Joint Injections Explained: Cortisone, Gel, and PRP – Which One Is Right for You?

If your knee, shoulder or hip hurts and tablets are no longer doing enough, your doctor may suggest a joint injection. Many patients hear "cortisone shot", "gel injection" or "PRP" without knowing the difference. This guide explains, in plain language, the main types of joint injections, what each one does, how long it may last, and how to know which one could suit you.

How Does a Joint Injection Work?

Think of a joint as a hinge. Healthy cartilage covers the ends of the bones, and a slippery fluid inside the joint helps them glide smoothly. When the cartilage wears down, as in osteoarthritis, or when the joint lining becomes inflamed, the hinge becomes stiff, swollen and painful.

A joint injection places medicine exactly where the problem is. Because it goes straight into the joint, a small dose can have a strong local effect, with far less impact on the rest of the body than many medicines taken by mouth.

The knee is the joint injected most often, followed by the shoulder, hip, ankle and the small joints of the hand.

Cortisone (Steroid) Injections: The Fast Calmer

Cortisone is a powerful anti-inflammatory medicine. It is usually mixed with a local anaesthetic, so many patients feel some relief within minutes, and the main effect of the cortisone builds over the next few days.

Best suited for:

Sudden flare-ups of knee or hip arthritis

A swollen joint with extra fluid inside

Inflamed tendons or bursae around a joint, such as in the shoulder

Some types of inflammatory arthritis

What to expect: relief usually lasts from a few weeks to a few months. It calms inflammation but does not rebuild cartilage.

Good to know:

Doctors usually limit cortisone to a few injections per year in the same joint

People with diabetes may notice higher blood sugar readings for a few days

Your surgeon may avoid giving it in the months just before a joint replacement

Hyaluronic Acid (Gel) Injections: Topping Up the Lubricant

Hyaluronic acid is a natural part of joint fluid. It works like the oil in an engine, helping the joint move smoothly and absorb shock. In arthritis, this natural lubricant becomes thinner and less effective. A hyaluronic acid injection, also called viscosupplementation or a "gel shot", aims to top it up.

Best suited for:

Mild to moderate knee osteoarthritis

Patients who have not improved enough with medicines and physiotherapy

Patients who want to avoid repeated cortisone injections

What to expect: the effect is slower than cortisone and may take several weeks to appear, but in patients who respond it can last for several months. Depending on the product, it is given as a single injection or as a short course.

PRP Injections: Using Your Own Blood

PRP stands for platelet-rich plasma. A small amount of your blood is taken, spun in a machine to concentrate the platelets, and then injected into the joint or tendon. Platelets contain growth factors that are involved in the body's natural healing process.

Best suited for:

Early to moderate knee osteoarthritis in selected patients

Long-standing tendon problems, such as tennis elbow or jumper’s knee

What to expect: improvement is gradual over several weeks. Because PRP comes from your own blood, allergic reactions are very unlikely. Research results are mixed: some studies show benefit compared with other injections, while others show no clear advantage, so careful patient selection matters. You can read more in our article: When Are PRP Injections Useful for Joints?

Other Injections You May Hear About

Local anaesthetic injections: often used as a test. If the pain disappears after numbing a joint, it confirms that joint is the true source of the pain

Stem cell injections: still being studied, and there is not yet enough evidence that they regrow worn cartilage

Prolotherapy (dextrose): sometimes used for ligament and tendon problems, with variable results

Be careful with any clinic that promises to "regrow cartilage" or guarantees you will never need surgery.

Quick Comparison

Cortisone: works fast, lasts weeks to months, best for flare-ups and swelling

Hyaluronic acid: works slower, may last months, best for mild to moderate knee arthritis

PRP: works gradually, made from your own blood, best for selected arthritis and tendon cases

There is no single "best" injection. The right choice depends on your diagnosis.

What Happens on the Day?

The procedure usually takes only a few minutes. The skin is cleaned carefully, and the doctor may use ultrasound to guide the needle precisely into the joint. It usually feels like a short pinch, and you can walk out afterwards.

Aftercare Tips

Rest the joint from heavy exercise for about 48 hours

Use an ice pack if the area feels sore

Continue your physiotherapy exercises as advised

Contact your doctor urgently if you develop fever, increasing redness, heat or worsening pain, as infection, although rare, needs prompt treatment

Are Joint Injections Safe?

Yes, when done under sterile conditions by an experienced doctor, serious complications are rare. Temporary soreness for a day or two is the most common side effect.

Can a Joint Injection Replace Surgery?

Sometimes it can delay surgery, but it cannot fix mechanical problems such as a torn ligament, and it cannot rebuild a severely worn joint. In those cases, arthroscopy or joint replacement may be the better option.

Which Joint Injection Is Right for Me?

That depends on what is causing your pain, how advanced the arthritis is on X-ray, whether the joint is swollen, your age and activity level, and conditions such as diabetes. A proper examination is the first step. For more on arthritis itself, read our article: Joint Osteoarthritis: Symptoms, Causes, and Treatment.

Summary

Joint injections can be an effective way to reduce pain and get moving again. Cortisone calms inflammation quickly, hyaluronic acid helps lubricate an arthritic knee, and PRP uses your own blood to support healing in selected cases. The best results come when the injection is chosen after an accurate diagnosis and combined with exercise and physiotherapy.

References

Kolasinski SL, Neogi T, Hochberg MC, et al. 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee. Arthritis Rheumatol. 2020;72(2):220-233.

Bannuru RR, Osani MC, Vaysbrot EE, et al. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis Cartilage. 2019;27(11):1578-1589.

Jüni P, Hari R, Rutjes AWS, et al. Intra-articular corticosteroid for knee osteoarthritis. Cochrane Database Syst Rev. 2015;(10):CD005328.

Bellamy N, Campbell J, Robinson V, et al. Viscosupplementation for the treatment of osteoarthritis of the knee. Cochrane Database Syst Rev. 2006;(2):CD005321.

Belk JW, Kraeutler MJ, Houck DA, et al. Platelet-Rich Plasma Versus Hyaluronic Acid for Knee Osteoarthritis: A Systematic Review and Meta-analysis of Randomized Controlled Trials. Am J Sports Med. 2021;49(1):249-260.

Bennell KL, Paterson KL, Metcalf BR, et al. Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial. JAMA. 2021;326(20):2021-2030.

Choudhry MN, Malik RA, Charalambous CP. Blood Glucose Levels Following Intra-Articular Steroid Injections in Patients with Diabetes: A Systematic Review. JBJS Rev. 2016;4(3):e5.

Werner BC, Cancienne JM, Browne JA. The Timing of Total Hip Arthroplasty After Intraarticular Hip Injection Affects Postoperative Infection Risk. J Arthroplasty. 2016;31(4):820-823.

Medically reviewed by: Dr. Osama Droubi, Specialist Orthopedic Surgeon

Review date: October 19, 2026