Joint Injections
What are Joint Injections?
Joint Injections refer to the procedure of injecting medication directly into a joint space to relieve pain and inflammation. The most common type is a corticosteroid (cortisone) injection, often combined with a bit of anesthetic, delivered into joints such as the knee, shoulder, hip, or others. These injections provide a potent anti-inflammatory effect right where it’s needed.
There are also other types of joint injections, like hyaluronic acid (gel) injections for knee arthritis, but typically when we say joint injection in a pain management context, we mean steroid injections. By reducing swelling and inflammation in the joint, pain is alleviated and mobility can improve.
Who is it for?
Joint injections are beneficial for individuals with painful joints due to arthritis or inflammation.
Examples:
Osteoarthritis: Especially in weight-bearing joints like knees and hips, or heavily used ones like shoulders. If you have moderate arthritis with pain limiting your function, but not ready for or wanting surgery, steroid injections can help.
Inflammatory joint flares: People with rheumatoid arthritis or gout might get a joint injected to calm a severe flare in one joint.
Bursitis or impingement: e.g., subacromial bursitis in the shoulder causing impingement – a steroid shot in that bursa can help.
Frozen Shoulder (Adhesive Capsulitis): Glenohumeral joint injection can reduce inflammation and pain to allow therapy.
Other Joints: We can inject ankles, wrists, thumb base (CMC joint for thumb arthritis), even jaw joint (TMJ) or acromioclavicular (AC) joint if needed. It’s often used if oral meds and therapy aren’t enough, and as an intermediate step before considering surgery like joint replacement. Patients who can’t take systemic anti-inflammatories due to side effects might benefit from localized steroid.
Those with joint pain who need relief to participate in rehab or an upcoming event/trip.
The patient should not have active infection (we never inject a septic joint, that’s a different scenario for surgery). We also check for bleeding risk or allergies. Basically, if you have a painful, swollen joint and imaging shows arthritis or inflammation, a joint injection is likely an option.
What to Expect – Before, During, After
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Little prep is needed. If you’re on blood thinners, we may or may not hold them (in small joints it’s usually fine to continue; for large deep joints like hip, we might want them held to avoid bleeding risk).
We’ll position you depending on joint: e.g., knee injection is usually with you lying down knee slightly bent; shoulder injection maybe sitting or lying; hip injection done under imaging guidance with you lying down. Large joints like hip often require fluoroscopy or ultrasound guidance to ensure accurate placement because the joint is deep.
We clean the skin thoroughly and use sterile gloves, drape, etc. We may apply a little local anesthetic to skin to reduce the needle pinch.
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The needle used is usually quite small for superficial joints (like knee, shoulder). For hip, a longer needle is needed. Under guidance (or by anatomical landmarks), we insert the needle into the joint space. You’ll feel a pinch and maybe pressure. If using fluoroscopy, sometimes a bit of contrast dye is injected first to confirm we’re in the joint.
Then we slowly inject the medication – often a mixture of long-acting steroid (like triamcinolone or methylprednisolone) and some lidocaine or bupivacaine. You might feel fullness or pressure in the joint.
Occasionally, if the joint is very tight (capsule contracted) it can be a bit uncomfortable as fluid is injected; we go slow to minimize that. The injection itself is over in a minute or two. We then remove the needle and place a band-aid.
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You’ll likely notice the joint feeling better within minutes due to the local anesthetic – a nice preview of relief. But that might wear off in a few hours, and then full effect of steroid comes in 24-48 hours. Some people get a slight increase in pain that evening or the next day (“steroid flare”) as the medication sets in – icing can help. We advise you to take it easy on that joint for the rest of the day (to let the steroid settle and to avoid aggravating it while numb). By day 2 or 3, you should start feeling the real benefit: less pain, easier movement.
We often schedule a follow-up or ask you to report how much relief and for how long. Relief duration varies: some get months of benefit, others weeks. Steroid injections aren’t done too frequently in the same joint – typically we limit to about 3-4 per year in a given joint (to avoid potential side effects to cartilage). If it’s a weight-bearing joint like knee, we might suggest you not do high-impact stuff for a couple days after injection.
For hips, sometimes we monitor for any post- injection pain as a precaution (rarely, injections can cause calcifications if repetitive, etc.). If you’re diabetic, note that steroid can transiently raise blood sugar for a day or two – monitor and adjust insulin as needed (we’ll remind you if applicable). Keep the injection site clean; risk of infection is extremely low but monitor for excessive redness or swelling. Usually, it’s smooth sailing.
Benefits
Benefits include: Rapid Pain Relief: Many patients experience quick reduction in pain, allowing them to walk, reach, or use that joint more comfortably for several weeks or months. Improved Function: Less pain means better mobility – can climb stairs after a knee injection, dress easily after a shoulder injection, etc. It can break a pain- inflammation cycle. Avoiding Systemic Effects: The steroid mainly acts in the joint rather than affecting your whole body. So, fewer side effects compared to taking high-dose oral steroids or lots of NSAIDs. Avoiding/Delaying Surgery: Injections can buy time or delay the need for joint replacement or other surgeries, especially if you’re trying to manage conservatively or not a surgical candidate presently. Diagnostic Info: If an injection significantly helps, it confirms the joint was indeed the pain source (e.g., hip vs spine causing groin pain). Minimal Down Time: It’s a quick outpatient thing, you can resume most normal activities by next day. Repeatable: While we don’t want to overdo it, injections can be repeated a few times a year if needed for chronic conditions.
Risks
SCS implantation is a surgical procedure, so it carries risks: Infection: There’s a very small risk we could introduce infection into the joint (septic arthritis). We take great care with sterile procedure. Estimated risk is extremely low, like 1 in several thousand, but it’s the most serious potential risk
because a joint infection needs urgent treatment (drainage, IV antibiotics). Watch for signs like fever, intense pain, redness after injection – if that occurs, seek immediate care. Bleeding: Rare, but if on blood thinners, a bit of bleeding in the joint could cause a flare. That’s why in some cases we pause certain blood thinners. Pain “flare”: A temporary increase in pain for a day or two after injection happens in a minority of cases (steroid crystallization can irritate). It resolves with rest, ice, and maybe a mild painkiller. Then improvement follows. Steroid side effects: Systemically, very minimal from a single joint injection, but if diabetic, watch blood sugar. Some people get transient facial flushing or insomnia the night of an injection (steroid effect). Repeated frequent injections could potentially weaken tendons or cartilage over time, which is why we limit frequency. For example, too many injections in a weight-bearing joint might theoretically speed cartilage breakdown (studies have mixed results on this, but we err on caution). Allergic reaction: Extremely rare to the steroid or lidocaine. If you have known allergies, we adjust what we use. No relief or short-term relief: Sometimes it just doesn’t help if the issue isn’t primarily inflammation (e.g., bone-on-bone arthritis might need more than steroid can give). Or it helps but only for a short time. We can’t always predict the duration – each patient responds differently. Soft tissue effects: If a bit of steroid leaks outside, it can cause local skin thinning or depigmentation (especially in superficial joints like fingers, or if an injection was shallow). This is minor but should be mentioned – you might see a lighter patch of skin or slight dent if it’s in a subcutaneous tissue (rare in big joints like knee since they’re deep). In the hip, there’s a very small risk of hitting a blood vessel or nerve if not properly guided, hence we often use imaging to ensure correct placement.
Frequently Asked Questions:
It varies widely. Some patients get relief for 6 months or more from one injection (especially if their arthritis is mild and they simultaneously work on strengthening, weight loss, etc.). Others might only get 4-6 weeks. A common range for moderate arthritis is a few months of good relief. Unfortunately, some might only get minimal time – if that’s the case, we reconsider our approach.
Factors: severity of joint damage (more damage, maybe shorter relief), how active you are (heavy strain might shorten it), and individual differences in response. We often say it’s not usually a permanent fix, but a way to manage flares. For chronic conditions, injections might be repeated 2-3 times a year if they keep helping. If it’s not lasting long enough, we either try a different approach or talk about next steps (like surgery if appropriate).
It won’t cure or reverse arthritis – unfortunately, it doesn’t rebuild cartilage. It’s a symptomatic treatment to reduce inflammation and pain. That said, by calming inflammation, it can allow you to exercise and strengthen, which in turn supports the joint and can slow progression of arthritis. It basically helps you manage the condition better. Some patients use injections to keep comfortable until they decide on a more definitive treatment (like knee replacement down the line). So, it’s part of a management plan, not a permanent cure.
It’s rare to be 100% pain-free, but many patients experience a dramatic reduction. The goal we set is usually at least 50% reduction in pain intensity. Some do report 80-100% relief, but we don’t promise that. We also aim to improve functional abilities – maybe you can stand an hour instead of 5 minutes, or sleep through the night, etc. You might still have to manage some residual pain with occasional meds or therapy, but it should be much more tolerable.
Think of SCS as a tool to manage chronic pain when other tools have failed. It’s quite successful when properly used, but it’s not an absolute cure for the underlying condition (e.g., it won’t remove arthritis or heal nerve damage, just mask the pain from it). We also encourage continuing a healthy lifestyle, exercise, etc., as tolerated, to maximize overall well-being.
We do our best to minimize discomfort. You’ll feel a quick needle stick for the numbing (if we numb first). The injection itself can cause a feeling of pressure or fullness in the joint. A knee injection, for example, often isn’t too bad – most patients say, “That’s it? It was better than I thought.” Shoulders can pinch a bit going through the capsule. Hips, since we often do under local anesthesia with imaging, you mostly feel a pinch and then some deep pressure. It’s usually very tolerable and quick. We sometimes have patients who fear needles, but afterward they’re pleasantly surprised how little it hurt. The area may ache a little later, but serious pain is not typical. We encourage you to relax the joint during injection to help – muscle tension can make it feel worse.
Post injection, keep the joint relatively rested for about 24 hours. For a knee, maybe avoid long walks or standing that day. For a shoulder, don’t overuse overhead activity same day. You can move it, just no heavy strain. Ice can be applied if it’s sore (15 minutes on, a few times that day). If you had numbing medicine, be cautious: e.g., a numb knee could buckle, so maybe wait until full sensation returns before walking a lot. Monitor for any signs of infection as mentioned (fever, extreme redness/swelling – very unlikely). You can usually resume normal activities by next day or so. If diabetic, check sugars. Also, if you have a physical therapy routine, ask if you should skip a day – sometimes for something like a knee, it’s fine to resume next day with perhaps lighter intensity.
The key is to gauge by pain – don’t do anything painful right after injection, ease back in as the steroid works. The injection site just needs to be kept clean – you can shower next day (or even same night if band-aid is on, but we usually say wait 12-24 hrs to be safe). And importantly, take advantage of pain relief: incorporate exercises or lifestyle changes that you couldn’t do before to support the joint longer term. That might extend the benefit of the injection.
Contact Us Today!
Don’t let joint pain keep you on the sidelines.
One Tree Health offers quick and effective joint injections that can reduce pain and get you moving freely again. Whether it’s a nagging knee, a stiff shoulder, or a sore hip, our specialists use precision- guided injections to deliver relief right where you need it.
Experience the ease of walking without that ache, or lifting your arm without wincing. Joint injections are a safe, minimally invasive way to manage arthritis and injury pain. Reach out to us today to schedule a consultation. We’ll evaluate your joint issue and see if a therapeutic injection is the right step for you. Regain your comfort and mobility – one simple injection can make a big difference.
Call or request an appointment now with One Tree Health’s pain management team and take the first step toward pain-free movement.
OneTreeHealth provides coordinated, compassionate care for patients recovering from injury specializing in orthopaedics, neurology, surgery, interventional pain management, and more. We simplify the recovery journey by managing care under one roof, so patients can focus on healing.
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