Steroid Injections for Knee & Shoulder Osteoarthritis: Pros and Cons

What are steroid injections?

Steroid (corticosteroid) injections deliver powerful anti-inflammatory medication directly into an affected joint—like the knee or shoulder—to reduce swelling and pain. These injections often include a local anesthetic (e.g., lidocaine) to boost immediate comfort.

Benefits

1. Fast-acting pain relief: Most patients experience significant pain reduction within days—sometimes even hours—which supports better participation in rehabilitation.
2. Delays need for surgery: By easing symptoms, steroid shots offer a conservative strategy to extend joint function and potentially postpone joint replacement.
3. Well-tolerated with few systemic effects: Because the medication is localized, major side effects are less common compared to oral steroids. Minor side effects are typically mild and short-lived.

Read our official blog Steroid Injections for Knee and Shoulder Osteoarthritis: Pros and Cons

Drawbacks

1. Short duration: Benefits usually last from a few weeks up to a few months; long-term improvement is inconsistent.
2. Possible joint damage with repeat use: Multiple injections—especially frequent high-dose ones—can accelerate cartilage loss, weaken tendons, and cause joint deterioration over time.
3. Injection-site or systemic reactions: You may experience temporary “cortisone flare” (worsened pain for 24–48 hours), warmth, swelling, skin discoloration, or increased blood sugar—especially in diabetics.
4. Risk of infection or nerve injury (rare): Although uncommon, infections and nerve damage may occur if sterile procedures aren’t meticulously followed.

What research shows

• A 2017 randomized trial revealed that quarterly injections of triamcinolone over two years resulted in more cartilage loss than placebo—but provided some symptom relief.
• A Cochrane analysis (2015) reported limited long-term benefit in quality of life; effects were inconsistent and often of short duration.

Clinical guidelines & frequency limits

• Injections should typically be limited to 3–4 times per year per joint to reduce risks.
• Many professional guidelines recommend steroids only after less-invasive treatments fail, especially in early or mild disease.

Alternatives to consider

If you’re seeking fewer injections or more regenerative outcomes, these options may be worth exploring:

• Hyaluronic acid injections (joint lubrication)
• Platelet-rich plasma (PRP)
• Physical therapy
• Shockwave therapy
• Regenerative treatments like stem cell-based approaches

Summary

Steroid injections are an effective option for short-term pain and inflammation relief, especially when conservative care isn’t enough. However, they do not cure the underlying disease and may carry risks—most notably joint damage, tendon weakening, and systemic effects, particularly with frequent use. Ideal candidates are those needing temporary symptom relief, aiming to boost physical therapy efforts, or seeking to postpone surgery.

Always discuss your options closely with a specialist—considering factors like injection frequency, joint condition, overall health, and alternative strategies—to create a plan tailored to your specific needs.