Cortisone injections for hip and knee arthritis — do they work?

Cortisone (corticosteroid) injections are a common non-surgical treatment for hip and knee arthritis. They can provide useful relief for some patients, but they are not a cure, the benefit is often temporary, and there are important considerations around repeated use and the timing of any future surgery.

How they work

A cortisone injection delivers a powerful anti-inflammatory medication directly into the joint, usually combined with local anaesthetic. By calming inflammation, it can reduce pain and improve movement. It does not repair cartilage or reverse arthritis — it dampens the inflammatory response that contributes to the pain.

How well do they work, and for how long?

Response varies considerably. Some patients get good relief for weeks to a few months; others get little benefit. The evidence suggests cortisone is helpful for short-term relief of arthritis pain, particularly during a painful flare, but that the effect generally wears off and does not change the underlying course of the arthritis. Hip injections are usually performed under imaging guidance to ensure the medication reaches the joint accurately.

A cortisone injection can buy time and settle a flare, but it treats the pain, not the arthritis.

Where they fit in

Cortisone can be a reasonable option for a patient who wants to delay surgery, who is not yet ready or fit for an operation, or who is managing a particularly painful period. It can also occasionally help confirm that a joint is the true source of pain. It is one tool among several, alongside weight management, physiotherapy and activity modification.

Risks of repeated use

Occasional injections are generally well tolerated, but repeated frequent injections are approached with caution. There is concern that frequent corticosteroid injections may, over time, be detrimental to the joint, and there is a small risk of infection with any injection. For these reasons, surgeons limit how often they are given.

Important: timing before joint replacement

This is a point many patients are unaware of. Having a cortisone injection into a joint shortly before a joint replacement is associated with a higher risk of infection of the new joint. For this reason, surgery is generally avoided for a period after an injection — commonly around three months. If joint replacement is on the horizon, it is worth discussing the timing of any injection with your surgeon first.

The bottom line

Cortisone has a genuine but limited role: useful short-term relief for the right patient at the right time, but not a long-term solution and not without trade-offs. Whether it is right for you depends on your circumstances and your plans — a conversation worth having at consultation.