Joint injections (steroid or hyaluronic acid)

Injections into a painful joint — either an anti-inflammatory steroid to calm pain and swelling for a while, or hyaluronic acid (a gel-like lubricant) aiming to ease osteoarthritis symptoms, though the evidence for hyaluronic acid is weak.

✓ Medically reviewed by a GMC-registered consultant · last reviewed September 2026 · next review September 2027 · how we review

In short

Steroid injections can calm a painful, inflamed joint for a short time (NICE says about 2–10 weeks) and work best alongside exercise and physiotherapy.
Hyaluronic acid ('gel') injections are not recommended by NICE for knee or hip osteoarthritis because the evidence does not show a worthwhile benefit, and they are generally not NHS-funded.
Neither injection cures arthritis or regrows cartilage; they treat symptoms, and the effect is temporary and varies a lot between people.
Be cautious about paying for repeated or 'course' injections, especially hyaluronic acid, and ask what the realistic benefit and limits are.

A plain-English summary. The detail — including risks and recovery — is below.

At a glance

TypeInjection of steroid or hyaluronic acid into a joint such as the knee

AnaestheticLocal anaesthetic is often mixed in or used to numb the skin; no general anaesthetic

How long it takesA short appointment; the injection itself takes a few minutes

Hospital stayOutpatient; you go home the same day

Time off workUsually none, though resting the joint for a day or two is advised

When you'll see resultsSteroid often helps within days and lasts weeks to a few months; hyaluronic acid is slower and its benefit is uncertain

On the NHS?Steroid injections are widely used on the NHS; hyaluronic acid is not recommended by NICE and is generally not NHS-funded

A general guide. Your specialist will give you advice for your situation.

Best fit

Steroid can reduce pain and swelling in an inflamed joint, often within days

Pause if

There is an infection in or near the joint, or you are generally unwell with an infection.

Main recovery point

If local anaesthetic was used, the joint may feel numb and more comfortable. Avoid relying on it too much, as the comfort is temporary and the joint is...

Good aftercare

Clear written advice on rest, activity and the signs of infection, with a named contact.

First few hours

If local anaesthetic was used, the joint may feel numb and more comfortable. Avoid relying on it too much, as the...

First 24–48 hours

Rest the joint and avoid strenuous activity. Some people have a short increase in pain (a steroid flare or a...

Days 2–7

A steroid usually starts to take effect and pain and swelling begin to ease. Keep the dressing dry for the first...

First few weeks

If a steroid works, the benefit builds; hyaluronic acid, if it helps at all, tends to work more slowly over this...

Medical line illustration of the knee joint for Joint injections (steroid or hyaluronic acid). — Illustration only - not a diagnosis, medical advice or a promise of result. Your anatomy and treatment plan may differ. Vuemedics does not publish before-and-after photos.

What are joint injections (steroid or hyaluronic acid)?

Joint injections put medicine directly into a painful joint, most often the knee, hip, shoulder or other large joints affected by osteoarthritis. There are two main types, which work in very different ways.

A steroid (corticosteroid) injection delivers a strong anti-inflammatory medicine into the joint to calm inflammation, easing pain and stiffness. UK guidance from NICE says steroid injections can be considered for short-term relief — typically lasting around 2 to 10 weeks — and are best used to support exercise and physiotherapy rather than on their own.

A hyaluronic acid injection (sometimes called viscosupplementation or a 'gel' injection) adds a thick, lubricating substance similar to one found naturally in joint fluid, with the aim of cushioning the joint and easing osteoarthritis symptoms. However, NICE reviewed the evidence and does not recommend hyaluronic acid injections for knee or hip osteoarthritis, because studies did not show a worthwhile benefit for pain, function or quality of life, and there was a suggestion of possible harm in the hip. For this reason it is generally not funded on the NHS, though some private clinics offer it.

Neither injection cures arthritis or regrows cartilage. At best they ease symptoms for a time. They are one part of a wider plan that should include exercise, weight management and other treatments, and it is reasonable to be cautious about paying privately for an injection — especially hyaluronic acid — whose benefit may be small or uncertain.

Types, options & approaches

There may be different ways to do this. The right approach depends on the clinical question and your circumstances.

Corticosteroid (steroid) injection

A strong anti-inflammatory injected into the joint to ease pain and swelling for a period, often within days. NICE supports it for short-term relief to support exercise; the effect is temporary and the number in one joint is limited.

Hyaluronic acid (viscosupplementation) injection

A gel-like lubricant injected into the joint, usually the knee, aiming to ease osteoarthritis symptoms. NICE does not recommend it for knee or hip osteoarthritis as the evidence does not show worthwhile benefit; it is generally private-only.

Steroid with local anaesthetic

Local anaesthetic is often mixed with the steroid. It can ease the injection, give early relief and help confirm that the pain is coming from that joint.

Ultrasound-guided injection

An ultrasound scanner guides the needle to the right spot, useful for deeper joints such as the hip or where accuracy matters. Available for both steroid and hyaluronic acid injections.

Steroid vs hyaluronic acid injection

Question	Steroid	Hyaluronic acid
Main aim	Calm inflammation, ease pain	Lubricate/cushion the joint
How soon it helps	Often within days	Slower, over weeks
NICE view (knee/hip OA)	Short-term relief, with exercise	Not recommended
Usually on the NHS?	Yes, when appropriate	Generally not funded

NICE recommends steroid injections only for short-term relief to support exercise, and does not recommend hyaluronic acid injections for knee or hip osteoarthritis.

Preparing for your injection

Tell the clinician if you have diabetes, as a steroid injection can raise your blood sugar for a few days.
Mention any blood-thinning medicines, a bleeding tendency, or if you feel unwell or have any infection.
Tell them about any allergy to steroids, hyaluronic acid, local anaesthetic or skin-cleaning fluids.
Let them know if you are or might be pregnant or are breastfeeding, so the options can be discussed.
Ask which injection is being offered and why, and what the realistic benefit and evidence are.
If hyaluronic acid is suggested privately, ask why, given that NICE does not recommend it for the knee or hip.
Plan to rest the joint for a day or two, and arrange help if it is a weight-bearing joint such as the knee or hip.

What happens

The clinician examines the joint and cleans the skin. They may numb the skin first, or mix a local anaesthetic with the medicine. A needle is used to place the steroid or hyaluronic acid into the joint, sometimes with ultrasound to guide it. You may feel a sharp scratch and some pressure or aching as the medicine goes in.

The injection itself usually takes only a few minutes. A small dressing or plaster is applied, which you keep dry for a day or two, and you can usually go home straight away.

If local anaesthetic was used, the joint may feel numb and more comfortable for a few hours before this wears off. A steroid usually takes a few days to take effect. Hyaluronic acid works more slowly, over weeks, and is sometimes given as a single injection or a short course depending on the product. You are usually advised to rest the joint for about a day.

Is this injection right for me?

A good consultation should explore whether it's the right choice for you now — including reasons to wait or consider something else.

May not be suitable if…

There is an infection in or near the joint, or you are generally unwell with an infection.
The pain is not coming from inflammation that a steroid can help, so the injection is unlikely to work.
There is an allergy to the steroid, hyaluronic acid, local anaesthetic or skin-cleaning fluid.
Hyaluronic acid for knee or hip osteoarthritis, where NICE does not recommend it and the benefit is unproven.
The same joint has already had the recommended maximum number of steroid injections.

Delay or rearrange if…

You have any active infection, a fever or feel unwell.
There is broken or infected skin over the injection site.
Your blood sugar is poorly controlled and you have diabetes, until this is discussed (for steroid).
You are on blood thinners that may need checking or adjusting first.
You are or might be pregnant or are breastfeeding, until the options have been discussed.

Alternatives to discuss

Physiotherapy and a strengthening or movement programme.
Simple painkillers or anti-inflammatory medicines, where suitable.
Weight management and activity changes to reduce load on the joint.
Waiting and reviewing, rather than injecting, where symptoms are mild.
Considering joint replacement or other surgery for advanced joint damage.

Before you decide

Use this as a shared-decision checklist. The aim is not just “can this be done?”, but whether it is right for you, now, with the risks and alternatives clearly understood.

What matters most to me?

Think about symptoms, daily life, work, caring responsibilities, sport, fertility, travel, appearance and anxiety — the right choice depends on your priorities, not just the medical facts.

What are all my options?

Ask about waiting, monitoring, medicines, rehabilitation, a smaller or larger procedure, a different test, NHS referral, or a second opinion where that would help.

What would make me pause?

Active infection, pregnancy, unstable medical problems, smoking, medicines that increase bleeding, poor support at home, or feeling pressured are all reasons to slow down and get tailored advice.

What happens if I do nothing today?

For some problems, waiting is safe; for others, delay can make treatment harder. A good consultation should explain the trade-off in plain English.

Benefits

Steroid can reduce pain and swelling in an inflamed joint, often within days
A window of less pain can make exercise and physiotherapy easier
A steroid injection targets one joint with less effect on the rest of the body than steroid tablets
Including local anaesthetic can help confirm which joint is the source of pain
Can be useful while waiting for, or deciding about, other treatments such as surgery
May suit people who cannot take, or want to reduce, oral painkillers

Risks & complications

More common

A short period of increased pain in the first day or two before it settles
Soreness, bruising or bleeding at the injection site, especially on blood thinners
A flushed face for a few days after a steroid injection
A few days of raised blood sugar if you have diabetes (with steroid)
No improvement in symptoms for some people, particularly with hyaluronic acid

Less common

A 'steroid flare' — a painful reaction around the site in the first 24 hours, lasting several days
Paler skin or a dimple where fat thins under the skin near a steroid injection
A reaction in the joint to hyaluronic acid, with temporary pain and swelling
Feeling faint or nauseated around the time of the injection

Rare but serious

Infection in the joint, which causes a hot, very painful, swollen joint and needs urgent care
Weakening or, rarely, rupture of a nearby tendon with repeated steroid injections
Temporary, or rarely lasting, numbness or nerve irritation near the injection
A severe allergic reaction, usually within the first 30 minutes

The most important risk to recognise for any joint injection is infection: a joint that becomes hot, increasingly painful and swollen over the days afterwards, especially with a fever, needs urgent medical attention. With steroid, repeated injections in the same joint can weaken tendons and thin skin and fat, so the number is usually limited. With hyaluronic acid, the main issue is that NICE found the evidence does not support a worthwhile benefit for knee or hip osteoarthritis, so the realistic value of paying for it is questionable. Ask which injection is being offered, why, and how it fits into your overall plan.

Published figures to discuss

How much benefit a joint injection gives varies widely with the joint, the condition and the type of injection. For steroid, NICE describes short-term relief (around 2–10 weeks) and recommends it as an adjunct to exercise. For hyaluronic acid, NICE reviewed the evidence and did not find a worthwhile benefit for knee or hip osteoarthritis, with a suggestion of possible harm in the hip, which is why it is not recommended. The serious risks of injection are rare, the most important being joint infection.

Figure	Reported range	How to interpret it	Source / confidence
Duration of steroid relief	NICE describes short-term relief, typically around 2 to 10 weeks	Often shorter where joint damage is advanced; best used to support exercise.	NICE NG226 — Osteoarthritis: diagnosis and management (recommendations)nice.org.ukSource-linked context
Benefit of hyaluronic acid (knee/hip OA)	Not recommended by NICE; evidence did not show worthwhile benefit for pain, function or quality of life	Possible harm suggested for hip osteoarthritis; generally not NHS-funded.	NHS — Steroid injectionsnhs.ukSource-linked context
Joint infection after injection	Rare (reported around 1 in 3,000 injections in NHS patient information)	A hot, very painful, swollen joint, especially with fever, needs urgent care.	NHS — Steroid injectionsnhs.ukPublished figure

These are literature figures, not a personalised prediction. Your own risks and likely benefits depend on your circumstances, your health, and how your care is carried out and followed up.

What happens afterwards

There is usually no real recovery time, but the joint is best rested for a day or two. A steroid typically takes a few days to work and any benefit is temporary; hyaluronic acid works more slowly over weeks and its benefit is uncertain. It is sensible to plan exercise or physiotherapy to make the most of any pain relief.

First few hours

If local anaesthetic was used, the joint may feel numb and more comfortable. Avoid relying on it too much, as the comfort is temporary and the joint is not healed.

First 24–48 hours

Rest the joint and avoid strenuous activity. Some people have a short increase in pain (a steroid flare or a reaction to hyaluronic acid); rest and simple painkillers usually help.

Days 2–7

A steroid usually starts to take effect and pain and swelling begin to ease. Keep the dressing dry for the first day or two.

First few weeks

If a steroid works, the benefit builds; hyaluronic acid, if it helps at all, tends to work more slowly over this period. Use any window of less pain for exercises or physiotherapy.

Review at about 6 weeks

A review is often arranged to see how well it worked and whether anything further, such as a different treatment, is needed.

What's normal — and not a worry

A short increase in pain in the first day or two before it improves
Mild bruising or soreness at the injection site
A flushed face for a few days after a steroid injection
A few days of higher blood sugar readings if you have diabetes
Gradual improvement over days (steroid) or weeks (hyaluronic acid), rather than instant relief

Aftercare

Rest the injected joint as much as possible on the day of the injection and the next day.
Avoid heavy use, sport or strenuous exercise of the joint for about two weeks.
Keep the dressing or plaster dry and in place for the first day or two.
Use simple painkillers and a cold pack if you have a flare of pain, unless advised otherwise.
If you have diabetes, check your blood sugar more closely for a few days after a steroid injection.
Use any window of pain relief to do recommended exercises or physiotherapy.
Know the signs of infection and who to contact if the joint becomes hot, very painful or swollen.

Before your injection

Simple painkillers and a cold pack at home for any flare
A way to rest the joint, such as time off heavy activity
Blood sugar testing kit ready if you have diabetes
A note of the clinic's contact number for urgent concerns
Any recommended exercises written down
A reminder of when your review appointment is

Scars and how they heal

There is no surgical wound, just a needle puncture covered with a small plaster. Some bruising or soreness at the site is common and usually fades within a week. Less often, the skin near a steroid injection can become paler or a little dimpled where fat thins under the surface; this is more likely with repeated injections in the same place and may not fully recover.

⚠ Get urgent help if…

A joint that becomes increasingly hot, swollen and very painful over the days after the injection
A high temperature, chills or feeling generally unwell after the injection (possible infection)
Signs of an allergic reaction, such as a spreading rash, swelling of the face or lips, or wheeze (call 999)
Pain or swelling at the site that keeps getting worse rather than settling
New weakness, numbness or loss of movement in the limb
Sudden severe pain or a feeling of something giving way, which could signal a tendon problem

Who to contact: your clinician, clinic or test provider first (keep their number to hand). For urgent advice when you can't reach them, call NHS 111. In an emergency, call 999.

General guidance — it doesn't replace the specific advice your specialist gives you.

Results & realistic expectations

A good result from a steroid injection is a useful reduction in pain and swelling that lets you move more easily and get on with exercise, usually within a few days and lasting weeks to a few months. Hyaluronic acid, where it is used, works more slowly, and NICE found the evidence does not show a worthwhile benefit for knee or hip osteoarthritis, so any effect may be small or absent.

Neither injection cures arthritis, repairs cartilage or fixes the underlying cause of pain. They are best thought of as a way to ease symptoms for a time, ideally to create a window in which strengthening exercises and other treatments can do their work. Whether and when to repeat an injection depends on how well it worked and on the limits for that joint.

How long it lasts

How long relief lasts is unpredictable. NICE describes steroid relief as typically short-term, around 2 to 10 weeks, and it tends to be shorter where joint damage is advanced. Because the effect wears off and repeated steroid can weaken tendons and thin skin and fat, injections in the same joint are usually limited. Any benefit from hyaluronic acid is uncertain and not supported by NICE for the knee or hip. Lasting improvement usually comes from tackling the underlying problem with exercise, weight management or, where appropriate, surgery — not from injections alone.

Related tests, treatments or support

Joint injections are often combined with physiotherapy and a strengthening programme, since a window of less pain makes exercise easier. They may also be used alongside painkillers, weight management or, for inflammatory arthritis, disease-modifying medicines. Steroid and hyaluronic acid are not usually given together, and your clinician should explain which they recommend and why.

Follow-up & long-term care

A review is often arranged at around six weeks to see how much the injection helped and how long any benefit lasted. This guides whether to repeat it, try a different treatment, or focus on exercise and other measures. If symptoms suggest infection or another problem before then, you should seek help straight away rather than waiting for the review.

Keeping up strengthening and movement exercises to maintain any benefit
Spacing out and limiting repeat steroid injections in the same joint
Managing weight and activity to reduce load on a painful joint
Reviewing the wider treatment plan if injections are needed often or stop helping
Being cautious about repeated private hyaluronic acid injections given the limited evidence

Repeat, follow-on and what comes next

If a steroid injection helps but wears off, a repeat may be considered, within the limits for that joint.
If an injection does not help at all, repeating it is usually not worthwhile, and a different treatment is considered.
Needing frequent injections is a sign to review the wider plan rather than to keep injecting.
Repeated private hyaluronic acid injections are hard to justify given the limited evidence.

Ask what happens if the result is unclear or needs repeating, and what is included if further tests or follow-up are needed.

What good aftercare looks like

Clear written advice on rest, activity and the signs of infection, with a named contact.
A review to check how well it worked and how long any benefit lasted.
Linking the injection to physiotherapy or an exercise plan, not using it in isolation.
Honest discussion of the evidence, including the limited benefit of hyaluronic acid, and of limits on repeat steroid injections.

What affects the cost

Costs vary a great deal between people and providers, and we don't publish prices. What matters is understanding what drives the cost and making sure your quote is complete. The main things that affect it:

Which injection is given (steroid or hyaluronic acid) and the product used
Whether ultrasound guidance is used to place the needle
Whether a single injection or a course of injections is recommended
The seniority of the clinician giving the injection
Whether a consultation and examination are part of the appointment
Whether a follow-up review or physiotherapy is included
The number of joints treated

Make sure your written quote includes

The fee for the consultation and the injection
Whether ultrasound guidance is included or charged separately
Whether the cost of the medicine is included, and for hyaluronic acid how many injections are proposed
Whether a follow-up review is included
What happens, and what it costs, if it does not work or a further injection is suggested
What support is available if a complication such as infection occurs
The cancellation policy

On the NHS? Steroid joint injections are commonly available on the NHS when clinically appropriate; hyaluronic acid injections are not recommended by NICE for knee or hip osteoarthritis and are generally only available privately.

You're entitled to your total cost in writing — including reports, follow-up and what happens if the result is inconclusive — before you decide.

Choosing a specialist safely

Check the specialist is on the GMC Specialist Register for this area.
Make sure they work at a CQC-registered service, and look for membership of the relevant Royal College or professional body.
You're entitled to time to consider and to have your questions answered before you agree — the specialist who looks after you should explain it, not a salesperson.
Be wary of pressure: time-limited offers or deposits taken before you've had time to think are red flags, not bargains.
You're entitled to your total cost in writing — including any follow-up — before you decide.

How Vuemedics verifies every consultant →

Questions to ask your medical professional

Take this to your consultation. A good specialist will welcome every one of these.

Which injection are you recommending, and what does the evidence say about its benefit for me?
If hyaluronic acid is suggested, why, given that NICE does not recommend it for the knee or hip?
How long might any benefit last, and what is the plan if it does not work?
How many injections can I safely have in this joint, and how far apart?
How does this fit with physiotherapy, exercise, weight management or surgery?
What are the signs of infection and exactly who do I contact if they happen?
Are you on the GMC Specialist Register for this area, and which Royal College or professional body are you a member of?
Will you be the specialist who carries out my injection, and who looks after me afterwards?
What are the risks for someone like me, and how often do your own patients have a problem or need it repeated or redone?
What does a realistic result look like — and what can this injection not achieve?
What are my options, including waiting, doing nothing for now, or choosing a different approach?
Can I have written information, results and aftercare instructions in a format I can use, including any accessibility or communication support I need?
What is the total cost in writing, including any follow-ups, and how much time do I have to decide?

Frequently asked questions

Are joint injections available on the NHS?

Steroid injections are commonly used on the NHS when appropriate. Hyaluronic acid is not recommended by NICE for knee or hip osteoarthritis and is generally not NHS-funded, though some private clinics offer it.

What is the difference between steroid and hyaluronic acid injections?

Steroid calms inflammation to ease pain for a short time. Hyaluronic acid is a gel-like lubricant aiming to cushion the joint. NICE supports steroid for short-term relief but does not recommend hyaluronic acid for knee or hip osteoarthritis.

How long does the relief last?

NICE describes steroid relief as typically about 2 to 10 weeks, and it varies a lot. Any benefit from hyaluronic acid is uncertain and not supported by NICE for the knee or hip.

Should I pay privately for a hyaluronic acid injection?

Be cautious. NICE reviewed the evidence and did not find a worthwhile benefit for knee or hip osteoarthritis, with a suggestion of possible harm in the hip. Ask the clinician why they are recommending it and what realistic benefit to expect.

Do these injections cure arthritis?

No. Neither steroid nor hyaluronic acid cures arthritis or regrows cartilage. They aim to ease symptoms for a time and work best alongside exercise, physiotherapy and weight management.

How many injections can I have?

Steroid injections in the same joint are usually limited because repeated steroid can weaken tendons and thin skin and fat. Hyaluronic acid is sometimes given as a course; given the limited evidence, ask whether repeating it is worthwhile.

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How we made this page

Medically reviewed by a GMC-registered consultant. Written in plain English, checked against NHS, NICE, GMC and relevant Royal College / specialist-society guidance, and kept under review. No clinic paid to appear on this page, and we publish no pricing. This is general information to help you prepare — it is not a substitute for advice from your own clinician. How we review our guides →

Source hierarchy: UK regulator and NHS/NICE guidance first, then relevant Royal College or specialist-society guidance, then peer-reviewed evidence for procedure-specific figures where available.

Sources & standards: NICE NG226 — Osteoarthritis: diagnosis and management (recommendations) NICE NG226 — Rationale and impact (injections) NHS — Steroid injections Versus Arthritis — Hyaluronan injections NICE CKS — Osteoarthritis

Reviews reflect patients' experience of care, not clinical outcomes. For procedure volumes and outcome data see PHIN.

Last medically reviewed 2026-09-21. Spotted something wrong or out of date? Report an error in this guide.