What Is a Knee Injection for Arthritis?
Steroid and other targeted injections to reduce pain and inflammation from knee osteoarthritis, often alongside physiotherapy and weight management.
A knee injection is a non-surgical procedure in which medication is placed directly into the knee joint. This is known as an intra-articular injection. The aim is to reduce inflammation and pain within the joint. This helps movement, sleep and daily activity become more comfortable.
Several types of injection are used in orthopaedic practice, and they are not all supported by the same level of evidence:
- Corticosteroid (steroid) injections: these are anti-inflammatory medications. NICE guidance on the management of osteoarthritis supports considering intra-articular corticosteroid injections where other treatments have been ineffective or unsuitable. This guidance recognises that the benefit is generally short term.
- Hyaluronic acid injections (viscosupplementation): intended to supplement the natural lubricating fluid within the joint. Current NICE guidance does not recommend intra-articular hyaluronan injections for the routine management of osteoarthritis. Any discussion of this option should include an honest explanation of the limited evidence.
- Platelet-rich plasma (PRP) and similar biological injections: these use a preparation made from a sample of your own blood. Evidence remains mixed, and these treatments are not currently recommended in routine NHS practice. They should only ever be discussed as an option with clear information about uncertainty.
Injections do not repair worn cartilage and do not reverse arthritis. They are a way of managing pain rather than a treatment for the underlying arthritis, and may create a useful window of improved comfort. During this window, physiotherapy, strengthening and weight management can be more easily undertaken.
Who May Benefit From a Knee Injection?
A knee injection may be considered for adults with confirmed knee osteoarthritis who continue to experience troublesome symptoms despite first-line measures. You may be a candidate for assessment if you experience:
- persistent knee pain that limits walking, stairs or standing
- stiffness, particularly first thing in the morning or after sitting
- episodes of swelling or a feeling of warmth in the joint
- pain that disturbs sleep or restricts work and hobbies
- limited benefit from painkillers, topical anti-inflammatories or exercise therapy
- a wish to delay or avoid surgery, or a medical reason why surgery is not currently suitable
Injections may be less suitable for people with active infection in or near the joint, or certain bleeding disorders. They may also be less suitable for people with poorly controlled diabetes or allergy to the medication being used. Suitability always depends on individual assessment. Your consultant will advise you based on your examination findings, imaging and general health.
Knee Injections: Conditions and Problems That May Be Treated
- osteoarthritis of the knee, including mild, moderate and advanced disease
- inflammatory flare-ups causing pain and swelling
- patellofemoral (kneecap) arthritis
- arthritis following previous injury or meniscal surgery
- persistent symptoms after failed conservative treatment
- pain limiting participation in physiotherapy or rehabilitation
- large knee effusion from bursa/inflammation
In some cases an injection can also help with diagnosis. If pain settles temporarily after an injection into the knee joint, this can help confirm something important. The joint itself is the main source of symptoms, rather than the hip or lower back.
Knee Injections: Potential Benefits
Outcomes vary considerably between individuals, and no injection can be guaranteed to work. Where treatment is effective, patients may notice:
- a reduction in knee pain, often over several weeks
- reduced swelling and inflammation within the joint
- improved ability to walk, climb stairs and sleep comfortably
- better tolerance of physiotherapy and strengthening exercises
- reduced reliance on oral pain medication in the short term
- time to plan surgery at a point that suits work, family or health circumstances
Some patients gain little or no benefit, and some experience relief that fades sooner than hoped. Being clear about this in advance is an important part of informed consent.
Knee Injections: Your Recovery Timeline
- Day 0: Home the same day, mild soreness at the injection site is common
- Day 1–2: Avoid strenuous or high-impact activity while the joint settles
- Week 1: Pain relief typically becomes noticeable within the first week
- Weeks–Months: Benefit commonly lasts from several weeks up to a few months
Knee Injections: Consultation and Assessment
Before any injection is offered, a thorough orthopaedic consultation is carried out. This usually includes:
- Medical history: your symptoms, how long they have lasted, previous injuries or operations and treatments already tried. We also review other medical conditions and current medications, including blood thinners.
- Physical examination: assessment of alignment, swelling, range of movement, ligament stability and walking pattern. We also examine the hip and spine where relevant.
- Imaging: weight-bearing X-rays are usually the most useful investigation for arthritis. An MRI scan may occasionally be requested if cartilage, meniscal or soft tissue problems are suspected.
- Discussion of options: including exercise therapy, weight management, footwear and walking aids, and medication. Other options include injections, arthroscopy in selected cases, and partial or total knee replacement.
Risks, expected benefits and alternatives are explained so that you can make an informed decision. Mr Shanmugasundaram Rajkumar will only recommend an injection where it is likely to help. This depends on your particular pattern of arthritis.
Knee Injections: How the Procedure Is Performed
A knee injection is a short outpatient procedure and does not require a general anaesthetic or an overnight stay. In practice:
- you sit or lie with the knee slightly bent and supported
- the skin is cleaned thoroughly using an aseptic technique
- a local anaesthetic may be used, or it may be combined with the injected medication
- a fine needle is passed into the joint space and the medication is injected
- if there is a large effusion, some fluid may be drawn off first to relieve pressure
- a small dressing is applied and you rest briefly before going home
Ultrasound guidance may be used in some cases to improve accuracy, particularly where the anatomy is difficult. The injection itself normally takes only a few minutes, although the appointment as a whole will be longer.
Knee Injections: Recovery and Aftercare
Most people are able to walk out of the clinic and drive home if they feel comfortable. Arranging a lift is sensible for a first injection. General guidance usually includes:
- resting the knee and avoiding strenuous activity or high impact exercise for around 24 to 48 hours
- using an ice pack for short periods if the knee feels sore
- continuing gentle movement and prescribed physiotherapy exercises as advised
- expecting possible short-lived soreness or a flare of pain in the first day or two
- allowing up to a week or two before judging the full effect of a steroid injection
A follow-up appointment is normally arranged to review your response, adjust your rehabilitation plan and discuss longer term management. Seek prompt medical advice if you develop increasing pain, marked swelling, redness or heat around the joint. Also seek help if you feel feverish or unwell, as these can suggest infection.
Knee Injections: Risks and Considerations
Knee injections are generally well tolerated, but they are not without risk. Possible issues include:
- temporary post-injection pain or flare
- bleeding or bruising at the injection site esp if on blood thinners
- facial flushing and a short-term rise in blood sugar, particularly relevant for people with diabetes
- thinning or lightening of the skin and fat at the injection site with steroid use
- joint infection, which is uncommon but serious and requires urgent treatment
- concerns about repeated steroid injections and cartilage health, which is why the number of injections is usually limited and spaced out
Injections are one part of a wider approach. Reliable evidence from the NHS, NICE and organisations such as Arthritis UK is clear. Exercise, muscle strengthening and weight management are core treatments for knee osteoarthritis. Where symptoms are advanced and quality of life is significantly affected, joint replacement surgery may offer more durable improvement. This can be discussed at your consultation.
Knee Injections: Why Choose Mr Shanmugasundaram Rajkumar?
Mr Shanmugasundaram Rajkumar is a Consultant Trauma and Orthopaedic Surgeon. He has more than 16 years of consultant experience in hip and knee surgery. He is fellowship-trained in lower limb arthroplasty and knee surgery. He also has previous experience at Wrightington Hospital, a recognised centre for joint replacement surgery.
- Honorary Senior Clinical Lecturer at the University of Glasgow
- College Tutor/Regional Surgical Advisor for the Royal College of Physicians and Surgeons of Glasgow
- Specialist expertise in primary and revision hip and knee replacement, knee arthroscopy and cartilage preservation surgery
- Uses ODEP 10A-rated hip and knee implants, with outcomes evidenced through National Joint Registry and Scottish Arthroplasty Project data
- Active researcher involved in randomised controlled trials and UK and European multicentre studies
- Published in peer-reviewed orthopaedic journals and a reviewer and consulting editor for international journals
- National lecturer and medical educator in Trauma & Orthopaedics
This combination of surgical and non-surgical expertise means injection treatment is considered within the full range of options. These options run from conservative care through to joint replacement, rather than as a standalone service.
Knee Injections: Location and Areas Served
Consultations for knee injections and wider arthritis care are available in Glasgow. Patients also travel from Renfrewshire and the surrounding areas of the west of Scotland. Appointments are arranged to allow enough time for a full assessment and unhurried discussion of your options.
Knee Injections: Frequently Asked Questions
Is a knee injection painful?
Most patients describe brief discomfort similar to a blood test. Some also feel a sensation of pressure as the medication enters the joint. Local anaesthetic is often used to reduce this. Mild soreness for a day or two afterwards is common.
How long does the appointment take?
The injection itself usually takes only a few minutes. Allow additional time for consultation, consent, preparation and a short rest afterwards.
How long do the effects last?
This varies considerably. Relief from a corticosteroid injection is generally short term, often lasting from a few weeks to a few months. Some patients notice little benefit, while others find it helpful enough to repeat when appropriate.
How often can injections be repeated?
Repeat injections are usually spaced out and limited in number over a year. Your consultant will advise on timing based on your response, your general health and the state of your joint.
Are there alternatives?
Yes. Alternatives include structured exercise and physiotherapy, weight management, and pain relief medication including topical anti-inflammatories. Other options include walking aids, footwear adjustments and, for advanced arthritis, partial or total knee replacement.
When should I book a consultation?
It is reasonable to seek a specialist opinion if knee pain is limiting your daily activities or disturbing your sleep. This also applies if it is not responding to the measures you have already tried.
What Is a Hip Injection for Arthritis?
A hip injection for arthritis delivers steroid or lubricating medication into the hip joint under image guidance. It reduces pain from hip osteoarthritis without surgery.
Steroid injections to reduce pain and inflammation from hip osteoarthritis, helping manage symptoms alongside physiotherapy and activity changes.
A hip injection is a non-surgical procedure in which medication is placed directly into or around the hip joint. Most commonly, this involves a corticosteroid (a strong anti-inflammatory medicine) combined with a local anaesthetic. The local anaesthetic works quickly and provides short lived numbing. The steroid, meanwhile, can reduce inflammation within the joint over a longer period.
Because the hip is a deep, ball and socket joint surrounded by thick muscle, injections are usually performed under imaging guidance. This is most often ultrasound or X-ray guidance (fluoroscopy). This helps confirm that the medication reaches the intended target. Injections given “blind”, without imaging, are far less reliable in the hip than in more superficial joints.
Hip injections serve two purposes. The first is therapeutic: to settle inflammation and reduce pain for a period of weeks or months. The second is diagnostic: if pain improves significantly straight after the local anaesthetic takes effect, this supports an important idea. The hip joint itself is likely the source of symptoms, rather than the lower back, pelvis or surrounding soft tissues. This information can be valuable when planning further treatment, including whether hip replacement surgery may eventually be appropriate.
An injection does not repair damaged cartilage or reverse arthritis. It is best understood as one part of a wider management plan. This plan may also include exercise, physiotherapy, weight management, walking aids and pain relief medication. This approach follows NICE guidance for osteoarthritis.
Who May Benefit From a Hip Injection?
A hip injection may be considered for adults with hip pain that has not settled with simpler measures. You may be suitable if you experience:
- Groin pain, deep buttock pain or pain radiating towards the thigh or knee
- Stiffness in the hip, particularly first thing in the morning or after sitting
- Difficulty with socks, shoes, nail cutting or getting in and out of a car
- Pain that disturbs sleep or limits walking distance
- A limp, reduced hip rotation or a feeling of the joint catching
- Symptoms that persist despite pain relief, activity modification and physiotherapy
An injection could also be considered where the source of pain is uncertain. For example, this applies when both the lumbar spine and the hip show wear on imaging. It may also apply where surgery is not currently suitable because of other medical conditions, timing or personal preference. Some patients choose an injection while waiting for surgery. Others use it to help manage a particular period, such as a holiday, a family event or a demanding work commitment.
A hip injection is not suitable for everyone. It may be avoided or delayed if there is active infection, poorly controlled diabetes, certain bleeding disorders or an allergy to the medications used. It may also be delayed if surgery on that hip is planned in the near future. Your clinician will advise based on your assessment.
Hip Injections: Conditions and Problems That May Be Treated
- Osteoarthritis of the hip, including moderate and advanced wear
- Inflammatory arthritis affecting the hip, alongside rheumatology care
- Hip impingement (femoroacetabular impingement) and associated labral irritation
- Post-traumatic arthritis following a previous hip injury or fracture
- Synovitis or joint inflammation causing pain flares
- Diagnostic uncertainty between hip, spine and pelvic sources of pain
Pain arising from outside the joint, such as trochanteric pain syndrome (pain over the outer hip), gluteal tendon problems or bursitis, is treated differently. This pain may require a separate targeted injection or a structured physiotherapy programme, rather than an intra-articular injection.
Hip Injections: Potential Benefits
Where an injection is appropriate, patients may notice:
- A reduction in hip pain, often within a few days of the procedure
- Improved comfort with walking, sleeping and daily tasks
- Better tolerance of physiotherapy and strengthening exercises
- Reduced reliance on oral pain relief medication for a period
- Useful diagnostic information to guide further treatment decisions
- A possible delay in the need for surgery in selected cases
Results vary considerably. Some people gain several months of meaningful relief, others gain only a few weeks, and a proportion notice little change. Evidence reviewed by organisations such as Cochrane is clear on this point. Corticosteroid injections in osteoarthritis tend to provide short to medium term relief rather than a lasting solution. Being realistic about this from the outset helps you plan sensibly.
Hip Injections: Your Recovery Timeline
- Day 0: Home the same day, some soreness around the hip is common
- Day 1–2: Avoid strenuous or high-impact activity while the joint settles
- Week 1: Pain relief typically becomes noticeable within the first week
- Weeks–Months: Benefit commonly lasts from several weeks up to a few months
Hip Injections: Consultation and Assessment
A thorough assessment comes before any injection is offered. During a consultation with Mr Shanmugasundaram Rajkumar you can expect:
- A discussion of your symptoms, how long they have been present and what aggravates them. We also cover how they affect your work, sleep and activities
- A review of your medical history, medications (including blood thinners), allergies and previous treatments
- A physical examination of the hip, spine and gait, assessing movement, strength and areas of tenderness
- Review of existing imaging or arrangement of X-rays, and occasionally an MRI scan where soft tissue detail is needed
- An explanation of all reasonable options, which may include exercise therapy, weight management and medication. Other options include injection therapy, joint preserving surgery or hip replacement
- A clear discussion of the likely benefits, risks and alternatives so you can give informed consent
If an injection is not likely to help you, that will be said openly. In some cases a different diagnosis or a spinal assessment will be more useful than proceeding with a procedure. A referral for another opinion may also be recommended.
Hip Injections: How the Procedure Is Performed
A hip injection is a day-case outpatient procedure. It is usually carried out in a treatment or imaging room and does not normally require a general anaesthetic.
Step by step
- You lie on your back on the couch and the hip area is cleaned with antiseptic solution.
- Ultrasound or X-ray guidance is used to identify the joint accurately.
- Local anaesthetic numbs the skin and deeper tissues, which may sting briefly.
- A fine needle is guided into the joint and the medication is injected. In some cases a small amount of contrast dye is used first to confirm needle position.
- A small dressing is applied. The injection itself usually takes only a few minutes.
Most patients are observed for a short period afterwards and can go home the same day. You will usually be advised to arrange transport home. This is because the leg can feel numb, heavy or slightly unsteady while the local anaesthetic is working.
Hip Injections: Recovery and Aftercare
Recovery is generally straightforward, though it does vary between individuals.
- First few hours: the hip may feel noticeably better because of the local anaesthetic. This effect wears off after a few hours and is not the final result.
- First 48 hours: some patients experience a temporary flare of discomfort as the anaesthetic wears off. This happens before the steroid takes effect. Ice packs and simple pain relief usually help.
- First week: relative rest is advisable. Avoid heavy lifting, high impact exercise and long periods of standing. Gentle movement is encouraged.
- Two to six weeks: the steroid effect is usually clearest during this period. Physiotherapy and strengthening work are often most productive at this stage.
You will normally be asked to keep a simple record of how your pain changes. This diagnostic information is genuinely useful at follow-up. A review appointment allows your response to be assessed and the next steps to be planned.
Seek prompt medical advice if you develop increasing pain and swelling after the first two days, or redness or heat around the injection site. Also seek help if you have a fever or feel generally unwell, as these can be signs of infection.
Hip Injections: Risks and Considerations
Hip injections are widely used and generally well tolerated, but no procedure is without risk. Possible issues include:
- A short term post-injection pain flare
- Bruising or bleeding at the injection site esp if on blood thinners; may need stopping for a couple of days prior to injection
- Facial flushing, and a temporary rise in blood sugar, which matters particularly for people with diabetes
- Temporary changes to the menstrual cycle
- Thinning or lightening of the skin and fat at the injection site, which is uncommon in a deep joint
- Joint infection, which is rare but serious and requires urgent assessment
- Little or no improvement in symptoms
Injections are usually limited in frequency, as repeated steroid injections into the same joint over time are not generally recommended. If a hip replacement is being planned, most surgeons prefer a gap of 6 months between injection and surgery to reduce infection risk. Mr Shanmugasundaram Rajkumar will explain the timing that applies to your situation.
Hip Injections: Why Choose Mr Shanmugasundaram Rajkumar?
Mr Shanmugasundaram Rajkumar is a Consultant Trauma and Orthopaedic Surgeon with more than 16 years of consultant experience. He specialises in hip and knee surgery, joint replacement and complex trauma care. He is fellowship-trained in lower limb arthroplasty and knee surgery. He also has previous experience at Wrightington Hospital, a recognised centre for joint replacement surgery.
- Honorary Senior Clinical Lecturer at the University of Glasgow
- College Tutor/ Regional Surgical Advisor for the Royal College of Physicians and Surgeons of Glasgow
- Expertise in primary and revision hip and knee replacement, knee arthroscopy and cartilage preservation
- Uses ODEP 10A-rated hip and knee implants, with outcomes evidenced through National Joint Registry and Scottish Arthroplasty Project data
- Active researcher involved in randomised controlled trials and UK and European multicentre studies
- Published in peer-reviewed orthopaedic journals and a reviewer for international surgical journals
- National lecturer and medical educator in Trauma & Orthopaedics
He manages the full range of hip care, from non-surgical treatment through to complex revision surgery. This means advice about injections is given in the context of your whole treatment pathway, rather than as an isolated procedure.
Hip Injections: Location and Areas Served
Consultations are available in Glasgow for hip and knee assessment. Patients also travel from Renfrewshire, Paisley and the wider west of Scotland. Appointments are arranged to allow enough time for examination, review of imaging and a full discussion of your options.
Hip Injections: Frequently Asked Questions
Is a hip injection painful?
Most patients describe pressure and brief stinging rather than severe pain. Local anaesthetic is used to numb the area first, and the injection itself typically takes only a few minutes.
How long does relief last?
This varies. Some people gain several months of relief, others a few weeks, and some notice little change. Response often depends on the severity of arthritis and the level of inflammation present.
Can I drive afterwards?
You should not drive immediately after the procedure. Arrange for someone to take you home. Only return to driving when you can control the vehicle comfortably and safely.
Will an injection delay the need for a hip replacement?
It may help some patients manage symptoms for a period, but it does not reverse arthritis. If pain and function continue to deteriorate, surgery may still become the more appropriate option.
What are the alternatives?
Alternatives include structured exercise and physiotherapy, weight management, walking aids, pain relief medication, and surgical options such as hip replacement. Your clinician will discuss which combination suits your diagnosis.
When should I book a consultation?
Consider booking if hip pain is limiting your walking, sleep or daily activities despite simple measures. Also consider it if you want a clear explanation of what is causing your symptoms.
At a glance
Setting
Outpatient clinic
Procedure time
10–20 minutes
Anaesthetic
Local, injection only
Recovery
Same day, avoid strenuous activity 24–48 hrs
Relief
Typically weeks to several months
Fees & insurance
New Consultation
£180
Follow-up
£110
Insurers
Bupa · AXA Health · Aviva · Vitality · WPA
Self-pay
All-inclusive quotation on request
A written quotation is provided before any procedure is booked.
Discuss your hip or knee
Request an appointment at Ross Hall Hospital, Glasgow.