top of page

What you 'Knee'-d to know: steroid injections for knee pain

Injection chair in Moderni Spine clinic procedure room
Procedure room at Moderni Spine


Should I get a steroid injection for my knee?

Knee pain is a very common problem with a common cause being our old friend Arthur (aka Arthritis). While there are various treatment options available, steroid injections are a commonly used and effective approach to managing knee pain caused by arthritis.

What is a steroid injection?

Steroid injections, also known as corticosteroid or cortisone injections, involve injecting a powerful anti-inflammatory medication to the knee joint. These injections contain a synthetic form of our body's hormone called cortisol. The adrenal glands (which sit on top of the kidneys) produce cortisol which helps reduce inflammation and alleviate pain. Sometimes if we have repetitive inflammation, it can be hard for our body to get the signals correctly and may not produce enough, or due to poorer circulation we may not get enough to where we need it. That's where a steroid injection may add a hand (....or a knee ;)

So...what does it do when it's put the knee?

When administered into the knee joint, steroid injections work by targeting and suppressing the local inflammatory response, which is often responsible for causing knee pain. You can sort of think of the steroid as hundreds of tiny people with buckets of water trying to put out a fire in your knee. Additionally, steroids can help minimize swelling, and improve joint mobility. Accompanying the injections with the use of ice, non-steroidal anti-inflammatory medications or herbal anti-inflammatory supplements such as Turmeric, can all fight the inflammation.

Benefits of Steroid Injections for the Knee:

1. Effective Pain Relief:

Because these injections generally contain a numbing medication, they usually provide rapid pain relief, within a few days the anti-inflammatory effect of the steroid will also be noticeable. Steroid injections provide rapid pain relief, offering patients an opportunity to resume their daily activities without discomfort. According to a study published in the Journal of Bone and Joint Surgery, a significant reduction in pain was observed within 48 hours of a steroid injection, with relief lasting for several weeks or even months.

These injections can last only weeks and for some people years. It depends on so many factors including what the underlying issue is (what that fire looks like), body's own response to steroids, physical activity, body habitus and ergonomics. If you had one that lasted a month your next one could last 6 months or vice a versa. There isn't always a clear answer. That is why it is important to talk to your provider about how many steroid injections it may take before relief is found, how many you can have and what other options there might be.

2. Non-Surgical Approach: Steroid injections offer a non-surgical treatment option for individuals suffering from knee pain. They can be particularly beneficial for patients who are not suitable candidates for surgery at this time, or they are trying to postpone surgery for a specific seasonal/work related reason, insurance reason, age or weight reason per the orthopedic surgeon.

Recent studies have shown that steroid injections can potentially delay the need for knee surgery, such as knee replacement or arthroscopy. This delay can provide patients with additional time to explore alternative treatment options if appropriate or improve their overall joint health.

3. Improved Functionality: In addition to pain relief, steroid injections can enhance knee joint functionality by reducing inflammation and swelling. This allows patients to regain their range of motion and perform activities that were previously limited due to knee pain. This is very important for improving in physical therapy and strengthening the surround muscles of the knee to continue to support the joint.

Recent Studies Supporting the Efficacy of Steroid Injections:

1. A systematic review and meta-analysis published in the journal Annals of Internal Medicine examined the effectiveness of intra-articular corticosteroid injections for knee osteoarthritis. The study concluded that these injections provided short-term pain relief and improved physical function compared to a placebo.

2. A randomized controlled trial published in the journal JAMA evaluated the efficacy of corticosteroid injections for knee pain in patients with osteoarthritis. The study found that patients who received steroid injections experienced greater pain reduction and improved function compared to those who received a placebo injection.

So.... it's all good right?

Not necessarily. Come on, you don't think everything is as straightforward as that did you?

For the most part steroid injections are VERY safe and can be VERY effective. Possible downsides include risks from the injection itself just like any other procedure (infection, tendon damage, allergic reactions, bleeding). All of those risks are extremely low if the appropriate precautions are taken (such as allergy history, injecting into the right structures, cleaning and using aseptic or sterile procedure techniques).

More severe reactions are even more rare. Osteonecrosis (which translates as death of bone) is an extremely rare but serious side effect in which the steroid contributes to decreased blood flow to the bone causing death.

The most common question I get about steroid side effects is regarding osteoporosis. Osteoporosis is the weakening of bone. Prolonged or high-dose steroid use can lead to a decrease in bone density. Risk factors again are going to be the dosage, frequency, and length of time steroids are used. The more steroid in the bloodstream the more likely the harm on bone health overall, so steroids taken as a pill or through 'IV' are more likely to cause bone weakening. Make sure to have a conversation with the pain provider about your age, bone health and family history. This will help set better expectations on how many injections are appropriate, for how long, and other preventative measures needed to be taken.

....And that is that:

Steroid injections for the knee have proven to be a valuable treatment option for individuals suffering from knee pain. They offer effective pain relief, improve functionality, and may delay the need for surgery. Recent studies support the efficacy of steroid injections, highlighting their potential benefits in managing knee pain. Very infrequent steroid injections are likely not to be a problem. However, if you think you need to continue injections, come talk with me at Moderni Spine so we can discuss if it is a suitable treatment plan for you.

Don't forget, our $100 Knee Injection Event on 7/20/2023 from 8am to 2pm at Moderni Spine clinic. Pre-registration is a must but it's as easy as clicking the YELLOW button. Afterall, I do love Yellow!

Thanks for reading Moderni Minutes!


1. McAlindon TE, et al. (2017). Effectiveness of Intra-Articular Therapies for Osteoarthritis: A Network Meta-analysis. Ann Intern Med, 166(6), 453-462.

2. Jüni P, et al. (2015). Intra-Articular Corticosteroid for Knee Osteoarthritis. JAMA, 313(7), 695-696.


bottom of page