Joint Injections · Updated August 2026
Joint Injection (Corticosteroid)
Corticosteroid joint injections deliver a powerful anti-inflammatory medication directly into a painful joint to reduce inflammation, swelling, and pain. They are one of the most commonly performed interventional pain procedures.
Medically reviewed by Joshua L. Hare, DO, Founder & Medical Director
Conditions Treated
Osteoarthritis of the knee, hip,[1] shoulder, or other joints, rheumatoid arthritis flares, bursitis, tendinitis, gout
| What it is | A corticosteroid placed directly inside a painful joint, usually with a local anesthetic. National guidance strongly recommends intraarticular glucocorticoid injections[1] for knee and hip osteoarthritis. |
|---|---|
| Who it is for | Adults with osteoarthritis of the knee or hip, and adults with pain in other joints where a specific painful structure has been identified. It is also used for inflammatory flares, bursitis and tendinitis. |
| How it is guided | Ultrasound or fluoroscopy, so the medication reaches the joint space itself. For the hip in particular, ultrasound guidance is strongly recommended.[1] |
| How fast it works | The local anesthetic gives immediate but temporary relief. The steroid takes over across the next 2 to 7 days. |
| Typical visit | About 10 to 15 minutes. You can normally return to your usual routine the same day, going easy on the treated joint for a day or two. |
| How often | Usually held to 3 or 4 injections per joint per year, a limit this practice keeps in order to protect cartilage. |
What a Strong Recommendation Actually Means
Most treatment pages tell you a procedure is recommended. Fewer explain who recommended it or how firmly, which is the part that should decide whether you agree to it. The American College of Rheumatology and the Arthritis Foundation publish the guideline most US clinicians follow for osteoarthritis, and they grade every option they review.
A strong recommendation[1] is issued when the voting panel infers that the evidence of efficacy is compelling and that benefits clearly outweigh harms and burdens. A conditional recommendation[1] is issued when the evidence is low or very low quality, or when benefits and harms sit close enough together that shared decision-making between you and your clinician particularly matters. Put in patient terms, that weaker grade means most informed patients would choose it and some would not.[1] Either grade requires 70% consensus[1] among the panel.
Against that scale, intraarticular glucocorticoid injections are strongly recommended for patients with knee and/or hip osteoarthritis.[1] That is the guideline's strongest tier, and the injection shares it with the everyday measures listed further down this page.
Which Joints the Guideline Supports
The strength of the evidence is not the same in every joint, and it is worth knowing where yours falls before the appointment.
- Knee and hip
- The strongest position the guideline takes: strongly recommended,[1] on compelling evidence of benefit.
- Hand
- Conditionally recommended.[1] The guideline is explicit that this is conditional given the lack of evidence specific to this anatomic location,[1] rather than because of a finding against it.
- Other joints, bursae and tendons
- Treated on the clinical picture. Shoulder pain, bursitis and tendinitis are common reasons for an injection here, guided by examination and imaging rather than by an osteoarthritis guideline written around the knee, hip and hand.
The distinction matters because it tells you how much of the decision is settled by evidence and how much is a conversation. In a knee, the guidance is firm. In a hand, the guideline is deliberately handing the decision back to you and your physician.
Why the Needle Is Guided
A corticosteroid only does its work if it lands inside the joint space. Deep joints in particular are difficult to enter reliably by feel, which is why imaging is used rather than landmarks alone. For the hip the guideline goes further than a general preference: ultrasound guidance for intraarticular glucocorticoid injection is strongly recommended for injection into hip joints.[1]
At this practice the joint is entered under ultrasound or fluoroscopy depending on which joint is being treated and what is being avoided along the way. Your physician will tell you which is being used and why before starting.
What the Injection Does, and How Quickly
The syringe carries a corticosteroid and a local anesthetic, and they work on different clocks. The local anesthetic acts within minutes, which is why many patients notice the joint feels better before they have left the building. That early relief is temporary and it is also diagnostic: if numbing the inside of the joint takes your pain away, the joint is very likely the structure generating it.
The corticosteroid is the part intended to last. It works by reducing inflammation inside the joint, and it takes 2 to 7 days to reach full effect. Relief is commonly measured in weeks to months rather than years. The guideline describes the trial evidence in knee osteoarthritis as demonstrating short-term efficacy,[1] and this page states that plainly rather than implying a permanent result, because knowing the expected window is what lets you plan the rest of your treatment around it.
The Injection Is One Part of the Plan
An injection that quiets a joint for a few months is most useful when that window is spent on the things that hold the improvement. The same guideline gives its strongest grade to several of them, and they are not add-ons to the injection so much as the treatment the injection is buying room for.
- Exercise,[1] which carries a strong recommendation in its own right.
- Weight loss for patients with knee and/or hip osteoarthritis who are overweight or obese,[1] because load through the joint is the mechanical part of the problem.
- Self-efficacy and self-management programs,[1] strongly recommended.
- Cane use[1] and, for the right knee pattern, tibiofemoral bracing.[1]
- Topical anti-inflammatories for knee osteoarthritis[1] and oral anti-inflammatories.[1]
The guideline notes that osteoarthritis spans decades of a patient's life[1] and that most people end up using several of these together or in sequence rather than one alone.
How Often It Can Be Repeated, and Why There Is a Limit
Corticosteroid joint injections at this practice are usually held to three or four per joint per year. The limit is deliberate and it is about protecting cartilage over the long run rather than about rationing appointments.
If your relief is reliably lasting several months, repeating the injection within that limit is a reasonable long-term plan. If it is fading much faster than that, the more useful conversation is not about injecting more often. It is about whether the joint has moved past what an injection can hold, and what the next step should be, which for a knee may include options the same guideline conditionally recommends[1] and for a worn hip or knee may mean a surgical opinion.
Before Your Appointment
A few things can change either the plan or its timing. Raise them when the appointment is booked rather than on the day:
- Anticoagulant or antiplatelet medication.
- Diabetes, or blood sugar you are actively managing.
- Any current infection, anywhere, and broken skin over the joint itself.
- Pregnancy, or the possibility of it.
- A previous reaction to a steroid injection or to contrast dye.
None of these rules an injection out by itself. Each one is something your physician would rather know beforehand than discover mid-procedure.
Diabetes is worth raising specifically. Corticosteroids can raise blood glucose for several days after an injection, so if you monitor your glucose you should expect a higher reading for a short period and know in advance how you will handle it.
Afterward, go easy on the treated joint for a day or two. Soreness at the injection site during the first day is common. Contact the practice if the joint becomes hot, increasingly swollen or painful after the first 48 hours, or if you develop a fever, since those are the signs that need to be looked at rather than waited out.
References
Clinical sources for this page.
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