What Is a Joint Injection?
A joint injection places a small dose of corticosteroid, usually with a local anaesthetic, into or around a painful joint, bursa or tendon sheath. It calms local inflammation so that pain and swelling settle and the joint moves more easily.
In rheumatology, an injection is rarely the whole answer. Dr Malley uses it to settle a flare quickly while the cause is diagnosed and longer-term treatment is agreed with you and your GP.
Which Joint Symptoms Need Urgent Assessment?
Your symptom
Possible cause
What to do
A hot, red, swollen joint with fever
Joint infection (septic arthritis)
Call 111 or go to A&E the same day
Sudden, severe pain in the big toe or ankle
Gout flare
Book a prompt appointment
A new swollen joint with morning stiffness
Inflammatory arthritis
Book a rheumatology assessment
Stiff shoulders or hips in the morning
Polymyalgia rheumatica (PMR)
Book a prompt appointment
New headache, tender scalp or jaw pain when chewing
Giant cell arteritis
Same-day NHS assessment: call 111
Sudden loss of vision
Giant cell arteritis affecting the eye
Call 999 or go to A&E
If a joint is hot and very painful and you feel feverish or unwell, the NHS advises getting urgent help through NHS 111 or A&E. See the NHS guidance on septic arthritis and giant cell arteritis.
Joint Conditions Dr Malley Treats with Injections
Inflammatory arthritis flares: one or two swollen joints settled while longer-term medicines start working.
Gout: a flare in a single joint when tablets are not suitable, alongside a urate-lowering plan.
Bursitis: shoulder, hip and knee bursitis that has not settled with rest and physiotherapy.
Tendinitis: tennis elbow, golfer’s elbow and tendon-sheath inflammation in the hand and wrist.
Carpal tunnel symptoms: numbness and tingling in the hand while the cause is assessed.
Osteoarthritis flares: a painful flare in a knee or hand joint, as part of an exercise and pain plan.
Treatment Options
The right option depends on the joint, the cause and your other treatment. Dr Malley explains the choices and agrees the plan with you before anything is done.
Steroid Joint Injection
A corticosteroid injection into the joint itself, such as the knee, shoulder or wrist, usually with local anaesthetic.
Soft-Tissue Injection
An injection around a bursa or tendon sheath for bursitis, tendinitis or carpal tunnel symptoms.
Joint Aspiration
Draining fluid from a swollen joint to ease pressure and test the fluid for crystals or infection, often at the same visit.
Longer-Term Treatment
Where a flare is part of an ongoing condition, injections sit alongside disease-modifying medicines and regular review.
Joint Injection or Another Treatment?
Treatment
How it helps
How quickly
Often used for
Steroid injection
Calms inflammation in one joint or tendon
Usually within days
A flare in one or two joints
Anti-inflammatory tablets
Ease pain and swelling in several joints
Within days
Short flares, if safe for you
Physiotherapy and exercise
Builds strength and movement
Over several weeks
Bursitis, tendon and osteoarthritis pain
Disease-modifying medicines
Control the underlying arthritis
Over weeks to months
Long-term inflammatory arthritis
An injection often works best alongside one of the other options rather than instead of them. Dr Malley explains each choice and its limits before you decide.
Why Patients Choose Dr Malley for Joint Injections
Assessment first: every injection follows a full rheumatology assessment, so the cause is treated as well as the pain.
Same visit where suitable: if an injection is right for you, it can often be given at the first appointment.
Joined-up care: a clear letter goes to your GP, and to your oncology team if you are on immunotherapy.
Written aftercare: you leave with an aftercare leaflet and a direct line to the secretary.
Recognised expertise
Consultant Rheumatologist and General Physician, Royal Free Hospital, since 2022
MBChB, BMedSci, MRCP(UK)(Rheumatology)
GMC number 7329051
Honorary Clinical Associate Professor, UCL Medical School
Meet Dr Tamir Malley
Consultant Rheumatologist, Royal Free Hospital
Dr Malley trained in Edinburgh, Oxford and London and leads the rheumatology Hot Clinic for urgent new problems at the Royal Free. He sees patients privately in Devonshire Street W1 and at the Royal Free Private Patients Unit.
Before Your Injection
Medicines: mention blood thinners and diabetes medicines when you book. Do not stop any prescribed medicine unless you are told to.
Feeling unwell: if you have a fever, or a skin infection near the joint, the injection is postponed.
Previous injections: bring the dates of any earlier injections into the same joint.
On the day: wear loose clothing so the joint is easy to reach, and eat and drink as normal.
What Happens on the Day of Your Injection
1
Assessment
Dr Malley takes your history, examines the joint and reviews any tests.
2
Your options
He explains whether an injection is right for you, and the alternatives.
3
Consent
You agree the plan, including the benefits and possible side effects.
4
Injection
A quick procedure in clinic, usually taking a few minutes.
Dr Malley will talk you through the expected benefits and the possible risks before you decide. You can take time to think it over.
Recovery, Risks and Results
Most people go home straight away. Rest the joint for 24 to 48 hours and avoid heavy use; any benefit usually builds over several days.
Any benefit usually builds over a few days. Dr Malley reviews how you have responded at a follow-up and plans the next step if the flare returns.
A short flare of pain at the injection site for a day or two
Facial flushing or a small, pale patch of skin
A temporary rise in blood sugar if you have diabetes
Infection, which is rare: seek help urgently if the joint becomes hot and very painful