Injections are one of the most effective nonsurgical tools for managing knee arthritis pain. They can provide meaningful relief, buy time before surgery, and in some cases help patients avoid or significantly delay knee replacement.
Dr. Leo Zalikha offers several types of knee injections as part of a broader nonsurgical arthritis management strategy. The right injection depends on your stage of arthritis, what you have tried before, and your goals.
Injections are not a cure for arthritis. They do not regenerate cartilage or reverse joint damage. But they can reduce pain and inflammation, improve function, and help you stay active while managing your condition.
Corticosteroid injections are the most common type of knee injection. They deliver a potent anti-inflammatory medication directly into the joint.
Best for: Acute flares of knee arthritis pain with significant swelling. Patients who need fast relief.
What to expect: Relief typically begins within a few days and can last several weeks to months. The duration varies by individual.
Limitations: The effect is temporary. Repeated cortisone injections (more than three to four per year) may have diminishing returns and potential effects on cartilage health. Dr. Zalikha uses these strategically rather than on a fixed schedule.
Hyaluronic acid injections supplement the knee's natural synovial fluid. In an arthritic knee, the natural fluid loses its viscosity and cushioning properties. Hyaluronic acid restores some of that function.
Best for: Mild to moderate knee arthritis. Patients who want an alternative to cortisone or have had a limited response to steroid injections.
What to expect: Effect develops gradually over two to four weeks. Duration of relief is variable but often lasts several months. Some patients benefit from repeat courses.
Limitations: Less effective for severe (bone-on-bone) arthritis. Multiple formulations exist (single injection vs. series), and Dr. Zalikha recommends the option best supported by evidence and appropriate for your situation.
Platelet-rich plasma (PRP) and other biologic injections use concentrated growth factors from your own blood or other biologic sources to promote a healing response in the joint.
Best for: Mild to moderate arthritis in patients interested in biologic approaches. Sometimes considered when cortisone and hyaluronic acid have provided insufficient relief.
What to expect: PRP involves a blood draw, processing in a centrifuge, and injection of the concentrated platelet solution into the knee. Results are variable. Some patients report significant improvement; others notice little change.
Limitations: Insurance typically does not cover PRP. The evidence is evolving, and Dr. Zalikha discusses the current data honestly so patients can make informed decisions.
Injections are one part of a treatment plan, not the entire plan. Dr. Zalikha uses injections in combination with other nonsurgical measures:
Physical therapy to strengthen the muscles around the knee
Weight optimization to reduce joint stress
Activity modification to protect the joint while staying active
Oral and topical anti-inflammatory medications
The goal is to manage symptoms effectively and maintain quality of life. For some patients, injections are a bridge that provides relief while they work on strengthening and weight management. For others, injections are part of a long-term maintenance strategy that keeps them functioning well without surgery.
Knee injections are performed in the office and take only a few minutes. The skin is cleaned, the area may be numbed with a topical anesthetic, and the medication is injected into the joint space using a standard needle. Most patients describe the injection as mildly uncomfortable but tolerable.
After the injection:
