What Is a Steroid Injection for Knee Arthritis?
A steroid joint injection for knee arthritis involves injecting a corticosteroid medication directly into the knee joint. Osteoarthritis, the most common form of arthritis affecting the knee, is characterized by degeneration of joint cartilage, leading to painful symptoms such as swelling and stiffness. Steroid joint injections are used to treat these painful joint conditions, including osteoarthritis, rheumatoid arthritis, or other inflammatory joint conditions, by reducing inflammation and thereby reducing pain in the affected joint.[1]
- Procedure: This type of joint injection is usually performed by a health professional or healthcare professional in a clinic, sometimes with ultrasound guidance for accuracy. The knee is cleaned, numbed, and the steroid is injected into the joint space.
- Medications used: Common steroids include triamcinolone, methylprednisolone, or hydrocortisone, often combined with a local anesthetic for immediate pain relief. These corticosteroids are different from anabolic steroids used by bodybuilders. Because corticosteroids can have effects throughout the body, monitoring for side effects is important.
- Duration: The procedure takes about 10–20 minutes, and most patients can walk out of the clinic shortly after.
How Effective Are Steroid Injections for Knee Arthritis?
Steroid injections can provide rapid pain relief and reduced swelling for many people with knee arthritis. The benefits typically last from a few weeks to several months, but the effect is temporary and varies from person to person.[2]
- Immediate relief: Most patients notice improvement within 24–48 hours. When steroid injections start to work can vary, but relief often begins within 24–48 hours, depending on the type of steroid and individual response.
- Duration: Pain relief may last 1–3 months, sometimes longer for mild cases.
- Repeat injections: Generally limited to 3–4 times per year to avoid cartilage damage and side effects. Repeated joint injections can increase the risk of cartilage damage and other complications.
Joint injections work by reducing inflammation within the joint, which reduces pain and improves function. However, effectiveness can vary due to other factors, such as underlying medical conditions or the use of other medicines. It is important to discuss all current medications with your healthcare provider, as combining steroid injections with other medicines may affect outcomes and safety.
Steroid injections are best used as part of a comprehensive treatment plan, not as a long-term solution.
Risks and Side Effects of Steroid Injections
- The most common side effects of steroid joint injections include a temporary increase in pain or swelling (post-injection flare), increased risk of joint infection (rare but serious), skin thinning or discoloration at the injection site, and elevated blood sugar (especially in people with diabetes).
- Repeated use of steroid joint injections can lead to cartilage damage or joint deterioration.
- Certain medical conditions, such as diabetes or immune system disorders, can increase the risk of complications from steroid joint injections.
- Joint injections should be avoided if there is a skin infection, boil, abscess, or any signs of infection around the knee, as this can increase the risk of serious complications.
- It is important to inform your healthcare professionals about any other medicines you are taking, as interactions with steroid joint injections can occur.
- Healthcare professionals, including orthopaedic surgeons, are trained to manage the risks and complications associated with steroid joint injections.
Discuss the risks and benefits with your healthcare provider before proceeding.
The Steroid Injection Procedure
The steroid injection procedure is a straightforward process typically performed in a healthcare professional’s office or clinic. Before the injection, your healthcare professional will carefully clean and prepare the injection site to reduce the risk of infection. You may be asked to wear comfortable clothing or a gown to allow easy access to the affected area, such as the knee joint.
To help minimize discomfort, a local anaesthetic is often used to numb the area before the steroid injection. This means you may feel only a slight pinch or stinging sensation as the small needle is inserted into the joint or soft tissue. Once the needle is in place, the steroid medication is slowly injected into the joint, targeting the source of pain and inflammation. Some patients notice a feeling of pressure or tightness during the injection, but this is usually brief.
The entire procedure usually takes just a few minutes. After the injection, you may be asked to remain in the clinic for a short time so the healthcare professional can monitor for any immediate side effects or reactions. You’ll also receive instructions on how to care for the injection site—this may include keeping the area clean, watching for signs of infection, and applying ice to reduce swelling if needed.
It’s important to follow your healthcare professional’s advice after a steroid injection. This often means avoiding strenuous activity or heavy exercise for a few days to allow the joint to recover. Over-the-counter pain relief can be used if you experience mild discomfort at the injection site.
In some cases, especially when treating deeper joints or complex musculoskeletal conditions, your healthcare professional may use ultrasound guidance to ensure the steroid injection is delivered precisely where it’s needed. This technique can improve accuracy and outcomes, particularly for joints like the hip or shoulder.
Steroid injections are commonly used to relieve pain and reduce inflammation in a range of conditions, including osteoarthritis, rheumatoid arthritis, and other forms of inflammatory arthritis. They can also be effective for joint pain and swelling in the knee, as well as other musculoskeletal conditions affecting the soft tissue.
While steroid injections can provide significant pain relief and help reduce inflammation, it’s important to be aware of potential risks. These include a small risk of infection at the injection site, a temporary increase in pain or swelling (known as a flare-up), and, with repeated injections, the possibility of cartilage damage or other complications. Your healthcare professional will discuss these risks with you and help determine whether a steroid injection is the best treatment for your symptoms.
Steroid injections are just one option for managing knee pain and joint pain. Other treatments, such as physical therapy, hyaluronic acid injections, and medications, may also be recommended depending on your specific condition and overall health. By working closely with your healthcare professional, you can develop a treatment plan that addresses the underlying cause of your pain and helps you achieve lasting relief.
Case Study: Steroid Injection for Knee Arthritis
A 70-year-old patient with moderate knee osteoarthritis experienced daily pain and swelling. After a steroid injection, pain improved by 80% within two days and the patient resumed walking and exercise. Relief lasted for three months, after which the patient transitioned to physical therapy and prolotherapy for long-term management.
When Are Steroid Injections Recommended?
- For moderate to severe, painful knee conditions not relieved by oral medications or physical therapy
- During acute flare-ups of painful joint pain and swelling
- For patients who are not candidates for surgery or need temporary relief before knee replacement surgery (timing and risks should be discussed with a healthcare professional)
Other factors, such as patient age, medical history, and response to other treatments, also influence the decision to use steroid injections.
Steroid injections are not recommended for routine, long-term use due to potential side effects.
Treatments for Knee Arthritis
Conservative Treatments
- Physical therapy: Exercises to strengthen muscles and improve joint flexibility
- Pain management: NSAIDs, acetaminophen, other medicines such as disease-modifying drugs, or topical creams for pain relief
- Weight management: Reduces stress on the knee and slows disease progression
- Assistive devices: Braces, canes, or walkers for support
- Lifestyle changes: Regular exercise, balanced diet, and stress management
Other factors, such as patient comorbidities and lifestyle, also influence the choice of conservative treatments.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat knee arthritis.
Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.
Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to help with knee arthritis.
As prolotherapy is helping to treat the root cause of knee arthritis, it is deemed to be a permanent fix, preventing the symptoms from returning.
Other Interventions
- Hyaluronic acid injections: These are a type of joint injection used to lubricate the joint and reduce pain, particularly in cases of knee arthritis. Joint injections like these can help decrease inflammation and target pain directly within the joint capsule.
- Surgery: Knee replacement surgery or repair for advanced arthritis not responding to conservative care is typically performed by an orthopaedic surgeon, a specialist in musculoskeletal treatments and surgical interventions.
Frequently Asked Questions
How long does a steroid injection last for knee arthritis?
Relief typically lasts 1–3 months, but varies by individual.[2] Steroid injections start to provide relief within 24–48 hours for most patients, though the onset may vary depending on the type of steroid used and the underlying condition.
Are steroid injections safe?
They are generally safe when used occasionally, but repeated injections can lead to an increased risk of cartilage damage and other side effects. The most common side effects include temporary pain, swelling, and risk of infection. Certain medical conditions may increase the risk of complications from steroid injections.
Is prolotherapy safe for knee arthritis?
Prolotherapy is considered safe when performed by a qualified practitioner and has shown promising results for knee arthritis pain and function.[3]
Can I exercise after a steroid injection?
Rest for 24–48 hours after the injection, then gradually resume activity as advised by your healthcare provider.
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Author Bio
Having performed over 10,000 procedures, Mr Eaton is one of the UK’s leading practitioners in the field of treating knee arthritis, with patients travelling to see him from across the UK, Europe, and the Middle East.
With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms associated with knee arthritis and providing effective treatment options to alleviate them. He emphasizes that the steroid injections used in his treatments are corticosteroids for inflammation, not anabolic steroids, which are sometimes used by bodybuilders to enhance muscle growth and strength.
He qualified in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy. He continued on to complete further qualifications at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and the medical department of Heidelberg University in Germany.
Over the years he has had the privilege of treating many elite-level athletes, including both Olympic and Commonwealth medallists.
References
- NHS. (2023). Steroid injections. https://www.nhs.uk/conditions/steroid-injections/
- Arthritis Foundation. (2023). Steroid Injections for Arthritis. https://www.arthritis.org/health-wellness/treatment/treatment-plan/medication/steroid-injections-for-arthritis
- Rabago, D., et al. (2016). Prolotherapy in Primary Care Practice. Primary Care: Clinics in Office Practice, 43(2), 329-338. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4913113/