Pain- Hyaluronic Acid- As I mentioned I've had these injections for about 2 decades, about once or twice a year and about 25% of the time it hurts even with a numbing shot. Only a few times was I laid up afterwards. Never let a doctor in training give you one. Even after numbing I was screaming from one novice doctor digging around for the right spot while being supervised by my doctor. I had my regular orthopedist give me the second one in my other leg. Next appointment she came in to give them to me and I refused and asked for my regular doctor. One time the shots weren't too painful, the doctor left the room and I almost collapsed on the floor from pain once I put weight on one leg, the other leg was fine. It was lunch time and the entire staff seemed to have disappeared I had to hop down a long hall in the orthopedic hospital. Once at the entrance I was afraid to ask the sign in desk for a wheel chair because they might not let me drive. At home I put an ice pack on it for the swelling. It took me 5 days to recover. I learned to get off the table while a staff member is in the room. It's important to get yourself to relax. Also run all your errands before getting the shot and plan take easy that evening if necessary. My latest doctor have given them to me twice now without serious pain or side effects.