Joint Injections
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Key Takeaways
- Joint injections provide temporary pain and symptom relief for various joint-related conditions, such as arthritis.
- Joint injections are available as corticosteroid injections, hyaluronic acid injections, and platelet-rich plasma injections.
- Joint injections are generally considered safe, but they do carry some risk of side effects. Mild side effects are usually manageable, but you should contact your doctor immediately if you notice anything unusual.
What are Joint Injections?
If you are experiencing mild or debilitating joint pain, a joint injection may be beneficial in treating your symptoms. As the name suggests, a joint injection involves using a syringe to inject medication directly into a joint, such as your elbow or knee. Joint injections are commonly prescribed to provide temporary but effective pain and symptom relief for any joint experiencing pain, discomfort, or symptoms of arthritis and other concerning conditions.
A joint injection may be suitable if your symptoms haven’t improved with nonsurgical treatment or if surgery isn’t an option for you. It is a temporary treatment but can provide symptom relief for several months.
How Do Joint Injections Work?
When your joint sustains an injury or other ailment, the immune system responds by deploying white blood cells that fight off infection and speed up recovery. At the same time, this causes noticeable redness, warmth, and mild swelling around the affected joint. However, there may be instances where the inflammation lasts longer than it should for various reasons. When this happens, the body registers that it still needs to heal, which causes the immune system to continue sending white blood cells to attack nearby healthy tissues and organs, causing severe inflammation.
Some joint injections are administered to calm the immune system and reduce white blood cell production, thereby reducing inflammation and promoting joint healing. In some cases, joint conditions like arthritis can cause complications such as stiffness, reduced range of motion and decreased flexibility. To treat these complications, your doctor will administer a joint injection to reduce the severity of symptoms and provide temporary relief.
The Benefits of Joint Injections
A joint injection can provide several benefits:
- Fast pain relief.
- No scarring.
- Minimal discomfort.
- Minimal downtime.
- Temporarily treats arthritis symptoms.
- Positive results that last several months.
Our pain physician will outline what to expect from the joint injection, as results may vary from person to person.
Types of Joint Injections
Depending on your condition, your doctor will recommend one of three joint injections to help address your joint pain. Other joint injections, such as stem cell injections, are available in some countries, but further medical studies are needed to prove their effectiveness in treating joint pain.
Corticosteroid Injections
Also known as cortisone injections, they are steroid injections with anti-inflammatory properties that help reduce pain, swelling, and tenderness in the joints. They can help alleviate various symptoms of inflammatory arthritis. It is common for a corticosteroid injection to include a local anaesthetic to help reduce discomfort, as the steroid may take a few days to take effect. The effects tend to last anywhere between three weeks and three months.
Your doctor will slowly inject the corticosteroid medicine into a specific joint that requires treatment. They may also use ultrasound or X-rays to determine the best place to inject the medicine for optimal results.
Corticosteroids may be a helpful indicator to determine whether surgery is needed to treat the underlying condition. If the injection provides immediate relief after the shot, it may be a sign that your symptoms originate from the joint and can be addressed with surgery. If there is minimal or no relief (even with ultrasound guidance), this may suggest that the pain stems from somewhere outside the joint, indicating an injury, fracture, or neuromuscular damage. Your doctor may perform additional tests to confirm the diagnosis before recommending surgery.
However, caution is advised, as corticosteroid injections are only temporary solutions and are not suitable for long-term management. Many doctors may limit the number of injections given each year to minimise the risk of complications (such as cartilage damage or infections). This is because prolonged corticosteroid use can cause various harmful side effects.
Hyaluronic Acid (HA) Injections
Also known as gel injections or viscosupplementation, HA injections are typically prescribed for treating knee joint arthritis. They are chemically similar to the synovial fluid in knee joints. As arthritis causes synovial fluid to thin, it can lead to inflammation and pain. HA injections help restore the fluid’s natural properties so it can lubricate the joint, absorb shock during movement, and prevent cartilage degradation.
Before administering an HA injection, your doctor may inject a local anaesthetic into the space around the joint to prepare your knee. Draining excess fluid that causes the knee to swell may also be necessary. You may require weekly injections for three to five weeks before you feel its effects. Some people have reported relief lasting anywhere from five months to a year. You may experience some mild soreness or stiffness a few days after the injection, but if it worsens, see your doctor immediately.
While HA injections are not recommended as a first-line treatment, they are generally safe and can help relieve symptoms of mild to moderate knee joint arthritis. Further studies are needed to assess the effectiveness of HA injections in treating other joints, such as the shoulder.
Polynucleotide injections are an alternative form of viscosupplementation which are available to improve joint function and reduce pain.
Platelet-Rich Plasma (PRP) Injections
PRP injections are a relatively new form of joint injection that uses your blood cells to improve joint healing. The injection involves using platelets, a vital component that promotes clotting and healing, taken from your blood and reintroduced into the joint with blood plasma (the liquid component of blood). This helps to promote faster healing and relieve arthritis symptoms. PRP injections may be particularly beneficial for treating those with early arthritis and certain musculoskeletal conditions.
Studies are still determining how PRP injections work. It is believed that special proteins called growth factors found in platelets may help stimulate the healing process, but further research is needed to better understand. Nevertheless, some individuals who have undergone a PRP joint injection have reported results that lasted from several weeks to up to a year.
PRP injections tend to cause minimal side effects, but doctors must ensure that your blood remains sterile to prevent the risk of contamination that can be harmful to your well-being. Moreover, PRP injections can be costly due to the preparation involved, as they cannot be mass-produced since they rely on the patient’s platelets.
Potential Side Effects of Joint Injections
Before a joint injection procedure, your doctor will notify you of the potential risks, as individuals will respond differently to the treatment. Side effects may include:
- Allergic reactions to the medication.
- Potential nerve damage.
- Temporary flare of arthritis symptoms.
- Sudden swelling or inflammation.
- Risk of infection.
- Unexpected bleeding.
Preparing for a Joint Injection
Before Your Joint Injection
During the initial consultation, you will discuss your joint injection options with your doctor. They may then perform the necessary physical and imaging tests to determine the best treatment course for your condition. This is the perfect time to ask questions about the joint injection, what to expect, and to clear up any doubts or concerns you might have regarding the procedure or your recovery. Your doctor will do their best to answer your questions and provide as much information as possible to help you decide.
You may also need to provide additional information to your doctor, such as your current medications. You may need to make some modifications to your lifestyle before your joint injection to minimise unpleasant complications.
- Current health: If you have a chronic condition, you will have to be evaluated thoroughly to determine if you are eligible for the necessary treatments for your condition. Notify your doctor if your temperature was above 38℃ in the past two weeks.
- Medications: Before the procedure, you may have to stop taking aspirin, specific supplements, or blood thinners. Consult your doctor for further advice.
- Post-procedure support: It may help to have someone accompany you to the clinic or hospital for moral support and to assist with various things if you experience minor side effects after the injection.
- Nutrition: Have a healthy, balanced breakfast before the procedure (unless directed otherwise) and stay hydrated.
During Your Joint Injection
You may be asked to sit or lie down and position yourself on the bed, so your doctor can easily reach and inject the joint. They will clean and disinfect the injection area before numbing the area with a numbing cream or spray. Once done, they will carefully inject the medicine into your joint. If necessary, they will use an ultrasound or X-ray to monitor the needle’s progress and ensure the injection reaches the right area for treatment.
You may feel some pressure as the needle is inserted, and the injection releases its contents. If you experience substantial discomfort, let your doctor know immediately.
After Your Joint Injection
You may need to stay a while for your doctor to assess your condition. If your doctor believes you are well, you may be discharged. You may also need to modify your daily activities briefly to minimise strain on the affected joint and allow it to heal properly. You can apply ice or a cooling pad to relieve pain around the injection site for 10 to 15 minutes a day, 3 to 4 times daily. Avoid using a bathtub or hot tub for at least two days. You can still shower, but try not to get the injection site wet for a few days.
Follow-up visits may be vital to allow your doctor to monitor your recovery and make recommendations to help improve recovery outcomes. They may also ask you to look for signs of infection or side effects, like frequent pain, redness, and swelling that lasts more than 48 hours. Light exercise can also help to promote your recovery, but avoid overexerting yourself to prevent unwanted complications, such as a sprain.
Frequently Asked Questions
Various studies and clinical trials have been conducted to ensure joint injections benefit those who need them. Given that results can vary from person to person due to multiple factors, including genetics, your doctor will recommend the joint injection that best suits your current health and medical status based on the information provided. They will also help you manage both major and minor side effects, to reduce discomfort and ensure a smooth recovery.
Your doctor will typically outline what to expect right after your joint injection, and that may include some pain or discomfort that should go away after one or two days. However, contact your doctor immediately if the pain and discomfort remain for several days.
A joint injection temporarily relieves pain and symptoms of various joint conditions like arthritis. If you prefer a more permanent solution, surgery may be ideal. Consult your doctor for a thorough medical assessment to determine your eligibility for surgery.
Consultant Anaesthetist and Pain Physician
Dr. Hope Ang
MBBS (NUS) | MMed (Anaes) | FAMS
Dr Hope Ang is a Consultant Anaesthesiologist with extensive expertise in acute and chronic pain management, dedicated to helping patients regain function, reduce suffering, and improve quality of life through evidence-based, personalised care.
With more than 18 years of clinical experience, Dr Ang specialises in the assessment and treatment of complex chronic pain conditions, including musculoskeletal pain, neuropathic pain, cancer-related pain, and persistent postoperative pain. His approach integrates interventional pain procedures, ultrasound-guided regional techniques, multimodal pharmacological strategies, and close collaboration with multidisciplinary care teams to address both the physical and functional impact of chronic pain.
Related Treatments
A platelet-rich plasma (PRP) injection uses platelets and plasma to support healing in mild to moderate knee pain. Platelets are responsible for blood clotting and also contain proteins called growth factors that support your body’s healing, while plasma is the liquid component of blood. This formulation is achieved by separating blood into its individual components using a centrifuge, creating a liquid concentrate with a high platelet concentration.
Knee injections are a nonsurgical treatment that delivers medication into the knee to relieve pain and inflammation from osteoarthritis, tendon injuries, bursitis and other conditions. Options include corticosteroids, hyaluronic acid viscosupplementation and PRP, helping improve mobility and delay the need for surgery.
