Corticosteroid Injections for Knee Pain

The male patient visitng doctor for shot inoculation

Overview

Corticosteroids are commonly used for short term relief of knee pain, particularly osteoarthritis.  It involves injecting corticosteroids directly into the knee.  Research shows there is a small to moderate effect lasting several weeks.  It is inexpensive, and side effects can include loss of pigment or skin color, atrophy or shrinkage of tissue and damage to fat cells. It might also lead to further cartilage breakdown in a small number of cases. 

Source:

Cook CS, Smith PA. Clinical Update: Why PRP Should Be Your First Choice for Injection Therapy in Treating Osteoarthritis of the Knee. Curr Rev Musculoskelet Med. 2018;11(4):583-592. 

RESCU Treatment Ratings

R = Risk      E = Effectiveness      S = Self-Care

C = Cost     U = Usefulness (overall rating)

1 = Least Favorable     5 = Most Favorable

R

RISK: 2/5

2_Hearts_Treatment_Rating

Steroid injections have some risks. They can cause increased pain and swelling in the area of injection. Cortisone reduces the body’s ability to fight infection, and it is always possible the injection itself can introduce infection.

Some people can have an allergic reaction to the ingredients, and diabetics always need to be careful about corticosteroid injections as it can significantly increase blood sugar levels. In addition, some studies have indicated that injections can increase the risk of tendon rupture. Also, some patients, especially those with darker skin, may experience skin discoloration or lightening.

Some studies have indicated that corticosteroid injection can cause long-term degeneration of tendons. While the risk of complications is low, they are nevertheless real and potentially serious.

Source:

Smidt N, van der Windt DA, Assendelft W, et al. Corticosteroid injections, physiotherapy, or a wait-and-see policy for lateral epicondylitis: a randomized controlled trial. Lancet. 2002 Feb 23;359(9307):657-662.

Bisset L, Smidt N, Van der Windt DA, et al. Conservative treatments for tennis elbow do subgroups of patients respond differently? Rheumatology (Oxford). 2007;46(10):1601-1605.

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