Sarah J. Kerr, BA
Joint injections are medicines injected into a joint. They are given to reduce pain and swelling in a joint. The medicine is often a combination of corticosteroids and local anesthetic (numbing medicine). Injections may relieve pain for several weeks or months.
This treatment is most often used in joints like the hips, knees, and shoulders.
Your doctor may recommend a joint injection if you have pain and/or swelling from:
Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:
Another possible complication is steroid flare. This is an increase in swelling of the joint. It may be caused by preservatives in the medicine mix. The flare can develop within a few hours of the injection. It may last up to three days. This swelling will go away on its own. Applying ice to the area will help.
Sometimes, you may have a reaction to the local anesthetic used. Reaction can occur up to 30 minutes after the injection and may include:
Your doctor may limit the number of injections per year (eg, no more than four injections per year). Repeated use of injections may quicken normal age-related changes in the joint. This can cause problems with cartilage, ligaments, and tendons.
Talk to your doctor about these risks before the procedure.
Before the procedure, your doctor will do a physical exam. Your doctor will also discuss risks associated with joint injections. Joint injections may not be a good choice if you:
Your doctor may use a local anesthetic on your skin before giving the injection. This will make the area numb for a short time. Your doctor may also use a cold treatment to numb the skin.
This procedure can usually be done in your doctor's office.
Your doctor will locate the site where the injection will be placed. The area may be marked with a pen or marker. The injection area will be wiped with an alcohol pad.
Your doctor may flex the joint being injected. The doctor will then inject the joint in the area where it is most swollen and tender. The needle will be inserted to the bone. It is then pulled back slightly before the injection is given.
The local anesthetic may provide immediate relief. It will also help your doctor confirm the diagnosis. The steroid may provide relief from pain, swelling, and inflammation for a longer period of time.
You may have some pain when the injection is given. It is also possible that your symptoms may worsen for the first 24-48 hours after the injection. Talk to your doctor about steps to reduce pain.
Right after the procedure, the staff may:
You will be able to leave after being monitored for 30 minutes.
When you return home, take these steps:
Call your doctor if you notice any signs of infection, such as:
If you have an emergency, call for medical help right away.
American College of Rheumatology
The Arthritis Foundation
The Arthritis Society
Public Health Agency of Canada
Beddoe AE, Schub T. Pain, chronic. CINAHL Nursing Guide. EBSCO Nursing Reference Center website. Available at: http://www.ebscohost.com/biomedical-libraries/the-cinahl-database. Updated January 20, 2012. Accessed May 28, 2012.
Cardone DA, Tallia AF. Diagnostic and therapeutic injection of the hip and knee. Am Fam Physician. 2003;67(10):2147-2152.
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MacMahon PJ, Eustace SJ, Kavanagh EC. Injectable corticosteroid and local anesthetic preparations: a review for radiologists. Radiology. 2009;252:647-661.
Reilly DT. Ask the doctor: should I be worried about the side effects from cortisone shots? Harv Health Lett. 2012;37(6):8.
Last reviewed September 2014 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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