Corticosteroid Injections for Joint Pain: What They Do, How Long They Last, and When to Avoid Them

When your knee, shoulder, or hip suddenly locks up with sharp pain, and even walking feels impossible, you might hear your doctor suggest a corticosteroid injection. It’s not a cure. But for many people, it’s the fastest way to get back on their feet - at least for a little while.

How Corticosteroid Injections Actually Work

Corticosteroid injections, often called cortisone shots, don’t fix broken cartilage or worn-out joints. They don’t regrow tissue. What they do is quiet the fire inside your joint.

Inside inflamed joints, your body releases chemicals like interleukin-1 and tumor necrosis factor-alpha. These trigger swelling, heat, and pain. Corticosteroids work by slipping into cells and turning off the genes that make these inflammatory signals. They also reduce the number of white blood cells flooding the area and make the fluid in your joint thicker, which helps cushion movement.

The injection usually contains a crystalline corticosteroid - like triamcinolone, methylprednisolone, or betamethasone - mixed with a local anesthetic like lidocaine. The anesthetic gives you immediate relief, but the real magic takes a few days. That’s when the steroid starts blocking inflammation at the source.

Who Gets These Injections and Why

These shots aren’t for everyone. They’re most effective for sudden, painful flare-ups caused by inflammation, not just wear and tear.

• Acute gout attacks: A single injection can clear up swelling and pain in hours.
• Tendonitis or bursitis: Think tennis elbow, shoulder bursitis, or hip pain from inflamed bursae. Injections often let people return to daily activities in days, not weeks.
• Rheumatoid arthritis flares: When medication isn’t enough, a joint injection can buy time until the next dose kicks in.
• Osteoarthritis: For mild to moderate cases, especially when pain is worse than expected for the level of joint damage.

But if you have advanced osteoarthritis - where bone is grinding on bone - studies show these injections offer little to no benefit after six weeks. The American College of Rheumatology now advises against using them in these cases.

How Long Does the Relief Last?

This is where expectations matter. Many people think a cortisone shot means “no more pain forever.” It doesn’t.

Most patients feel better within 24 to 72 hours. The peak relief usually hits around week two. Then it fades.

On average, pain relief lasts 2 to 4 weeks. For some, it’s 8 to 12 weeks - especially if the inflammation was mild and the joint wasn’t severely damaged. A 2023 meta-analysis of 15 studies found no meaningful benefit after 6 weeks, and by 24 weeks, there was no difference between those who got the shot and those who got a saltwater injection.

One big reason people feel better longer? They rest. After the shot, they avoid overusing the joint. That rest helps the inflammation calm down naturally. The shot doesn’t heal - it just gives you a window to heal.

How Many Times Can You Get One?

This is where things get tricky.

Doctors generally recommend no more than 3 to 4 injections per joint per year. Why? Because repeated exposure to corticosteroids can weaken tendons, cartilage, and even bone.

A 2023 study in AJR Online found that people who got knee or hip injections within 3 months before joint replacement surgery were more than twice as likely to develop a serious post-op infection. That’s not a small risk.

Also, each injection carries a small chance of causing a flare-up - where the joint gets even more painful for a day or two after the shot. About 2 to 8% of patients experience this. It’s caused by tiny crystals in the steroid irritating the joint. Ice and ibuprofen usually fix it.

And if you’re diabetic? Your blood sugar can spike for up to 72 hours after the injection. You’ll need to check your levels more often.

What You’ll Feel During and After the Shot

The procedure takes less than 10 minutes. Your doctor will clean the skin, numb it with a spray or tiny needle, then insert a longer needle into the joint. Ultrasound guidance is now standard in most clinics - it boosts accuracy from 70% to 95%. That means less chance of hitting the wrong spot.

You’ll feel pressure, maybe a pinch. The anesthetic numbs the area quickly. Afterward, the joint might feel sore for a day. That’s normal.

You’re usually told to avoid heavy lifting or strenuous activity for 48 hours. Why? To let the steroid settle and prevent it from moving out of the joint. If you jump back into running or lifting weights too soon, you might undo the benefit - or even cause damage.

Cost and Accessibility

Without insurance, a corticosteroid injection costs between $100 and $300 in the U.S. That’s a fraction of what PRP ($500-$1,500) or hyaluronic acid shots ($500-$1,000) cost.

But cost isn’t the only factor. PRP and stem cell therapies are growing in popularity, but they don’t work faster. Corticosteroids still win for immediate relief.

In Australia, Medicare covers the cost if the injection is done by a qualified specialist and for an approved condition. Private clinics may charge more, but the drug itself is low-cost.

When Corticosteroid Injections Are a Bad Idea

There are clear red flags:

• You’ve had three or more injections in the same joint in the past year.
• Your joint shows advanced arthritis on X-ray or MRI.
• You have an active infection anywhere in your body.
• You’re scheduled for joint replacement surgery within the next 3 months.
• Your blood sugar is poorly controlled and you’re not monitoring it closely.
• You’ve had a bad reaction to a previous injection - like skin thinning, depigmentation, or a severe flare.

If any of these apply, talk to your doctor about alternatives: physical therapy, weight management, bracing, or even oral anti-inflammatories.

What’s New in 2026?

In 2023, the FDA approved a new extended-release version of triamcinolone called Zilretta. It’s designed to release slowly over 12 weeks. In trials, 45% of osteoarthritis patients had pain relief for 3 months - double the rate of standard shots.

But it’s not a magic bullet. It still doesn’t stop joint damage. And it costs more - around $1,000 per injection. Most insurers require prior authorization.

Researchers are now testing combinations - like pairing corticosteroids with PRP. The idea? Use the steroid to calm inflammation quickly, then let PRP help repair tissue over time. Early results are promising, but we’re still years away from knowing if this approach is safer long-term.

Real Stories, Real Results

One patient in Sydney, 58, had severe hip bursitis that kept her from gardening. After her first injection, she was pain-free for 10 weeks. She went back to her weekly routine. The second shot lasted only 5 weeks. The third? A 3-day flare followed by 2 weeks of relief.

She didn’t get a fourth. Instead, she started physical therapy. Now, she’s managing her pain with strength training and activity pacing.

Another man, 64, with tennis elbow got a shot before a big golf tournament. He played the next day. Won his division. No pain. He didn’t need another shot for 18 months.

These aren’t outliers. They’re typical. The shot works - but only if you use it wisely.

Bottom Line

Corticosteroid injections are a powerful tool - but only for the right person, at the right time, and with the right expectations.

They’re not for chronic, long-term pain. They’re not for advanced joint damage. They’re not a substitute for exercise, weight control, or physical therapy.

But if you’re stuck with sudden, severe inflammation - and you need to move again, fast - they can be life-changing. Just don’t expect them to last. And never use them as a crutch.

Use them like a reset button. Not a permanent fix.