Introduction to Joint Injections
Joint injections are a widely used treatment for people living with rheumatoid arthritis, psoriatic arthritis, and other conditions that cause persistent joint pain. By delivering medication directly into the affected joint, these injections can provide significant relief from both pain and inflammation. Joint injections are suitable for a range of arthritis types, including osteoarthritis, rheumatoid arthritis, and psoriatic arthritis, and are often recommended when other treatments have not provided sufficient relief. The main goals of joint injections are to reduce inflammation, relieve pain, and restore joint function, helping patients return to their daily activities with less discomfort and improved mobility.
How Injections Work
Joint injections work by administering anti-inflammatory medication—such as steroid injections or hyaluronic acid—directly into the affected joint. This targeted approach helps to reduce inflammation and provide effective pain relief where it’s needed most. Depending on the type of arthritis and the severity of symptoms, different medications may be used. For example, steroid injections are commonly chosen for moderate arthritis to quickly reduce pain and swelling, while hyaluronic acid injections are often used to treat osteoarthritis by improving joint lubrication. The medication can be delivered using various methods, including injection pens or IV infusion, ensuring that the treatment is tailored to each patient’s needs and the specific joints affected.
1. Corticosteroid (Steroid) Injections
Corticosteroid injections—also called steroid or cortisone injections—are among the most common treatments for arthritis pain and swelling. They are often considered a first line treatment for joint pain and inflammation. They deliver powerful anti-inflammatory medication directly into the affected joint.[1]
- Common names: Triamcinolone (Kenalog), Methylprednisolone (Depo-Medrone), Hydrocortisone
- Uses: Osteoarthritis, rheumatoid arthritis, gout, and other inflammatory joint conditions
- Duration: Relief typically lasts a few months (1–3 months), but repeated use can damage cartilage.
- Side effects: Corticosteroid injections can cause side effects such as weight gain and increased blood pressure.
2. Hyaluronic Acid Injections (Viscosupplementation)
Hyaluronic acid injections are used to lubricate and cushion the joint, especially in knee osteoarthritis. They are sometimes called viscosupplementation or gel injections.
- Common names: Synvisc, Durolane, Ostenil, Euflexxa, Hyalgan
- Uses: Knee osteoarthritis (less commonly used for other joints)
- Duration: Relief may last 4–6 months, but effectiveness varies
3. Platelet-Rich Plasma (PRP) Injections
PRP injections use a patient’s own blood, processed to concentrate platelets and growth factors, which are then injected into the joint to promote healing and reduce inflammation.
- Common names: PRP, Platelet-rich plasma therapy
- Uses: Early osteoarthritis, tendon injuries, and some soft tissue conditions
- Duration: Relief may last several months; research is ongoing
4. Biologic Injections (DMARDs/Biologics)
Biologic drugs are advanced medications that target specific parts of the immune system. They are usually given as regular injections or infusions for autoimmune arthritis.
- Common names: Adalimumab (Humira), Etanercept (Enbrel), Infliximab (Remicade), Tocilizumab (Actemra). Some biologics are tumor necrosis factor (TNF) inhibitors.
- Uses: Rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, juvenile idiopathic arthritis
Some biologics target T cells to modulate the immune response.
- Duration: Ongoing treatment; not a one-time injection
- Risks: Increased risk of opportunistic infections, including tuberculosis and invasive fungal diseases. Patients should be screened for active infection before starting biologics. Certain biologics are FDA approved for arthritis treatment. Screening for hepatitis B is important before starting biologic therapy due to risk of reactivation. Progressive multifocal leukoencephalopathy is a rare but serious risk with some biologics, such as rituximab. Repeat administration of biologics is often required, and the optimal timing and frequency may vary.
5. Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat 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 arthritis.
As prolotherapy is helping to treat the root cause of arthritis, it is deemed to be a permanent fix, preventing the symptoms from returning.[3]
Disclaimer: The information provided in this section is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Prolotherapy may not be suitable for everyone, and outcomes can vary. Always seek the guidance of a qualified healthcare professional regarding your specific medical condition or treatment options. Never disregard professional medical advice or delay seeking it because of information you have read here.
Injection Procedure
The injection procedure is typically performed by a healthcare professional, such as an orthopaedic surgeon or rheumatologist, in a clinical setting. During the procedure, the medication is injected directly into the affected joint, often after administering a local anaesthetic to minimize discomfort. In some cases, ultrasound scanning is used to guide the needle and ensure precise placement of the medication within the joint. The entire process usually takes only a few minutes, allowing patients to return home the same day with minimal disruption to their routine.
Post-Treatment Care
After a joint injection, patients are generally advised to rest the affected joint for a short period to allow the medication to take full effect. It’s important to follow any instructions provided by the healthcare professional, which may include managing mild pain or swelling at the injection site. Attending follow-up appointments is essential to monitor progress and assess the effectiveness of the treatment. In some cases, physical therapy or occupational therapy may be recommended to further improve joint function and reduce pain, supporting a faster return to normal activities.
Treatment Goals
The primary aim of joint injections is to deliver significant relief from pain and inflammation, enabling patients to regain mobility and enhance their quality of life. Whether used alone or alongside other treatments such as physical therapy or medication, joint injections are designed to reduce pain, improve joint function, and help manage the symptoms of conditions like rheumatoid arthritis and psoriatic arthritis. By reducing inflammation and supporting joint health, these injections can make a meaningful difference for many patients, allowing them to stay active and enjoy a better overall sense of well-being.
Case Study: Choosing the Right Injection for Knee Arthritis
A 65-year-old patient with moderate knee osteoarthritis initially tried conservative treatments such as oral medications and physical therapy, but experienced only limited relief. The patient then tried steroid injections with temporary relief. After switching to hyaluronic acid injections, pain improved for six months. The patient then began prolotherapy, which provided longer-lasting pain relief and improved joint function. This case highlights the importance of a personalized, stepwise approach to arthritis injections. Lifestyle changes can also play a role in managing arthritis symptoms and improving overall quality of life. In severe cases, more aggressive interventions such as surgery may be considered if injections and other treatments fail.
Risks and Side Effects of Arthritis Injections
Adverse effects and risks may include:
- Temporary pain or swelling at the injection site
- Infection (rare but serious)
- Joint damage and cartilage damage with repeated steroid injections
- Allergic reactions (rare)
- Systemic side effects with biologics (increased infection risk, immune suppression)
Always discuss risks and benefits with your healthcare provider before starting any injection therapy.
When Are Injections Recommended for Arthritis?
- When oral medications and physical therapy do not provide adequate relief
- Hand arthritis injections may be considered when conservative measures fail to relieve hand arthritis, offering rapid and targeted relief.
- For acute flare-ups of pain and swelling
- To delay or avoid surgery in moderate to severe arthritis
- For autoimmune arthritis not controlled by standard treatments (biologics/DMARDs)
Frequently Asked Questions
What are the main types of injections for arthritis?
Steroid (corticosteroid), hyaluronic acid, PRP, biologics, and prolotherapy.[1]
How long do arthritis injections last?
Steroid injections last 1–3 months, hyaluronic acid 4–6 months, PRP several months, and biologics require ongoing treatment.
Is prolotherapy safe for arthritis?
Prolotherapy is considered safe when performed by a qualified practitioner and has shown promising results for arthritis pain and function.[3]
Can injections cure arthritis?
No injection cures arthritis, but they can provide significant pain relief and improve function as part of a comprehensive treatment plan.
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Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating 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 arthritis and providing effective treatment options to alleviate them.
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.
Mr Eaton’s expertise has been featured in many national news and media publications, including The Telegraph, The Daily Mail, The Daily Express, Women’s Health Magazine, and The Scotsman.
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). Injections for Arthritis. https://www.arthritis.org/health-wellness/treatment/treatment-plan/medication/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/
Disclaimer: This article is for informational purposes only and does not substitute for professional medical advice. Always consult your healthcare provider before making treatment decisions.