Bottom line: Lifecare Primary Medical in Richmond, TX offers corticosteroid (cortisone) injections for knee and shoulder pain and trigger point injections for tight, painful muscle knots. Injections can ease pain for several weeks or longer and make exercise and therapy easier, but they do not cure arthritis. Most guidelines limit cortisone shots to about 3 to 4 per year in a joint, and every injection starts with an exam to confirm it is the right choice.
Clinical guide
How cortisone injections work
A cortisone shot, also called a corticosteroid or steroid injection, places a strong anti-inflammatory medicine directly into a painful joint or the tissue around it. It is usually mixed with a local anesthetic, which can bring quick, short-lived numbness, while the steroid itself calms inflammation over the next few days. Because the medicine goes straight to the problem area, very little reaches the rest of the body compared with steroid pills.
Joint injections are one part of a broader plan for joint pain, not a cure. They work best when they create a window of relief that lets you move more, sleep better and make progress with exercise, weight management and physical therapy. Our joint and back pain care page explains the full evaluation.
Knee and shoulder injections
Knee osteoarthritis is one of the most common reasons adults ask about a cortisone shot. The American College of Rheumatology strongly recommends intra-articular corticosteroid injections for knee osteoarthritis, and the Osteoarthritis Research Society International lists them as a conditional option for short-term pain relief. Studies show the benefit can be modest and may fade within weeks for some people, while others get relief that lasts longer.
In the shoulder, steroid injections are commonly used for painful conditions such as bursitis, rotator cuff irritation and arthritis. Before any injection, your provider examines the joint, reviews prior imaging and treatment, and confirms that the pain pattern fits a condition likely to respond. Sudden swelling, a hot red joint, fever or pain after a fall need a different evaluation first.
- Often a good fit: flare of knee or shoulder arthritis, bursitis, pain that limits exercise or physical therapy
- Needs more evaluation first: new injury, locking or giving way, suspected tear, unexplained swelling
- Usually not used: tendinitis of the Achilles, patellar or biceps tendons, because of the risk of tendon rupture
Trigger point injections for muscle knots
Trigger points are tight, tender knots in a band of muscle that can cause local pain and pain that spreads to other areas, such as headaches from neck and shoulder muscles or low back pain that radiates into the hip. A trigger point injection uses a thin needle to deliver a small amount of local anesthetic, sometimes with a corticosteroid, directly into the knot. This can relax the muscle band, improve blood flow and help break the cycle of pain and tension. Trigger point injections are often combined with stretching, posture work, heat and physical therapy.
Benefits, limits and how often you can have injections
A well-placed injection can reduce pain for several weeks or longer. It may take a few days to reach full effect, and some people notice a brief increase in pain for a day or two after the shot. Relief varies from person to person and from joint to joint.
| Question | What guidelines and evidence say |
|---|
| How often? | There is no formal limit, but the American Academy of Orthopaedic Surgeons describes a practical guideline of about 3 to 4 cortisone shots per year in a joint |
| Why limit them? | Repeated injections may contribute to cartilage breakdown, and relief tends to shrink while infection and tendon risks add up |
| Planning surgery? | Joint replacement is generally delayed at least 3 months after a steroid injection into that joint |
| Diminishing relief? | If shots stop helping, it is time to reassess, including referral to orthopedics |
We track the date and site of each injection in your chart so we can follow these limits over time.
Risks and who should be careful
Serious complications are uncommon, but every injection carries some risk. Possible side effects include temporary pain flare, bruising or bleeding, skin thinning or lightening at the site, facial flushing and, rarely, infection. A joint that becomes increasingly red, hot, swollen and painful days after an injection, especially with fever, needs urgent care. Trigger point injections near the chest wall carry a rare risk of lung puncture.
- Diabetes: steroid that escapes the joint can raise blood sugar for a few days, so check your glucose more often after a shot
- Blood thinners: tell us if you take anticoagulants or antiplatelet medicines
- Infection or skin problems at the injection site mean the shot must wait
- Pregnancy, allergies to local anesthetics and needle anxiety are discussed before treatment
What to expect at your injection visit
- Evaluation. Your provider reviews your history, examines the area and confirms an injection is appropriate.
- Consent and preparation. We explain benefits and risks, clean the skin and may use a cooling spray or numbing medicine.
- The injection. The shot itself usually takes only moments.
- Aftercare. Rest the area for a day or two, use ice for soreness and avoid strenuous activity as directed. Call us with signs of infection.
- Follow-up. We check your response and build a longer-term plan with exercise and other treatments.
