Understanding Your Options for Knee Pain Relief
Knee pain injections offer a non-surgical path to relief when everyday activities become a struggle. If you’re dealing with chronic knee pain that limits your mobility, here’s what you need to know:
Quick Answer: Main Types of Knee Pain Injections
| Injection Type | How It Works | Relief Timeline | Best For |
|---|---|---|---|
| Corticosteroid (Cortisone) | Reduces inflammation | 24-48 hours | Quick relief, acute flare-ups |
| Hyaluronic Acid (Gel) | Lubricates joint | 1 week or more | Mild-moderate arthritis, longer-lasting relief |
| PRP (Platelet-Rich Plasma) | Promotes healing | Several weeks | Tissue regeneration, chronic pain |
Knee pain affects roughly one in four Americans over age 60, making it a leading reason people seek medical care. When rest, ice, and over-the-counter pain relievers aren’t enough, injections deliver medication directly into your knee joint—targeting pain and inflammation where it starts.
I’m Dr. Zach Cohen, a double board-certified Anesthesiology and Chronic Pain Medicine specialist. With fellowship training from UC San Diego, I’ve helped hundreds of patients in the San Diego area find relief with knee pain injections and other minimally invasive treatments, focusing on restoring mobility without surgery.
What Are Knee Injections and Who Are They For?
Your knee is a complex joint of bones, cartilage, and fluid that allows you to move. When injury, arthritis, or wear-and-tear damages this system, the resulting pain can be debilitating.
Knee pain injections deliver medication directly into the knee joint (an “intra-articular” approach). This targeted method is often more effective and has fewer side effects than oral medications. The injections work in different ways: some calm inflammation, while others add lubrication to a dry joint. The goal is always to reduce pain and improve movement.
Injections are typically recommended when conservative treatments like rest, physical therapy, or over-the-counter medications fail to provide adequate relief.
Who is a candidate for knee injections? Injections are most commonly used for osteoarthritis, the wear-and-tear type of arthritis. They can significantly improve pain and function in mild to moderate cases. Other conditions that respond well include:
- Rheumatoid Arthritis: To manage flare-ups in the knee.
- Gout: To provide fast relief from inflammation caused by uric acid crystals.
- Injuries: Certain ligament, tendon, or meniscus problems may also benefit.
The bottom line is that if your knee pain isn’t improving and is limiting your activities, it’s worth discussing with a pain specialist whether injections could help.
For more information on non-surgical approaches to managing knee pain, visit our page on Non-Surgical Knee Pain.
Comparing the Main Types of Knee Pain Injections
Choosing the right knee pain injection depends on the cause and severity of your pain, as well as your treatment goals.
At California Pain Consultants, we create a personalized treatment plan by reviewing your medical history, examining your knee, and discussing your goals. This ensures we select the injection with the best chance of success for you.
The two most common knee pain injections are corticosteroids and hyaluronic acid. They work in different ways and have different strengths.
| Injection Type | Speed of Relief | Duration of Effect | Primary Function |
|---|---|---|---|
| Corticosteroid (Cortisone) | Fast (24-48 hours) | Weeks to Months | Reduces inflammation |
| Hyaluronic Acid (Gel) | Slower (1 week or more) | Up to 6 Months | Lubricates & cushions joint |
Let’s look at each type more closely.
Corticosteroid (Cortisone) Injections
Corticosteroid injections, or cortisone shots, are powerful anti-inflammatory medications. Injected directly into the knee, cortisone provides rapid relief, typically within 24 to 48 hours, by blocking the chemicals that cause inflammation and pain.
They are highly effective for conditions driven by inflammation, such as osteoarthritis flare-ups, bursitis, and tendonitis. Relief typically lasts for several weeks to a few months. Due to potential long-term effects like cartilage softening, we limit these injections to three or four per year in the same joint.
While excellent for quick relief, cortisone is not a long-term solution. Potential side effects include a temporary increase in blood sugar or blood pressure, which we will discuss with you.
For more comprehensive information about managing your discomfort, visit our page on Pain Relief.
Hyaluronic Acid (Gel) Injections
Hyaluronic acid (HA) injections, also known as gel shots or viscosupplementation, work by lubricating the joint. In a healthy knee, synovial fluid contains hyaluronic acid, which provides lubrication and shock absorption. In osteoarthritis, this fluid thins out, leading to painful friction.
HA injections supplement the knee’s natural fluid, restoring lubrication and cushioning to reduce pain. This mechanical approach is best for mild to moderate osteoarthritis. Relief is slower to appear than with cortisone, often taking a week or more, but the effects are longer-lasting—typically up to six months.
HA is often administered in a series of one to five weekly injections. Unlike cortisone, repeated treatments are safe and do not carry the same risk of joint damage, making them a better option for long-term management.
You can learn more about this treatment option on our Gel Injection page.
The Injection Process: What to Expect from Procedure to Recovery
The process for a knee pain injection is straightforward, and we prioritize your comfort and safety throughout.
Consultation and Diagnosis
Your treatment begins with a thorough consultation. We discuss your symptoms, perform a physical exam, and review any imaging (X-rays or MRIs) to determine if an injection is right for you and which type will be most effective.
The Procedure Step-by-Step
The procedure itself takes only a few minutes. We first sterilize the skin over your knee. A local anesthetic is used to numb the area, ensuring the procedure is comfortable. We often use ultrasound guidance to see the needle in real-time, ensuring the medication is delivered to the exact spot for maximum effectiveness. If there is excess fluid in the knee, we may remove it (aspirate) before injecting the medication. Finally, the medication is slowly injected, and a small bandage is applied.
Post-Injection Care and Recovery
After the injection, you can go home with simple care instructions. We recommend resting the knee and applying ice for the first 24 to 48 hours to manage any mild soreness. Avoid strenuous activity during this time to allow the medication to work effectively.
Potential Risks
Knee pain injections are very safe, but all procedures have potential risks, which we will discuss with you. Potential risks, though rare, include:
- Temporary pain, swelling, or bruising at the injection site.
- A temporary “post-injection flare” of symptoms, especially with cortisone.
- Infection (extremely rare due to sterile techniques).
- Allergic reaction to the medication.
- A temporary increase in blood sugar for diabetic patients receiving cortisone.
Our team is here to support you. Contact us if you have any concerns after your procedure.
For more comprehensive information on managing knee pain, check out our guide on Pain Management for Knee Pain.
Beyond Cortisone and Gel: Exploring Other Knee Injection Options
Beyond traditional injections, regenerative therapies use your body’s own healing abilities to treat knee pain. At California Pain Consultants, we stay current with these advances and offer options that might be right for your specific situation.
Platelet-Rich Plasma (PRP) Injections
Platelet-Rich Plasma (PRP) therapy concentrates your body’s natural healing factors to repair damaged tissue. The process involves drawing a small amount of your blood, spinning it in a centrifuge to concentrate the platelets, and injecting this PRP into your knee. These platelets are rich in growth factors that stimulate tissue repair and reduce inflammation.
PRP can be effective for mild to moderate osteoarthritis, tendonitis, or ligament injuries. Relief is not immediate and can take several weeks to develop, but the results can be long-lasting. While many studies show positive results, PRP is still considered emerging by some medical guidelines and is often not covered by insurance.
You can learn more about this treatment on our PRP page.
Prolotherapy
Prolotherapy involves injecting a mild irritant solution (typically dextrose) into ligaments and tendons around the knee. This triggers a localized healing response, which can strengthen connective tissues, stabilize the joint, and reduce pain. It’s considered for osteoarthritis and chronic ligament or tendon issues. It requires a series of injections and is generally considered an alternative treatment.
Experimental or Newer Injections
The frontier of regenerative medicine continues to expand. Stem cell injections, using cells from your bone marrow or fat, aim to regenerate cartilage, but research is still ongoing to confirm their effectiveness. These treatments are not yet FDA-approved for knee pain and are not covered by insurance.
We keep a close watch on emerging research and discuss these options with patients who might benefit. Our approach is to ensure you’re fully informed about the current evidence, potential risks, and realistic expectations. These newer treatments often cost more and may not be covered by insurance due to limited scientific evidence or lack of FDA approval for knee pain injections.
Injections vs. Other Treatments: Making an Informed Choice
The most successful outcomes for knee pain often come from a stepped approach, starting with conservative methods before considering injections. At California Pain Consultants, we’ve found that this thoughtful approach leads to the best results, and knee pain injections are just one piece of the puzzle.
Conservative First-Line Treatments
Before considering injections, we explore conservative first-line treatments:
- Physical therapy to strengthen muscles and improve flexibility.
- Weight loss to reduce stress on the knee joints.
- Over-the-counter NSAIDs (like ibuprofen) to manage inflammation.
- Bracing for added stability.
- Activity modification to avoid aggravating the joint.
When to Consider Injections
Injections are considered when conservative treatments fail to provide enough relief and pain continues to limit your daily activities. Injections are not a replacement for these therapies but a complement. The pain relief from an injection can make it easier to participate in physical therapy, creating a positive cycle of healing.
Injections as a Bridge to Surgery
Injections can also serve as a bridge, potentially delaying the need for knee replacement surgery. For example, studies suggest viscosupplementation (gel shots) can postpone surgery for several years in some patients. This allows you to maintain your natural joint longer, which is particularly beneficial for younger patients or those with health risks that make surgery less ideal.
While injections aren’t a solution for everyone, our philosophy is to exhaust all effective non-surgical options before considering surgery.
For a comprehensive overview of all your treatment options, refer to our Complete Knee Pain Treatment Guide.
Frequently Asked Questions about Knee Injections
Here are answers to some of the most common questions we receive about knee pain injections.
How long do the effects of knee injections last?
The duration of relief varies by injection type and individual patient response.
- Corticosteroid: Relief typically lasts several weeks to a few months.
- Hyaluronic Acid: Relief often lasts up to six months.
- Platelet-Rich Plasma (PRP): Relief can be long-lasting as it promotes natural healing, though it takes several weeks to become noticeable.
The duration also depends on the severity of your condition and your activity level. We monitor your progress and adjust our approach as needed.
Are knee injections painful?
We take steps to minimize discomfort during the injection.
During the procedure: A local anesthetic is used to numb the area. Most patients report feeling only a brief pinch and then a sensation of pressure, not significant pain.
After the procedure: It’s normal to have mild soreness for a day or two. A temporary “flare” of symptoms can occur with cortisone but resolves quickly with ice and rest.
Contact us immediately if you experience severe pain, swelling, redness, or fever, as these could be signs of a rare complication like infection.
Are knee injections covered by insurance?
Insurance coverage for knee pain injections depends on your plan and the type of injection.
Corticosteroid and Hyaluronic Acid: These are generally covered by most insurance plans, including Medicare, when medically necessary and after conservative treatments have been tried. Pre-authorization is often required.
PRP and Regenerative Injections: These are often considered experimental by insurance companies and may not be covered. Coverage is gradually improving as more research becomes available.
Our team can help you verify your benefits and understand any out-of-pocket costs. We recommend confirming coverage with your insurance provider before your procedure.
Find the Right Knee Pain Solution in San Diego
Persistent knee pain can diminish your quality of life, but you don’t have to live with it. At California Pain Consultants, we are dedicated to helping you find relief.
Our board-certified specialists serve the San Diego, La Mesa, and Chula Vista areas with personalized care. We understand that there is no one-size-fits-all solution for knee pain, which is why we take the time to understand your unique situation and goals to create a custom treatment plan.
Whether you need a corticosteroid injection for a flare-up, hyaluronic acid for long-term lubrication, or a regenerative therapy like PRP, we will guide you toward the best option. Our goal is to reduce your pain and restore your mobility, helping you return to the activities you love.
If you’re ready to take control of your knee pain, we’re here to help. Schedule your consultation with our pain specialists in La Mesa and start your journey toward relief.