Knee injections usually cause mild to moderate discomfort, like a pinch or pressure, but are often well-tolerated because doctors use local anesthetics to numb the area first; expect some soreness or aching for a couple of days afterward, managed with rest and ice, though some people feel significant pain temporarily. The pain level varies by person and type of injection, but the procedure itself is quick, and doctors use techniques like ultrasound guidance to minimize discomfort.
Your doctor can numb the area with an anesthetic like lidocaine before giving the injection, to make the procedure more comfortable. Most patients describe the injections as uncomfortable but not extremely painful. Patients with osteoarthritis in both knees can usually get them treated at the same appointment.
Depending on the site, average injection pain was 3.1–4.5 on a 10-point scale.
It is recommended that you refrain from any high level activities using your knee for approximately 48 hours. Routine activities including walking are permitted. The most commonly reported side effects are temporary pain, swelling and/or fluid accumulation in the injected knee.
One is to spray a topical anesthetic over the site of injection. Another is to inject some anesthetic to numb it up.
The most painful places for a cortisone shot are typically small, sensitive areas with dense nerve endings, like the palm of the hand, sole of the foot (plantar fascia), fingers, toes, or ankle joints, because they have less space for the medicine and more surface nerves compared to larger joints like the shoulder or knee. Pain is also worse if the tissue is already severely inflamed, and the needle size can play a role.
The most common side effect is mild pain and swelling at the injection site that goes away on its own. About 1% of people have a more severe reaction called an injection flare. It causes fluid to accumulate in the joint, with significant swelling and pain.
If you received a cortisone shot in your knee, stay off your feet when you can. Use ice on the injection site as needed to relieve pain. Don't use heating pads. Not use a bathtub, hot tub or whirlpool for two days.
You will likely be able to drive yourself home after the procedure. You can return to normal activity the next day. You may have pain relief almost immediately from the local anesthetic, but this may not last very long.
For other types of joint injections (such as those in the knee, shoulder, or hip) pain relief may begin within 24 to 72 hours, particularly if a local anesthetic is used. Corticosteroids in these injections generally take 3 to 5 days to begin working, with maximum relief occurring in up to 10 days.
The use of ultrasonography (US) to guide intra-articular knee injections may improve accuracy and the likelihood of directing medication into the joint space. A 22-gauge needle is ideal for knee injections with a 5-mL syringe, but any needle size from 22 to 25 gauge may be used.
In my practice, I often refer to the “4 P's” of pain management: Prevention, Precision, Personalization, and Participation. These principles help us provide the best care possible. Let's delve into each of these aspects. Prevention: The first P stands for Prevention.
A hydrocortisone injection usually takes a few days to start working, although sometimes they work in just a few hours. How many hydrocortisone injections will I need? This depends on your joint pain.
The injection is prepared. Usually, it contains a numbing agent in addition to the treatment. The doctor cleans the skin and typically applies a spray to numb the area. The doctor inserts the needle into the knee joint, often while using ultrasound or X-rays to guide the needle to the right location.
“Like any injection, it may seem more painful to some people than others, but there should not be a lot of pain since a sharp needle is used and the joint may be numbed first with a local anesthetic.”
Note: Side sleeping is usually an option several weeks into recovery, not immediately after surgery. Always check with your physical therapist or surgeon before trying this position.
All lower limb joints need particular care, as even walking puts pressure on these areas. Rest for at least 24-48 hours after a cortisone injection in your knee. You can then resume slow, gentle walking for short distances if you feel able to.
Depending on your location and options, the out of pocket costs for knee gel injections can range from around $1,000 to $2,500 for a series.
You don't usually need to make any special preparations before having a steroid injection. But it's best to wear comfortable clothes that allow easy access to the joint that will be injected.
Resting after your cortisone injection
This rest period is crucial because it allows the medication time to work without additional stress or strain on the area. During this time, avoid strenuous activities, heavy lifting, or any movements that could aggravate the pain or cause injury.
A: The brace needs to be worn during the 4 to 6 week period after your injection while you're weight bearing, including and especially during exercise. You do not need to wear it while on a stationary bike, as it is not a weight bearing activity.
The #1 mistake making bad knees worse is excessive rest and a sedentary lifestyle, leading to weaker supporting muscles, stiffness, and a vicious cycle of more pain; instead, gentle, consistent movement (like walking, swimming) is crucial to strengthen the joint and improve function, though it must be balanced with avoiding activities that cause sharp pain. Other major errors include ignoring pain signals, carrying excess weight, wearing unsupportive shoes, and poor movement patterns, says Parkside Sports Physiotherapy and Coastal Empire Orthopedics.
How to avoid a knee replacement: Nonsurgical treatment for bone-on-bone knee pain. You may be surprised to learn that surgery isn't always the best option. Often, nonsurgical options are very effective at treating knee pain from arthritis, injury or another condition.
Compared to cortisone injections, PRP therapy offers several advantages: Reduced risk of side effects: PRP is derived from the patient's own blood, minimizing the risk of allergic reactions or other adverse effects.