Knee osteoarthritis affects millions of people—particularly as we age. It happens when the protective cartilage that cushions the ends of the bones gradually breaks down, leading to knee pain, swelling, and stiffness. According to Paul So, MD, a physical medicine and rehabilitation physician at Atlantic Health, two injectable therapies can help.
“Arthritis can limit a person's mobility and quality of life,” he says. “For some people, injectable therapies can be a great option to reduce pain and inflammation for a more active lifestyle.”
What is a cortisone shot?
Cortisone is a natural hormone produced by the human body. A corticosteroid (steroid) injection is known for its anti-inflammatory effects and fast pain relief, particularly for knee osteoarthritis. When injected directly into the knee joint—often under image guidance—a cortisone shot can temporarily alleviate pain and inflammation, which can lead to functional improvement.
Although these injections work quickly, they’re not considered a long-term solution and are typically performed in conjunction with therapeutic exercise (physical therapy).
Benefits of cortisone shots:
- Provides pain relief for severe arthritis within days up to two weeks
- Effectively reduces pain, inflammation, and swelling
- Helps improve function and mobility
Limits of cortisone shots:
- Relief is typically temporary, lasting up to three months or longer
- Overuse can contribute to further progression of osteoarthritis
- Associated side effects, such as temporary elevation in blood sugar levels, can limit its use in some patients, such as those with underlying diabetes
What is a gel shot?
A gel injection (viscosupplementation) is another potential treatment for knee osteoarthritis. It contains hyaluronic acid, which is also produced in the body and found within joint (synovial) fluid. Hyaluronic acid acts as a natural lubricant for joints, and gel injections can help restore joint health.
Additionally, they can stimulate the joint’s natural production of hyaluronic acid. Gel shots are typically considered when cortisone injections do not provide any benefit.
Benefits of gel shots:
- Can last up to six months (longer duration compared to cortisone)
- Can reduce pain and inflammation to improve mobility and function
- Has a better side effect profile than cortisone injections (also does not contribute to progression of osteoarthritis)
Limits of gel shots:
- Onset is longer than cortisone (can take up to three weeks to notice relief)
- Can be used for other joints, but is primarily limited to the knee
- Is most effective for mild to moderate osteoarthritis, and less so for severe osteoarthritis
Talk with your doctor
A physical medicine and rehabilitation physician, or a physiatrist, can work with you on short- and long-term treatment plans. While both cortisone and gel shots can help treat pain due to osteoarthritis, one may be more beneficial than another.
“The best option for you depends on your function, severity of your osteoarthritis, and ultimate goals,” says Dr. So. “Although these injections do not reverse osteoarthritis, they can be effective when utilized as part of a broader treatment plan to manage your pain, function, and quality of life.”
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