Injections for joint pain: what to know
Learn about joint injections and shots for joint pain, including steroids, hyaluronic acid, and regenerative options for effective pain relief.
Table of Contents
Pain can stop you in your tracks, making it difficult to stay active and engaged. Whether it’s throbbing in your low back, a sharp twinge in your knee, or constant stiffness in your shoulders, pain can be a major obstacle.
Joint injections can reduce inflammation and provide temporary or longer-term pain relief, allowing you to move more freely and engage in activities that support your long-term health.
Here, learn from Hinge Health experts how different joint injections work, their benefits and side effects, and how they fit into an overall treatment plan that can include physical therapy and exercise.
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Reviewed by our clinical and medical experts
Richard Keyme, MD
Claudia Canales, PT, DPT
What are joint injections?
Joint injections deliver medications directly into painful joints and around irritated nerves. Your provider might recommend a joint injection if other conservative treatments (such as physical therapy and exercise, over-the-counter pain medications, heat, and ice) have not been effective. The type of injection and the duration of pain relief can vary based on the condition of your joint, your activity level, weight, and other factors.
Common types of joint injections
Different types of joint injections have varying results, safety profiles, long-term success, and side effects. Some types can provide immediate pain relief, while others may take longer to work. Some approaches are still considered experimental, are not FDA approved, and may not be covered by your insurance. Talk to your healthcare provider to determine which type of injection is best for your condition.
Corticosteroids
Corticosteroid injections (aka steroid shots) reduce inflammation and provide pain relief by delivering anti-inflammatory medication directly into painful joints or areas around irritated nerves. Pain relief from the injection usually takes a few days to start, although many people feel immediate temporary relief from the local anesthetic, like lidocaine, that is combined with the steroid. It's also common for some people to experience a temporary increase in pain for a few days after the injection.
Steroid shots are not a long-term solution, as their effects generally wear off after a few weeks or months. Side effects can include pain at the injection site, facial flushing, changes in blood pressure or sugar levels, mood alterations, and skin whitening. Frequent injections can affect your hormones, cause tissue changes around the injection site, damage cartilage, and delay healing. It’s important to discuss the risks, benefits, and alternatives with your healthcare provider before deciding on repeat corticosteroid injections.
Local anesthetic injections
Local anesthetic injections provide quick pain relief by numbing a specific area, which can let you participate in other treatments or physical therapy and exercise more effectively. Local anesthetic injections can also help pinpoint the source of your pain, leading to more effective treatment.
Local anesthetics have fewer systemic side effects than other treatments. They can be a good option for people who can’t undergo surgery. They are often combined with corticosteroids for immediate and longer-term pain relief. Some research shows that local anesthetics can be just as effective as corticosteroids for pain improvement in certain areas.
NSAID injections
These injections deliver non-steroidal anti-inflammatory drugs (NSAIDs) directly into a specific area, such as a joint or muscle, to reduce pain and inflammation. They can be effective for conditions like arthritis, tendonitis, and other musculoskeletal issues. Unlike oral NSAIDs (such as ibuprofen), which are absorbed through the digestive system, these injections provide targeted relief with fewer systemic side effects. Common NSAID injection medications include ketorolac and diclofenac. NSAID injections can be as effective as corticosteroids, making them a useful option for people who need frequent steroid injections or are awaiting joint surgery.
Hyaluronic acid or viscosupplementation
Hyaluronic acid (HA) is a gel-like substance naturally produced in your joints. As you age or with conditions like osteoarthritis, HA can thin. HA injections can help by adding more HA, improving joint lubrication and cushioning. HA can come from natural sources, like chickens (“rooster comb” injections), or be lab-made. Studies show different results: Some people have improved mobility and some temporary pain relief. Other studies show little benefit compared to a placebo. How well HA injections work can depend on your age, joint condition, and other factors. They might help people who haven't improved with other treatments or aren't ready for surgery.
Botulinum toxin (BoNT) injections
Botulinum toxin (BoNT) is a protein that blocks the release of chemicals that send signals from nerves to muscles. Botox is a well-known brand used for cosmetic purposes, but BoNT is also used to treat various conditions. BoNT injections may relieve joint pain by relaxing muscle spasms. Studies show that BoNT is generally safe and may provide pain relief for up to six months for certain joint conditions, but more research is needed on long-term benefits and best use.
Biologic therapies
Biologic therapies are relatively new joint injection treatments that use substances from living organisms to help reduce pain and promote healing in joints. Some early results show that biologic therapies may provide longer lasting pain relief than corticosteroid injections, but more research is needed. Common types of biologic therapies include:
Regenerative therapies
Regenerative therapies are injection treatments that aim to repair and rebuild damaged tissues in your joints. They use substances or cells which might enhance your body's natural healing processes, restore joint function, and reduce pain:
Platelet-rich plasma (PRP) injections use a concentrated form of your own plasma (the clear, liquid part of your blood) and platelets, which are important for clotting and wound healing. While these injections appear to be safe and can provide relief, some studies show the improvements are often small and more research is needed to fully understand the long-term results. Your pain may temporarily worsen after a PRP injection because it stimulates your body’s inflammatory healing process. PRP injections may be more effective for certain body areas and some types of PRP may work better than others. Overall, PRP injections can be a useful option for people who haven't found relief from other treatments, but they may not be a long-term solution.
Mesenchymal stem cell (MSC) injections deliver special cells, usually taken from your own bone marrow or fat tissue, into a joint. MSCs have the potential to turn into different types of tissues, like bone, cartilage, or muscle, which may help repair damaged joint tissue and reduce pain. MSCs also release helpful substances that can calm the immune system and assist in healing. Research is mixed, but some studies show that MSC injections can improve mobility and reduce joint pain, and may repair damaged cartilage. More studies are needed to confirm the long-term safety and effectiveness of MSC injections.
Bone marrow aspirate concentrate (BMAC) injections use cells, growth factors, and other substances extracted from your bone marrow (typically from the top of your pelvis) to treat a painful area. In a study on knee arthritis, for example, BMAC injections might help reduce pain and improve mobility. However, they don’t seem to be much better than other types of injections. More research is needed to understand how effective BMAC injections are for joint pain.
Autologous conditioned serum (ACS) injections involve processing your blood to create a concentrated serum rich in anti-inflammatory proteins. A study on knee arthritis shows that ACS injections may help lessen pain and improve joint function. More studies are needed to understand the long-term safety and effectiveness of ACS injections.
Prolotherapy
Prolotherapy is a treatment that involves injecting a mild irritant solution, like sugar water (commonly high concentration dextrose) into a joint or surrounding tissue to help it heal and reduce pain. The solution causes a mild inflammation, which is thought to trigger the body to repair and strengthen the damaged tissues, such as ligaments, tendons, or joints.
Some studies show that it can help reduce pain and improve function, but the evidence is mixed and more high-quality research is needed. Prolotherapy may be offered by providers who specialize in pain management, sports medicine, or orthopedics, but it’s often not covered by insurance.
What to expect with a joint injection
You can receive shots for joint pain in a clinic or hospital setting. Your provider will clean the area and inject a local anesthetic before inserting a needle into the joint. They may use imaging (such as ultrasound) to help guide the needle placement. Your provider may also remove excess joint fluid before the medication is injected. Most people can resume normal activities a few days after a joint injection. Unless an anesthetic is injected along with the medication, it may take several days or weeks to start experiencing pain relief.
Pain relief from joint injections is usually temporary. An injection might not lead to long-term improvements in your joint function. While injections are intended to reduce pain, they can come with temporary side effects such as:
Joint stiffness
Swelling
Redness or bruising
Pain near the injection site
Different joint injections can have varying side effects and risks. Talk to your provider to learn more.
Physical therapy (PT) is for more than just recovering from surgery or injury. It’s one of the top treatments for joint and muscle pain. It helps build strength, improve mobility, and reduce pain. And it doesn't always need to be in person.
Hinge Health members can conveniently access customized plans or chat with their care team at home or on the go — and experience an average 68% reduction in pain* within the first 12 weeks of their program. Learn more*.
Physical therapy and exercise: alternative or complement to injections
Physical therapy and exercise, either alone or combined with joint injections, can be as effective as or better than injections alone for certain conditions.
If pain is limiting your movement or ability to do daily activities, physical therapy (PT) can help. Physical therapists can assess you, rule out any serious causes of your pain, help you modify your activities, empower you with tools and tips to help you hurt less, and personalize your exercise program.
You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.
How Hinge Health can help you
If you have hypersensitivity or joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.
The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.
Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you.
See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.
This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition.
Looking for pain relief? Check if your employer or health plan covers our program
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