Arthritis Treatment Steroid Injections for Arthritis, Gout, and More Cortisone shots help reduce inflammation locally or systemically By Carol Eustice Carol Eustice Facebook Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. Learn about our editorial process Updated on March 03, 2023 Medically reviewed by Stella Bard, MD Medically reviewed by Stella Bard, MD LinkedIn Stella Bard, MD, is a board-certified Internist, specializing in rheumatology in Brooklyn, New York, and McKinney, Texas. Learn about our Medical Expert Board Print Table of Contents View All Table of Contents Steroid Injections for Arthritis Cortisone Injections for Gout Steroid Injection Side Effects Frequently Asked Questions Steroid injections, also known as cortisone injections, are used to manage joint pain caused by arthritis. These corticosteroid drugs are often used to treat knee pain, nerve pain from sciatica in the lower back, and arthritic pain caused by gout. Steroid injections are a synthetic version of the natural corticosteroids your body makes to control inflammation, manage stress, and support other functions. These injections can be made within an affected joint, in the buttocks or other muscles, or into a vein for a systemic effect. This article explains how cortisone injections for arthritis are administered, and what to expect if you receive steroid injections for knee pain, gout, or another condition. It also discusses the side effects. This photo contains content that some people may find graphic or disturbing. See Photo saritwuttisan / Getty Images Steroid Injections for Arthritis Cortisone injections for arthritis are used to control inflammation. There are several ways that corticosteroids can be administered, including: Steroid injections directly into a joint or other tissue Systemic oral medications to treat the whole body Intravenous (IV) cortisone injections Intramuscular injections to treat a specific site Steroid injections for knee pain or other musculoskeletal conditions may provide significant relief. For patients with rheumatoid arthritis, the injections are typically offered when only one or two joints display active synovitis. The goal of treatment is to quell symptoms of a flare-up, or to enable slower-acting drugs, such as Trexall (methotrexate) or Plaquenil (hydroxychloroquine), time to work. Most healthcare providers limit steroid injections for knee pain, or into another joint, to no more than three times per year. For example, you can have an injection in each knee twice, but not four times on the same side. This is to limit bone, ligament, or tendon damage. People often wonder how long they have to rest after a steroid injection, or how long after a cortisone shot they can walk again. The answers vary depending on the joint that's being treated, your overall health, and your healthcare provider recommendations. Taking steroid injections for knee pain as an example, it's likely that you will have to limit walking or other weight-bearing activity for a day or two after an injection. This gives it the best chance to be effective. Overuse in the first six hours after cortisone injection can actually aggravate arthritis. Keep in mind that a local anesthetic is typically combined with the steroid. This may mask any pain, so you may note be aware that you are putting too much stress on your joint after a cortisone injection for arthritis. Expect it to take up to 10 days for the full benefits of treatment to take effect. The type of steroid injection you have may vary, in part depending on your provider's preference. Some of these cortisone injection options include: Depo-Medrol (methylprednisolone acetate) Aristospan (triamcinolone hexacetonide)Kenalog (triamcinolone acetonide) Celestone (betamethasone) Cortisone Injections for Gout Gout is a common form of arthritis with similar symptoms of joint pain and inflammation, though for a different reason. It affects joints, often the big toe, because uric acid builds up in the body. A nonsteroidal anti-inflammatory drug (NSAID) like Aleve (naproxen) or Advil (ibuprofen) is often used to treat gout, but cortisone is a treatment option for some people experiencing gout flare-ups. Research that compares both NSAID and systemic corticosteroid drugs used to manage gout found both deliver similar results in pain management, but the systemic corticosteroids cause fewer side effects. Steroid injections also may be used if only one or two joints in the body are affected. Side Effects Most people do not experience steroid injection side effects, especially when they closely follow their healthcare provider's instructions and have cortisone injections at the right intervals. However, potential side effects of steroid injections include: Increased pain or swelling of the joint in the first 24 hoursSwelling, redness, or increased pain after 24 hours (may signal a joint infection)Tendon ruptureSkin discolorationLocal bleedingInfectionAllergic reaction A local steroid injection into the buttocks muscle provides a systemic effect. As with oral corticosteroids, it is uncertain how much of the systemic medication reaches any specific joint. Also, if the injection into the buttocks is repeated frequently, it can increase the risk of developing some common side effects seen with oral steroids, including osteoporosis and cataracts. If a specific joint is involved, then a steroid injection for knee pain or another joint typically will go into that joint rather than using a systemic treatment approach. Local steroid injections are well-tolerated and less likely to be associated with serious side effects compared to oral corticosteroids. Keep in mind, though, that steroid injections for arthritis may be less effective when the affected joint is severely damaged. Frequently Asked Questions How long do steroid injections last? The answers will vary depending on the specific medication, the location being treated, how much damage there is to the knee or other site, and how long you've been receiving cortisone injections. Typically, pain relief will last anywhere between six weeks and six months. Learn More: Injections to Relieve Knee Pain Does cortisone cause weight gain? This is a common concern with steroid use, but it's more often seen with systemic corticosteroids than with local cortisone injections. Ask your healthcare provider if you're concerned about this side effect. Learn More: Short- and Long-Term Side Effects of Systemic Steroids Does cortisone keep you awake? Some cortisone drugs taken for conditions like asthma may cause insomnia, which is why it may be better to take them early in the day. Some research suggests that steroid injections to treat back pain will improve the quality of sleep. Learn More: Insomnia and Common Sleep Disorders 9 Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Abramowicz S, Kim S, Prahalad S, Chouinard AF, Kaban LB. Juvenile arthritis: current concepts in terminology, etiopathogenesis, diagnosis, and management. Int J Oral Maxillofac Surg. 2016;45(7):801-12. doi:10.1016/j.ijom.2016.03.013 Ferreira JF, Ahmed mohamed AA, Emery P. Glucocorticoids and Rheumatoid Arthritis. Rheum Dis Clin North Am. 2016;42(1):33-46, vii. doi:10.1016/j.rdc.2015.08.006 Panyaphurikun N, Kamkaew P, Saelim S, Jaisuk T. Systemic corticosteroids versus non-steroidal anti-inflammatory drugs for acute gout. The Clinical Academia 2019;43(4), 112–126. King W, Miller DC, Smith CC. Systemic Effects of Epidural Corticosteroid Injection. Pain Med. 2018;19(2):404-405. doi:10.1093/pm/pnx173 Freire V, Bureau NJ. Injectable Corticosteroids: Take Precautions and Use Caution. Semin Musculoskelet Radiol. 2016;20(5):401-408. doi:10.1055/s-0036-1594286 NYU Langone Health. Therapeutic Injections for Osteoarthritis of the Knee. Conklin AI, Hong J. Obesity prevention in corticosteroid-treated patients: Use and effectiveness of strategies for weight management. Clin Obes. 2019 Aug;9(4):e12312. doi:10.1111/cob.12312 Asthma and Allergy Foundation of America. Oral corticosteroids for asthma. Radoš I, Budrovac D, Omrčen I, Černohorski H, Tot OK, Drenjančević IH, et al. The Influence of Epidural Steroids Injections with Transforaminal and Interlaminal Approaches on Quality of Sleeping, Anxiety, and Depression in Patients With Chronic Lumbal Radicular Pain - Prospective, Randomized Research. Collegium Antropologicum, 2018; Vol 42 No. 3. Additional Reading Matzkin EG, Curry EJ, Kong Q, Rogers MJ, Henry M, Smith EL. Efficacy and Treatment Response of Intra-articular Corticosteroid Injections in Patients With Symptomatic Knee Osteoarthritis. J Am Acad Orthop Surg. 2017;25(10):703-714. doi:10.5435/JAAOS-D-16-00541 By Carol Eustice Carol Eustice is a writer covering arthritis and chronic illness, who herself has been diagnosed with both rheumatoid arthritis and osteoarthritis. See Our Editorial Process Meet Our Medical Expert Board Share Feedback Was this page helpful? Thanks for your feedback! What is your feedback? Other Helpful Report an Error Submit