Is an mri of the knees required before orthovisc? is this type of injection unbearably painful? can anaesthetics be used?

No: Viscosupplementation( orthovisc, synvisc, (hylan g-f 20) etc.)may require approval from your insurance carrier(usually documentation that other treatments such as NSAIDs,PT haven't helped) but generally not an MRI.Most injections are done in the office w/local anesthetics( lidocaine) and/ or ' cold spray' and are easily tolerated.best of luck!