case we’ll talk through other options, such as Arthrosamid® or a surgical opinion.
The evidence
What does the research show?
The main Cingal® trial compared it with hyaluronic acid alone and with a saltwater placebo, in 368 people with knee osteoarthritis [1].
At one and three weeks, Cingal® reduced pain more than hyaluronic acid alone.
Up to 26 weeks, Cingal® reduced pain more than placebo.
That fits what’s known about steroid injections, which often work quickly but fade over weeks [2]. NICE advises the NHS not to offer hyaluronic acid injections for osteoarthritis, so Cingal® is mainly available privately [3].
The trial reports averages. Some people get months of relief and others notice little, and we’ll be honest with you about what’s realistic for your knee.
Compared
How does Cingal® compare?
Cingal®
Cortisone
Durolane®
Ostenil® Plus
What it is
Hyaluronic acid with a steroid
Steroid
Stabilised hyaluronic acid
Hyaluronic acid with mannitol
Relief starts
Within days
Within days
Over a few weeks
Over 2–4 weeks
Contains a steroid
Yes
Yes
No
No
Price at Vale
£400
£250
£350
£300
If you’d rather avoid a steroid, for example because of diabetes, Durolane® or Ostenil® Plus may suit you better.
Step by step
What happens at your appointment?
01
Step 1 of 4
Free consultation
We ask about your knee, your general health and your medicines, including any diabetes treatment. We examine the knee and scan it with ultrasound, and look at any X-rays or MRI scans you have.
02
Step 2 of 4
Your options
We explain whether Cingal® is a sensible choice, what the alternatives are and what each costs. There’s no pressure to decide on the day.
03
Step 3 of 4
The injection
The skin is cleaned and the needle is guided into the knee using the live ultrasound image. If the knee is very swollen, we may draw off some fluid first.
04
Step 4 of 4
Aftercare
You can walk out straight afterwards. For a day or two, avoid running, long walks and heavy lifting, then build back up with the exercises we give you. If you have diabetes, check your blood sugar more often for a few days.
Step 1 of 4
When to get help
After your injection
Mild soreness for a day or two is common. Contact us, or seek urgent medical advice, if the knee becomes increasingly hot, red, swollen and painful, or you feel feverish or unwell. These can be signs of infection, which is rare but needs prompt treatment.
Injection Therapist and Chiropractor, Clinic Director
GCC 03996
Dr Gabriel Azzini
Doctor, Sport & Exercise Medicine
GMC 7689922
Registered and regulated
Google reviews
What our patients say
5.0from 150 Google reviews
Hyaluronic acid★★★★★
I first saw Gary for a consultation regarding the arthritis in my knees with a view to having a hyaluronic acid injection. Gary was extremely knowledgeable and went through all the options before suggesting which would be the best option for me.
Paula F. · 2025 · Google review
Knee injection★★★★★
My mum had acute knee pain which has been treated at the clinic, she now has much better mobility and positive outlook due to the treatment received. Gary has been so helpful and supportive throughout the consultation and treatment.
Robert C. · 2024 · Google review
Cortisone injection★★★★★
I recently had an ultrasound guided cortisone injection with Gary… Gary took the time to explain everything clearly before the procedure which really put me at ease, not easy when you’re not a fan of needles! The process itself was essentially pain free.
James T. · 2026 · Google review
Frozen shoulder★★★★★
Gary helped me with my frozen shoulder. He was very thorough, professional and informative. I was given a cortisone injection, which he talked me through. During the procedure he was calming and efficient.
Annette P. · 2026 · Google review
Stem cell★★★★★
I cannot thank Gary and Gabriel enough for the stem cell treatment they gave me. When I started my treatment my tendonitis was so bad in my elbows that I couldn’t carry my little children, drive the car or do my day job without getting in severe pain.
Most people feel a sharp scratch and some pressure as the gel goes in. Ultrasound guidance helps us place the needle quickly and accurately.
Are there any risks or side effects?
The knee may be sore or swollen for a day or two, and some people have facial flushing. The steroid can raise blood sugar for a few days if you have diabetes. Infection is rare. We go through your health and medicines at your consultation.
I have diabetes. Can I still have Cingal®?
Often, yes. We’ll suggest checking your blood sugar more often for a few days afterwards. Tell us about your diabetes and medicines at your consultation.
How quickly does it work?
In the main trial, people having Cingal® had less pain than those having hyaluronic acid alone at one and three weeks. Many notice a difference within days.
How long does it last?
In the trial, pain was still lower than with a placebo injection at six months. Some people do better than that, and some notice little difference.
How often can I have Cingal®?
Because it contains a steroid, we avoid repeating it too often in the same knee. We’ll review how long the benefit lasted before suggesting another.
Got another question?Ask us at your consultation. You don’t have to go ahead.
ClinicVale Health Clinic, 31–33 Vale Road, Tunbridge Wells TN1 1BS
References
Hangody L, Szody R, Lukasik P, et al. Intraarticular injection of a cross-linked sodium hyaluronate combined with triamcinolone hexacetonide (Cingal) to provide symptomatic relief of osteoarthritis of the knee: a randomized, double-blind, placebo-controlled multicenter clinical trial. Cartilage 2018;9(3):276–283. doi:10.1177/1947603517703732
Jüni P, Hari R, Rutjes AW, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev 2015;(10):CD005328. doi:10.1002/14651858.CD005328.pub3
National Institute for Health and Care Excellence. Osteoarthritis in over 16s: diagnosis and management. NICE guideline NG226. 2022.
Written by Gary Edwards, Injection Therapist (PG Cert Injection Therapy) and Chiropractor (GCC 03996). Last updated 15 October 2026.
