How Effective Is A Steroid Injection For Knee Arthritis?

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.

Physicians often use steroid injections, also known as corticosteroids, to manage knee arthritis symptoms. However, emerging research questions both their overall value and long-term effects on joint structures. Shifts in clinical practice can take time, even when studies raise safety concerns. That shift may now be overdue for corticosteroid use for knee arthritis.

Recent studies suggest that symptom relief from these injections may be temporary. Some evidence also links repeated use to cartilage damage and joint deterioration. Despite this, corticosteroids remain a frequent choice, largely due to insurance coverage and patient demand.

Not all physicians may be aware of how corticosteroids can affect joint structures. This lack of awareness raises concern about ongoing use without a clear understanding of potential trade-offs. Imaging-based research continues to evaluate their clinical role and long-term impact.

How Steroid Shots Work For Pain Caused By Knee Arthritis 

Corticosteroid injections may help reduce knee arthritis symptoms by suppressing the immune response. This effect can lower joint inflammation and temporarily relieve pain. However, the underlying joint degeneration continues, even when symptoms improve for a short time.

Physicians typically inject corticosteroids directly into the knee joint to reach the affected area. This local approach may provide faster symptom relief compared to oral medications. These injections are usually considered for individuals with moderate to severe knee arthritis.

Steroid shots are often used when other conservative options, such as physical therapy or nonsteroidal anti-inflammatory drugs, fail to reduce symptoms. While the effects can be noticeable, the relief is typically short-lived, and repeated use may carry risks.

Benefits Of Steroid Injection For The Knee

Steroid injections help manage symptoms of knee arthritis by reducing joint inflammation. Relief may begin within a few days and can last several weeks to a few months. These injections do not address the root cause of arthritis but may offer temporary improvement during symptom flare-ups.

Although their effects are short-lived, understanding how corticosteroids act on the immune system helps explain why they remain a common option in orthopedic care. In the context of knee arthritis, corticosteroids may:

• Reduce inflammation: Corticosteroids lower immune-driven inflammation, which may ease joint swelling, pain, and stiffness in arthritic knees.
• Help with autoimmune disease: They reduce abnormal immune activity in conditions like rheumatoid arthritis or lupus, helping manage symptoms and flare-ups.

Other Conditions That May Benefit From Steroid Shots

Steroid injections are not used exclusively for knee arthritis. Physicians may recommend them for a range of musculoskeletal conditions where inflammation contributes to pain or limited mobility. In orthopedic care, these injections may help support conservative treatment plans before exploring more invasive options.

They may help reduce inflammation and discomfort in joints, tendons, or soft tissues affected by chronic or inflammatory conditions. The following are common musculoskeletal issues where corticosteroid injections may be considered:

Long-Term Side Effects That You Need To Consider

Steroid injections may offer short-term relief from knee arthritis symptoms. However, their effects are temporary and do not address the underlying cause of joint degeneration. As a result, repeated use has raised concerns among researchers and clinicians.

Over time, corticosteroids may contribute to joint damage or other complications. While occasional use may carry limited risk, long-term or frequent injections have been associated with structural changes in the joint. Reported risks of repeated steroid use include:

Progression Of Cartilage Loss 

Steroid injections may appear helpful at first by reducing pain and swelling. However, emerging research has raised concerns about their long-term effects on joint tissue—especially cartilage. Repeated corticosteroid exposure has been associated with accelerated cartilage degeneration in some studies.

This is particularly relevant for individuals with knee arthritis, where preserving joint structure plays a key role in long-term function. Some individuals have reported worsening joint function or discomfort in the months following the injection.

As early as 2013, medical literature began to question the routine use of corticosteroids in arthritic joints. Research has pointed to a possible link between repeated or high-dose injections and progressive cartilage loss over time.

Weakened Tendons

Steroid injections are not limited to joints like the knee. Physicians may also inject them near or around tendons to help reduce inflammation related to conditions such as tendinitis. However, research has raised concerns that corticosteroids may interfere with the tendon’s ability to repair itself.

One documented concern is that corticosteroids may reduce the number and function of cells involved in tissue healing. This weakening of the tendon structure may increase the risk of re-injury or contribute to long-term dysfunction.

Studies involving individuals with tendinitis have shown that symptoms often improve initially but may return with increased severity. This pattern suggests that steroid injections may temporarily mask pain without addressing the underlying condition.

Laboratory research supports these clinical findings. Corticosteroids like triamcinolone have been shown to reduce populations of mesenchymal cells involved in orthopedic tissue repair. In one study, even low doses eliminated most of these cells.

Additional Effects Of Steroid Injections On The Body

Steroid injections may have effects beyond the targeted joint or tendon. Systemic changes have been observed, particularly with repeated or high-dose exposure. One study found that older women experienced increased bone loss following corticosteroid injections, raising concerns about long-term skeletal health.

Other research has identified disruptions in blood sugar regulation, which may be especially relevant for individuals with diabetes or insulin resistance. Corticosteroids have also been linked to a potential increase in infection risk, including complications following joint replacement procedures.

In one study, participants who received injections in both knees showed signs of adrenal insufficiency. This condition occurs when the body reduces its natural hormone production in response to repeated corticosteroid exposure.

Due to concerns about systemic effects, some physicians have reduced their use of high-dose epidural corticosteroids. In select cases, physicians in the licensed Regenexx network may consider procedures using Regenexx PL injectate as a less invasive option to support the body’s natural healing response.

Additional Risks For Patients With Underlying Conditions

Steroid injections may pose additional risks for individuals with pre-existing health conditions such as diabetes or high blood pressure. In some cases, corticosteroids have been shown to raise blood sugar levels by increasing glucose production and reducing insulin sensitivity.

This temporary shift may complicate blood sugar management in individuals with insulin resistance or diabetes. For others, corticosteroids may promote sodium retention and fluid buildup, which can lead to a short-term increase in blood pressure.

These effects may place additional strain on individuals already managing hypertension or metabolic conditions. Patients with underlying health concerns should review these risks with their physician when considering corticosteroid-based care.

Studies Revealing Concerns About Steroid Injections

A double-blind, placebo-controlled study examined the long-term effects of the corticosteroid triamcinolone versus saline injections in individuals with knee arthritis. Researchers assessed both structural changes in the knee and self-reported pain levels over time.

Participants received injections every 12 weeks for two years. Findings showed that those who received corticosteroids experienced approximately twice the amount of cartilage loss compared to the placebo group.

Despite this increase in structural damage, both groups reported similar levels of knee pain. Neither group achieved symptom relief that met thresholds considered clinically meaningful.

The study concluded that repeated corticosteroid injections did not provide substantial long-term pain relief and may contribute to cartilage loss. These results raise important considerations about the continued use of corticosteroids in managing knee arthritis.

Ongoing research is exploring treatment options that may reduce symptoms while preserving joint structure. This includes approaches that aim to support the body’s natural healing response.

Are There Nonsteroidal Injections For Knee Arthritis Pain?

Steroid injections are not the only option for managing symptoms associated with knee arthritis. Emerging interventional orthobiologic approaches aim to reduce inflammation and support joint health without using corticosteroids.

Procedures using Regenexx lab processes offer nonsteroidal alternatives that utilize components from the individual’s own blood. These image-guided injections may help target joint structures while minimizing the risk of medication-related tissue damage.

One option includes the Regenexx SCP injectate, a proprietary platelet-rich plasma (PRP) formulation that contains a higher concentration of platelets than typical bedside centrifuge systems produce. These platelets release growth factors that may support joint tissue.

Another option is the Regenexx PL injectate, derived from platelet lysate—a refined, growth-factor-enriched form of PRP. This injectate is for use in areas that may be more sensitive to fluid volume or inflammatory response.

Each procedure using Regenexx injectates is customized based on diagnostic imaging and the individual’s specific condition or injury. These procedures aim to reduce pain and support the body’s natural healing response—without the use of corticosteroids or surgery.

Explore Nonsteroidal Solutions For Your Pain Management

Steroid injections may offer short-term relief, but research has raised concerns about their potential long-term effects on joint structures and overall health. For individuals seeking alternatives, nonsteroidal options may support a joint-preserving approach to orthopedic care.

Procedures using Regenexx lab processes utilize image-guided techniques and the patient’s own blood to make super-concentrated platelet-rich plasma (PRP) or the patient’s bone marrow concentrate, which contains stem cells. These customized treatments aim to reduce pain and support mobility without relying on corticosteroids.

As musculoskeletal care continues to advance, new strategies offer alternatives that focus on tissue compatibility and targeted delivery. For those looking to avoid repeated steroid exposure, Regenexx procedures may offer a less invasive path guided by advanced imaging and individualized treatment planning.

Medically Reviewed By:

Dr. Chaz Fausel, MD

Dr. Chaz Fausel is a Denver-based interventional orthopedics specialist and Regenexx educator, trained at Emory and the Centeno-Schultz Clinic.