Arthritis treatment often involves corticosteroid, biologic, and PRP injections. Injections can deliver medication directly to the affected joint and provide longer relief.
Arthritis is not a single condition — there are around 100 different types. The most common is osteoarthritis (OA).
Many people with arthritis can manage their symptoms with a combination of lifestyle strategies — such as diet, exercise, and efforts to maintain a moderate weight — as well as medical treatments such as over-the-counter (OTC) and prescription medications and physical therapy.
Sometimes, a doctor may recommend that a person receive injections for arthritis. An injection provides medication directly to the affected joint or targets the portion of the immune system responsible for inflammation in the joint.
This article reviews the different injections available for arthritis, why a doctor may recommend them, the risks, and more.
Doctors do not always recommend injections for arthritis. Various other treatment options and self-care approaches can help relieve arthritis symptoms.
A doctor may recommend injections for:
- rheumatoid arthritis (RA) and other inflammatory arthritis types
- severe OA pain
- temporary symptom relief until doctors find appropriate longer-term medication
Injections for arthritis provide medication either directly to the affected joints or to the areas surrounding them. There are several types of injections, which work differently to provide relief for various arthritis symptoms:
- Corticosteroids: These help reduce pain and inflammation.
- Biologics: These are a subset of medications known as disease-modifying antirheumatic drugs (DMARDs). Biologics help block certain parts of the immune system, reducing inflammation that causes joint pain.
- Hyaluronic acid: This provides a lubricant for affected joints to reduce stiffness and pain.
- Platelet-rich plasma (PRP): This involves drawing blood, modifying it, and injecting it back into the area around the affected joint to reduce inflammation. This treatment is fairly new, and research into its effects is ongoing.
The American College of Rheumatology recommends corticosteroid injections over any other types of injections for OA.
The sections below outline each injection type in more detail.
Corticosteroid injections mimic the hormone cortisone, which the body makes naturally. Corticosteroids help suppress the immune system.
Injections of corticosteroids provide a high dose of medication directly into the affected joints. They can help reduce inflammation in the joints and relieve pain, swelling, and stiffness.
A person may experience relief for about 1 month after an injection.
There are several types of steroid injections, including:
Doctors can often provide steroid injections in their offices. They often mix the steroid with a numbing agent.
After receiving the injection, a person may need to wait 10–15 minutes before leaving.
A person may receive injections while their doctor determines an appropriate long-term care plan. Once this is in place, the doctor may reduce or discontinue the shots.
Biologics are a type of DMARDs. While conventional DMARDs suppress the whole immune system, biologics target specific areas.
Laboratories create biologics using components such as sugars, proteins, nucleic acids, and living organisms.
Biologics can successfully treat arthritis in some people but not others. This is often because of the complex nature of inflammatory diseases like RA.
These medications can also reduce a person’s ability to fight infections and can cause other potential side effects. A person should discuss the risks and benefits with a doctor before getting an injection.
Biologics often help with RA, psoriatic arthritis, and other forms of inflammatory arthritis.
Some common biologics are:
- certolizumab pegol (Cimzia)
- adalimumab (Humira)
- golimumab (Simponi, Simponi Aria)
- etanercept (Enbrel)
- infliximab (Remicade)
- belimumab (Benlysta)
- rituximab (Rituxan)
- canakinumab (Ilaris)
- anakinra (Kineret)
The exact treatment and time frame between treatments will depend on which biologics a doctor believes will work best. A person can ask their doctor how often they will need injections.
Hyaluronic acid is a naturally occurring lubricant in joints. It often deteriorates in OA.
Hyaluronic acid injections provide lubrication to the affected joints, but they often require several visits to the doctor before becoming effective. The Food and Drug Administration (FDA) has approved these injections for use in the knee. Doctors may also recommend them for the shoulder or hip, but these are “off-label” uses, which means the FDA has not approved them.
Doctors may recommend these injections to replace lost lubrication in people with mild to moderate forms of OA.
Approved brands in the United States include:
Treatment will vary based on the brand. In most cases, a person will need weekly injections for 3–5 weeks.
A lab makes PRP from a person’s blood. A medical professional draws the blood, and then a lab uses a centrifuge to separate the components. A medical professional then injects the serum directly into the affected joint.
The serum has anti-inflammatory and immune-modulating effects on the joint. While these injections may help reduce joint pain and stiffness, insurance does not generally cover the costs, which can total as much as $2,000.
The treatment regimen can vary. A specialist may provide a one-time shot or one shot per week for up to 3 weeks.
Like other treatments, injectable medications come with some risk of side effects and adverse reactions:
- The injections themselves may be a bit uncomfortable. A person may also notice a flare-up of symptoms within the first 24–48 hours after a steroid injection.
- Injections can lead to infection if healthcare professionals do not properly sterilize the skin or needles.
- Repeated injections of steroids can lead to cartilage breakdown and weakening of the tendons and ligaments.
- Hyaluronic acid may cause some discomfort, pain, swelling, or stiffness.
- Pain at the injection site may occur with PRP, but more serious negative effects are rare.
Injections for arthritis are one form of treatment doctors may use to help reduce inflammation, provide lubrication, or relieve pain. Other treatments can range from simple interventions to surgery.
Treatment options a person may use alone or in combination include:
- hot and cold therapy
- healthy diet
- exercise that promotes strength, flexibility, and cardiovascular health
- OTC pain medications
- nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
- topical NSAIDs
- topical capsaicin
- transcutaneous electrical nerve stimulation (TENS)
- physical therapy
- occupational therapy
- surgical joint replacement or repair
A person should contact a doctor if they experience intense pain that lasts longer than 48 hours after an injection or if they notice other reactions to the injection.
A person may wish to talk with a doctor if their current treatments are not helping with their arthritis symptoms. A doctor may recommend injections or other therapies.
Injections can provide short-term relief of arthritis pain, swelling, and stiffness. A person may need repeated injections to maintain the benefits.
In some cases, a doctor may use injections for a short time while figuring out a long-term treatment option suitable for the individual.
Arthritis is not curable, but most people can find a treatment regimen that helps them manage their symptoms.
Arthritis injections deliver medication directly to the affected joints. Some people find them effective for reducing pain, swelling, and inflammation.
Repeated steroid injections may cause cartilage breakdown, so a doctor may recommend them for only short-term use. Other injections may cause side effects such as pain and bruising at the injection site.
Injections provide short-term relief, which means a person may need repeated injections. People can try a combination of medication, lifestyle strategies, and home remedies to manage their symptoms.