Hyaluronic Acid (HA) Injection Versus Control for Painful Shoulder Conditions: A Systematic Review and Meta-Analysis of Randomized Controlled Trials .

Shoulder pain affects millions worldwide and is a leading cause of disability, particularly among older adults. Evidence from 13 randomized controlled trials comparing hyaluronic acid (HA) injections with control treatments for painful shoulder conditions was analyzed. Low to moderate quality evidence showed that HA provides small but measurable pain improvements at 3 and 6 months, and modest functional gains at 3 months, though effects did not reach minimal important difference thresholds. No benefits were found at 1 month, and functional improvement was not sustained at 6 months. HA was well tolerated, with only mild post-injection reactions reported and no significant differences in adverse or serious adverse events. Two ongoing clinical trials are expected to add new data.