Steroid shots for pain management: what to know

Pain can feel like a roadblock, stopping you from doing what you enjoy. Whether it’s the persistent ache of arthritis, the sharp twinge of tendonitis, or the chronic stiffness of an inflamed joint, pain can be a barrier between you and your goals, making simple tasks feel insurmountable.

Enter steroid injections. Steroid shots can help reduce inflammation and provide temporary pain relief. They are not a permanent solution, but they can offer a much-needed reprieve, allowing you to start moving in ways that help you heal long-term. 

Here, learn from Hinge Health experts how steroid injections work, their benefits and side effects, and how they fit into an overall treatment plan that can include physical therapy and exercise.

What are steroid injections?

Corticosteroids, more commonly known as steroids, are anti-inflammatory medications that can be injected into painful joints and around irritated nerves. Steroid shots are usually given in a clinic or hospital setting. Your provider might use imaging (such as ultrasound or X-ray fluoroscopy) to help guide the delivery of the medication.

Steroid injections are typically given when other pain treatments, such as heat and ice, over-the-counter medications, and physical therapy, haven't been effective enough to manage your pain. They’re also considered when pain is so severe that it makes it hard to tolerate physical therapy and exercises. Some people experience less pain within a few days after an injection, and most steroid injections include an anesthetic (numbing medication) that can provide immediate relief for a few hours.

Sometimes, steroid injections are used to diagnose an issue. Pain relief immediately after a steroid injection with an anesthetic tells your doctor that the injection site may be the source of your pain. Knowing the location of your pain may help your providers better manage your symptoms.

How steroid injections work

Steroid injections work by reducing inflammation. Acute (or short-term) inflammation is your body’s way of protecting you from injury, infection, or illness. When your body detects something unfamiliar, it releases chemicals to fight off that foreign substance. This process also causes you to experience symptoms like redness, warmth, swelling, and sometimes pain.

While short-term inflammation is a good thing, chronic (ongoing) inflammation can be a problem. Chronic inflammation can result from many factors, including inflammatory foods, ongoing stress, medical conditions (e.g., rheumatoid arthritis), and more. When chronic inflammation happens, you can experience a whole host of symptoms, such as fatigue, joint stiffness, and pain. Steroid injections can provide temporary relief from these symptoms.

Steroid injections vs. oral medications

Oral corticosteroids help reduce swelling and inflammation all over your body. They are often used for conditions that affect many parts of your body, like rheumatoid arthritis, skin problems, and autoimmune diseases. They can be used to control severe symptoms or for long-term treatment. Steroid shots, on the other hand, deliver the medicine directly to the area that is swollen or painful. They have fewer side effects and are usually preferred when you need to target a specific area.

Effectiveness of steroid injections

Steroid injections can relieve pain and help restore function, but the relief usually wears off after a few weeks or months. They might be appropriate to help with immediate pain, but are not a long-term pain-relief solution. 

Steroid shots can, however, provide pain relief needed to return to activity or continue treating your condition with other methods, such as physical therapy and exercise. The effectiveness of steroid injections varies depending on the person and the body area being treated. Common conditions treated by steroid injections include:

• Low back pain. Steroid injections for low back pain or pain that radiates to the legs can significantly reduce pain, help you move better, and delay the need for surgery, especially when combined with local anesthetics. Pain relief varies for different back conditions and is often short term. 

• Knee osteoarthritis. Steroid injections can provide quick pain relief, but the effects don’t last long. For better long-term results, physical therapy is often more effective.

• Tennis elbow. Steroid injections for tennis elbow can bring better short-term pain relief than anti-inflammatory medications, but they might cause more pain and weaker tendons long-term. 

• Carpal tunnel syndrome. Steroid injections for carpal tunnel syndrome can work better than wearing a brace in the short term, but their benefits may not last. 

• Hand osteoarthritis. Steroid injections for hand arthritis work better than placebos for pain in your knuckles (interphalangeal joints), but not in the joint where your thumb meets your wrist (carpometacarpal joint). 

• De Quervain’s tenosynovitis. This is a condition that causes pain and swelling in the wrist, often affecting people who frequently pick up a baby or toddler (known as “mommy thumb”), play racket sports, or do other repetitive motions. Many people find relief after one or two corticosteroid injections.

• Trigger finger. Steroid injections effectively relieve symptoms for many people with few side effects or complications.

• Rotator cuff tendinopathy. Corticosteroid injections under the top of your shoulder blade (“subacromial”) can help with pain and movement in the short term, but they might not be better than physical therapy in the long run.

• Frozen Shoulder (adhesive capsulitis). This condition occurs when the tissues around the shoulder joint become tight and stiff, leading to pain and reduced movement. Steroid injections inside the shoulder joint capsule can provide short-term pain relief, but the pain may come back over time. Gradual shoulder stretching and physical therapy are often essential for recovery.

Side effects of steroid injections

Side effects from steroid injections can include:

• Pain or bruising near the injection site

• Flushing of your face for a few hours after the injection

• Bleeding problems

• Temporary high blood pressure or blood sugar

• Blanching (whitening) of the skin near the injection area

• Changes in mood and menstruation

Risks of steroid shots

Although rare, serious risks can occur with steroid injections, such as:

• Infections

• Bone changes

• Allergic reactions

• Tendon problems

Repeated steroid injections can damage soft tissues. Frequent steroid injections (less than three months between injections) can delay your body’s normal healing response and may lead to cartilage loss. This is why doctors limit how many injections you receive and how often you receive them.

What to expect with a steroid injection

You can receive steroid injections in a clinic or hospital setting. Your provider will clean the area and inject a local anesthetic before inserting a needle into the joint. They may use imaging (such as ultrasound) to help guide the needle placement. Your provider may also remove excess joint fluid before the medication is injected. Most people can resume normal activities a few days after a steroid injection. Unless an anesthetic is injected along with the medication, it may take several days or weeks to start experiencing pain relief.

Pain relief from steroid injections is usually temporary. An injection might not lead to long-term improvements in your joint function. While steroid injections are intended to reduce pain, they can come with temporary side effects such as:

• Joint stiffness

• Swelling

• Redness or bruising

• Pain near the injection site

Alternatives to steroid injections

Physical therapy and exercise

Physical therapy and exercise, either alone or combined with steroid injections, can be as effective as or better than steroid injections alone for certain conditions. 

If pain is limiting your movement or ability to do daily activities, physical therapy (PT) can help. Physical therapists can assess you, rule out any serious causes of your pain, help you modify your activities, empower you with tools and tips to help you hurt less, and personalize your exercise program.

You can see a physical therapist in person or use a program like Hinge Health, where you may access a PT via telehealth/video visit.

More joint injection options

While corticosteroid injections are a common treatment for joint pain, several other types of joint injections are available, each with its own benefits and considerations. Some approaches are still considered experimental, are not FDA approved, and may not be covered by your insurance.

• Local anesthetics can offer quick, temporary pain relief and can help diagnose pain sources. They’re often combined with corticosteroids.

• NSAIDs deliver non-steroidal anti-inflammatory drugs directly to the joint, providing targeted relief. More research is needed, but a single NSAID injection may be an effective treatment with fewer side effects compared to regular use of oral NSAIDs.

• Hyaluronic acid (HA) injections deliver a gel-like substance to improve joint lubrication and cushioning.

• Botulinum toxin (BoNT) injections block nerve signals to muscles, potentially reducing joint pain from muscle spasms.

• Platelet-rich plasma (PRP) injections use a concentrated form of your own blood to stimulate healing.

• Mesenchymal stem cells (MSCs) deliver cells that can potentially repair damaged joint tissue.

• Bone marrow aspirate concentrate (BMAC) injections use cells and growth factors from your bone marrow to treat pain.

• Autologous conditioned serum (ACS) injections involve processing your blood to create a concentrated serum rich in anti-inflammatory proteins.

• Prolotherapy involves injecting an irritant solution into a painful joint to stimulate healing.

Discuss these options with your healthcare provider to find the best treatment for your specific condition. Use of these injections vary greatly depending on your provider’s preference and experience.

How Hinge Health can help you

If you have hypersensitivity or joint or muscle pain that makes it hard to move, you can get the relief you’ve been looking for with Hinge Health’s online exercise therapy program.

The best part: You don’t have to leave your home because our program is digital. That means you can easily get the care you need through our app, when and where it works for you.  

Through our program, you’ll have access to therapeutic exercises and stretches for your condition. Additionally, you’ll have a personal care team to guide, support, and tailor our program to you. 

See if you qualify for Hinge Health and confirm free coverage through your employer or benefit plan here.

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