Steroid Injection for Knee Pain and Knee Joint Osteoarthritis

Osteoarthritis (OA)—often called ‘wear-and-tear’ or ‘degenerative joint disease’ – is an arthritic condition in which the surfaces within your joints become damaged, so the joint doesn’t move as smoothly as it should. As the cartilage degenerates, the space between the joint narrows and the bones begin grinding against each other, leading to increased pain and reduced function.

Osteophytes (bony spurs) may form, creating more friction in the joint and further contributing to arthritic pain.
A knee steroid injection is a common procedure used to help manage the pain and inflammation caused by knee osteoarthritis. It involves injecting a corticosteroid medication directly into the joint to reduce inflammation and improve movement.

In the UK, patients can access knee steroid injection therapy through the NHS or private clinics. Choosing private treatment can offer faster access and personalized care, but it’s important to discuss the cost in advance, as prices can vary depending on the clinic and the specific procedure offered.

Causes

As part of normal life, your joints are exposed to a constant low level of damage. In most cases, your body repairs itself and you do not experience any symptoms. Almost everyone will eventually develop some degree of osteoarthritis. One common myth is that exercise like running will “wear out your knees”. In actual fact, research shows that people who run recreationally are less likely to develop arthritis in the knee than someone who is mostly sedentary (Alentorn-Geli et al, 2017).
However, several factors increase the risk of developing significant arthritis.

Risk factors include:

• Age. Osteoarthritis usually starts from the late 40s onwards (Blagojevic et al, 2010). This could be due to the weakening of the muscles, the body being less able to heal itself and the gradual wearing out of the joint with time. A study found that 33% of individuals older than 75 years have symptomatic and radiographic signs of knee osteoarthritis (Katz et al, 2021).
• Obesity. Weight increases the pressure in all the joints and greatly increases your risk of developing osteoarthritis (Katz et al, 2021). One pound of body weight results in 4 pounds of pressure on the knee joint (Messier et al, 2006).
• Gender. Osteoarthritis in the knee is twice as likely in women than men. (Blagojevic et al, 2010).
• Genetics. Studies have found that those with a family history of knee osteoarthritis have an increased risk of developing osteoarthritis (Katz et al, 2021).
• Joint Injury.  Injuries to the knee such as a torn meniscus or ligament injury can increase the risk of developing knee osteoarthritis in later life (Katz et al, 2021).
• Muscle weakness and joint laxity has been found to increase risk of symptomatic knee osteoarthritis (Zhang et al, 2010). A recent review found that knee extensor weakness increases risk of symptomatic knee osteoarthritis in men and women (Oiestead, B.E et al, 2021).
• Sedentary lifestyle has been found to be a risk for developing osteoarthritis (Katz et al, 2021). Those with knee osteoarthritis spent two-thirds of their daily time in sedentary behaviour (Lee at al, 2015).

Symptoms of Knee Joint Osteoarthritis

• Pain. Often described as a deep dull ache that is hard to locate. It tends to affect walking, kneeling, and certain exercises. In more severe cases, people may discuss options like having a knee steroid injection to help reduce inflammation and manage persistent pain.
• Stiffness. You may feel stiffness in the knee at certain times, often in the morning or after a period of rest. A knee steroid injection may be considered when stiffness is due to inflammation that doesn’t respond to simpler measures.Stiffness. You may feel stiffness in the knee at certain times, often in the morning or after a period of rest. A knee steroid injection may be considered when stiffness is due to inflammation that doesn’t respond to simpler measures.
• Creaking or grinding sensation when the joint moves.
• Swelling. You may notice hard swelling (caused by osteophytes) or soft swelling (caused by extra fluid in the joint). A knee steroid injection can help reduce joint swelling by targeting inflammation directly.

Anatomy

How to diagnose

Treatment

A knee replacement is not the only option when treating knee osteoarthritis.

Osteoarthritis of the knee joint can be well managed with conservative treatment and not require surgical intervention. Although it is not possible to reverse the degenerative changes, it is possible to reduce pain, improve strength and function.

Physiotherapy
The muscles surrounding your knee joint are like scaffolding. Strengthening the muscles around your knee can help stabilise and protect the joint. It’s also been shown to reduce pain and will prevent your knee giving way and therefore reducing the tendency to fall (Hunter et al 2009).

Aerobic exercise can reduce pain by stimulating the release of pain-relieving hormones called endorphins (Tanaka et al, 2013). It can also help you sleep easier, which is important for general health and well-being.
Our physiotherapists can advise on the best exercises to help build strength and fitness, whilst addressing each individual’s needs. It is important to have the right balance between rest and exercise, as too much activity can increase pain, whilst too little can cause the joints to stiffen up and deteriorate further.

Weight Management
Being overweight increases your risk of developing osteoarthritis and also makes it more likely the arthritis will get worse over time. When you walk, run or go up and down stairs the knee can take up to three to six times your body weight (Costigan et al, 2002). Therefore, even losing a small amount of weight can have a big difference to the strain on your knees. If you need to lose weight, you should follow a balanced, reduced-calorie diet combined with regular exercise.

Other ways you can help manage your pain

• Pace activities.
• Wear low-heeled shoes with soft, thick soles (such as trainers).
• Avoid keeping your knee still in a bent position for too long.
• Speak to your pharmacist about taking over the counter pain relief such as paracetamol or ibuprofen

Knee Osteoarthritis Injection Therapy

Other Knee Conditions:

• Patellofemoral Pain Syndrome
• Iliotibial Band Friction Syndrome