Knee Injections for Pain Relief
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What are Knee Injections?
Knee injections involve a direct delivery of medication into the knee via a medical syringe. It is a nonsurgical treatment used to relieve various knee symptoms, including joint pain that may be associated with osteoarthritis. It is also an alternative option for those who may be reluctant to undergo knee-related surgery.
Types of Knee Injections?
There are currently three types of knee injections available.
Corticosteroid Knee Injections
Also known as cortisone injections, this treatment method injects steroids into the knee to help relieve pain and reduce inflammation, particularly in arthritis-related knee conditions. Corticosteroids are artificial compounds that closely simulate the hormone cortisol, which reduces the immune system’s inflammatory actions. As such, corticosteroid knee injections may provide relief from pain, swelling, and inflammation for several weeks or months, with results varying from person to person. However, corticosteroid use is typically restricted to three injections a year, as excessive use may increase the risk of damage to the knee joint.
Viscosupplementation Injections
Hyaluronic acid injections are a common form of viscosupplementation, also referred to as knee gel injections. Hyaluronic acid, is a naturally occurring substance found in the knee which helps to lubricate the joints and absorb shock from pressure on the knee joint. This treatment aims to relieve the symptoms of osteoarthritis, which reduces hyaluronic acid levels in the joint.
The hyaluronic acid used in these injections is commonly derived from bacterial cultures or via various synthetic or botanical methods. It may provide pain relief for several months and may be repeated at 6-month intervals, depending on your doctor’s recommendation.
Other types of viscosupplementation injection which are available include sodium polynucleotide. This is derived from salmon DNA, and it helps to reduce knee pain and improve mobilityby reducing inflammation for up to 6 months.
Platelet-rich Plasma (PRP) Knee Injections
PRP injections are a form of regenerative therapy prepared using your blood. It specifically requires the use of platelets, which are found in your blood and help your blood clot. They also contain growth factors that support cell renewal and tissue regeneration, which may help improve recovery from mild to moderate osteoarthritis and from tendon or ligament injuries.
Your doctor will draw a small blood sample and place it in a centrifuge to separate the platelets from the blood, concentrating them in plasma (the liquid component of blood). They will then inject this solution into your knee joint to support the body’s natural healing process. After the injection, it may take some time before it begins to relieve your knee pain or other symptoms.
Who is Suitable for Knee Injections?
Knee injections are suitable for treating individuals with ongoing knee-related injuries or conditions. This includes inflammatory conditions, overuse, and various types of arthritis, such as osteoarthritis. People who live active lifestyles or are very involved in competitive sports tend to be at a higher risk of developing these conditions.
Knee injections may also relieve symptoms associated with conditions such as:
- Bursitis
- Tendonitis
- Rheumatoid arthritis
- Gout
- Other musculoskeletal issues
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It may also be a treatment option for those who require knee replacement surgery but wish to delay the surgical procedure and explore nonsurgical therapies first. You may also undergo knee injections concurrently with other nonsurgical treatments, such as physiotherapy.
In cases of arthritis, knee injections may gradually provide less pain relief and symptom improvement as the condition worsens. In such instances, it may be necessary to consider knee replacement surgery to minimise long-term pain and discomfort.
General Procedures for Knee Injections
Before the Injection
Before the injection, your doctor will conduct a physical examination to assess your knee joint’s overall range of motion, strength, and mobility. They may perform diagnostic imaging tests to obtain a clearer view of your knee joint and its surrounding structures and confirm the diagnosis. They will then arrange your treatment schedule based on your condition and outline what to expect from the procedure.
A knee injection is commonly performed on an outpatient basis. During your appointment, your doctor will carefully clean the injection site while preparing the syringe. The injection may contain a numbing agent to minimise discomfort during and after the procedure.
During the Injection
Once the injection site is ready, the doctor will gently insert the needle into your knee joint and might use the assistance of an imaging device.Â
Once the needle is correctly positioned, the doctor may perform a knee joint aspiration to remove excess joint fluid and relieve internal pressure. A sample of this fluid may be sent for laboratory analysis to determine the cause of your knee condition. The medication will then be injected in to the knee. Knee injections are usually inserted inside the joint capsule,(i.e. the space between the bones of the knee), so that the medication will flow throughout the whole knee joint. In some cases, they are injected into the surrounding tissues. After the injection, the needle is removed and safely disposed of. The injection site is then cleaned, and a bandage is applied.
After the Injection
You may experience some pain, discomfort, or swelling after the injection as the numbing effect wears off. Applying ice to the knee (avoid using warm or hot water) or taking over-the-counter pain relief medications may help to ease these symptoms. Furthermore, avoid placing pressure on the knee joint during daily activities for the next 48 hours to minimise pain or discomfort.
Frequently Asked Questions
Are knee injections safe?
Like most medical treatments, there may be some risks, including pain and swelling at the injection site or an allergic reaction. Contact your doctor if you continue to experience any side effects several days after your knee injection.
How long will a knee injection take?
A knee injection usually takes a few minutes. After the injection, you may return home or to the office and resume light daily activities.
What precautions should I take after a knee injection?
After a knee injection, avoid strenuous physical activities, baths, swimming, and hot tubs for the next 48 hours. Applying ice for 24 to 48 hours after the injection may help relieve soreness or swelling.
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.
