How are steroid and gel shots different?

How long do cortisone shots last?

A steroid shot may work sooner than gel, though relief can be brief. How long it lasts depends on the joint and its trouble. Your last response matters too. If each shot helps less, an automatic repeat won't suit everyone.

A calendar note will give the doctor a firm answer.

Which cortisone shot side effects matter?

Soreness may flare for a while after the shot. Steroid can also raise blood sugar for a short time. That matters if you have diabetes or trouble keeping sugar steady. Repeat shots call for another talk about relief, joint wear and surgery dates.

Don't change your medicine without speaking with the person who prescribed it.

What does a gel shot do?

A gel shot is meant to make joint fluid thicker and more slippery. It may take longer than steroid before you notice relief. Some people don't improve enough to make the visits worthwhile. Some gels require several visits, and coverage varies.

Choose one daily task, then notice whether walking or standing gets easier.

What if neither choice is enough?

QC Kinetix in Chandler can review other non-surgical choices. Regenerative treatments are care made at that office after blood or bone marrow is taken from you. They're offered to ease soreness while keeping your own joint working. The words medical providers mean the licensed staff who examine you.

You'll hear how those choices fit beside exercise or surgery.

Sources

1. The 2015 Cochrane review of 27 trials (1,767 participants) found intra-articular corticosteroid better than sham for knee OA pain (SMD -0.40, 95% CI -0.58 to -0.22; NNTB 8), but the benefit decayed with time: moderate at 1-2 weeks, small at 13 weeks, and no evidence of any effect at 26 weeks. All outcomes were graded LOW quality.

   Jüni P, et al. — Intra-articular corticosteroid for knee osteoarthritis.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD005328.pub3.

2. In a 2-year double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, 40 mg intra-articular triamcinolone every 12 weeks produced significantly greater cartilage volume loss than saline (index compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with no significant difference in knee pain.

   McAlindon TE, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

3. A 2022 BMJ systematic review and meta-analysis of 169 trials (21,163 participants) found viscosupplementation produced only a small pain reduction versus placebo (SMD -0.08, 95% CI -0.15 to -0.02; about -2.0 mm on a 100 mm VAS), below the minimal clinically important difference, and trial sequential analysis indicated conclusive evidence of clinical equivalence with placebo since 2009.

   Pereira TV, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

4. A systematic review of corticosteroid effects on articular cartilage found a time- and dose-dependent pattern: at low doses (roughly under 2-3 mg per dose in vivo) methylprednisolone, hydrocortisone and triamcinolone were associated with cell growth and recovery, while at higher doses (over 3 mg per dose, or 18-24 mg cumulative) they caused significant gross cartilage damage and chondrocyte toxicity.

   Wernecke C, et al. — The Effect of Intra-articular Corticosteroids on Articular Cartilage: A Systematic Review.. Orthop J Sports Med, 2015. DOI: 10.1177/2325967115581163.

5. A review of systemic absorption after locally injected glucocorticoid found substantial individual variability, and established that both intra-articular and epidural injections can produce systemic effects lasting WEEKS - while noting there are no guidelines addressing systemic absorption or overall systemic risk.

   Stout A, et al. — Systemic Absorption and Side Effects of Locally Injected Glucocorticoids.. PM R, 2019. DOI: 10.1002/pmrj.12042.

6. A review of ten studies found single local corticosteroid injections caused a significant but TRANSIENT rise in blood glucose in patients with diabetes, with no adverse reactions or complications reported, and concluded such injections are most likely safe in people whose diabetes is well controlled.

   Waterbrook AL, et al. — Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review.. Sports Health, 2017. DOI: 10.1177/1941738117702585.

7. The 2019 ACR/Arthritis Foundation OA guideline makes a STRONG recommendation for intra-articular glucocorticoid injection in knee OA, alongside strong recommendations for exercise, weight loss, self-management, tai chi, cane use, bracing and NSAIDs; intra-articular steroid injection for HAND OA is only conditionally recommended.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.