Even in a small joint, osteoarthritis (OA) can have a big impact on your life. For instance, OA in your fingers can keep you from holding a pen or opening a jar. A stiff or sore knee can make it hard to walk.
Getting a shot of corticosteroids (sometimes called a steroid shot) directly into a sore joint can ease pain quickly.
The pain of arthritis makes it tough for many people to get a good night’s sleep. Worse yet, tossing and turning at night can actually increase the perception of pain.
“There’s a reciprocal relationship between pain and poor sleep. The poorer people sleep, the more pain they tend to be in,” says Kevin Fontaine, PhD, assistant professor of rheumatology at Johns Hopkins University. “If people with arthritis can improve the quality of their sleep, they can usually reduce their day-to-day pain.”
Corticosteroids help fight inflammation -- the heat, redness, pain, and swelling in an injured or infected part of the body. Corticosteroid shots ease pain faster than anti-inflammatory pills. A single injection doesn’t cause stomach upset the way pills can. When corticosteroids are injected into a joint, their effects are mostly limited to that joint.
What to Expect
Most corticosteroid injections into your knee or a smaller joint, like the base of your thumb, can be done in a doctor’s office.
First, the doctor cleans your skin with an antiseptic. If the joint is puffy and filled with fluid, the doctor may insert a needle into the joint to remove the excess fluid. This quickly relieves some of the pain, because it reduces pressure in the joint. Removing extra fluid may also speed healing.
Next, the doctor uses a different syringe to inject the corticosteroid into the joint. Relief is almost instant, because the corticosteroid is usually mixed with a painkiller. The corticosteroid begins to curb inflammation within a few hours. The relief usually lasts from several weeks to several months.
Injecting a large joint, such as your hip, or in the spine is more complex. Your doctor may use imaging technology to help guide the needle into place.
What Are the Risks?
Corticosteroids can have side effects. Some can be dangerous, such as a greater risk of infection, weight gain, ulcers in your digestive tract and bleeding, osteoporosis, increases in blood pressure and blood glucose levels, and eye problems such as cataracts and glaucoma.
Injecting corticosteroids directly into a joint lessens or removes most of these side effects. There are, however, some special, if uncommon, risks of joint injection. They include:
Injury to the joint tissues, mainly with repeated injections
Thinning of cartilage, the smooth covering that protects the bones in the joint
Weakening of the ligaments of the joint
More inflammation in the joint caused by a corticosteroid that has crystallized
Irritation of the nerves, by the needle or the medication itself
Infecting the joint
Whitening or thinning of skin at the injection site
You should not have this type of treatment if you have an infection in or around a joint or you’re allergic to any of the drugs used.
Limits in Treating OA
Although corticosteroid injections can ease arthritis symptoms, they have limits. They can’t repair damaged cartilage or slow the progression of arthritis. Their relief is only temporary.
Most experts say you should limit injections to no more than once every three or four months. Get no more than about four shots in any one joint.
If you still have joint pain after corticosteroid injections, talk with your doctor about other treatments. Depending on the joints involved, other treatment options could include joint replacement.