Viscosupplements are gel-like substances, hyaluronates, that mimic the properties of naturally occurring joint fluid. Currently, there are five FDA approved hyaluronates which include: Hyalgan, Supartz, Synvisc, Euflexxa, and Orthovisc. These hyaluronates are injected into the joint. The number of injections performed varies with the type of viscosupplement used; however, usually three to five injections are required for the best response. While these medications are only FDA-approved to use in the knee, they can be used “off-label” to treat arthritis in the shoulder, the ankle, and the thumb joints (the “CMC joints”). Your doctors at The Hirsh Center have extensive experience with both “on-label” (FDA-approved) and “off-label” use of these injectable medications.