Cortisone Injections for Hip & Knee Arthritis

When an arthritic hip or knee flares up, a cortisone injection is often the fastest, most dependable way to settle it down. It's a tool I use regularly — for the right patient, at the right moment. Here's an honest look at what it does, what to expect, and where it fits.

What a cortisone injection is

Cortisone is a corticosteroid — a potent anti-inflammatory medication. Injected directly into the hip or knee joint, it works to reduce the inflammation that drives much of the pain and swelling of arthritis. It's one of the oldest and most established tools in joint care.

How it works and what to expect

By calming inflammation in the joint, cortisone can meaningfully reduce pain — often within a few days. The relief is real but temporary, typically lasting from a few weeks to a few months, and it varies from person to person. Occasionally there's a brief “steroid flare” — a day or two of increased soreness — before the improvement sets in. Patients with diabetes may notice a transient rise in blood sugar.

When a cortisone injection makes sense

It tends to be most useful in specific situations:

How often can you have cortisone injections?

Roughly every three months, as needed. That is the interval I work to, and it is the practical answer to a question patients are often given a vaguer version of.

You will sometimes hear that there is a hard cap — three a year, or some similar number. There is no fixed limit on how many you can have. What actually governs it is spacing them sensibly and whether they are still doing anything for you.

The genuine limitation is not a number on a chart. It is that as arthritis progresses, injections stop lasting as long. The same shot that gave someone six comfortable months two years ago may give them six weeks now — and that change is useful information. If you find yourself needing them closer and closer together, the injection is not failing you so much as telling you the arthritis has moved on.

Very frequent steroid injections are not ideal for a joint over the long run, which is the reason for spacing rather than for a hard ceiling. Worth knowing separately: a steroid injection close to surgery affects infection risk, so if an operation is being planned the timing matters — see cortisone injections before joint replacement.

How cortisone compares to gel and PRP

• Cortisone — fast, reliable anti-inflammatory relief; temporary and used selectively.
• Hyaluronic acid (gel) — supplements the joint's lubrication; well established for the knee, with comfort that can last longer than cortisone.
• PRP — uses your own concentrated platelets to modulate inflammation; evidence still evolving. See our evidence-based guide to PRP.

None reverse arthritis — they're different tools for managing symptoms, and all are part of the broader nonsurgical treatment plan.

Insurance and cost

Here's some good news on the practical side: because cortisone injections are a long-established, widely used part of arthritis care, they are generally covered by insurance — unlike elective options such as PRP. Coverage details still vary by plan, so it's always worth confirming with your insurer, but for most patients cost is far less of a barrier here than with regenerative options.

Where cortisone fits

Cortisone is one tool within a larger plan that's matched to your diagnosis. If you're considering it, it helps to understand the bigger picture: hip osteoarthritis or knee osteoarthritis, the full nonsurgical treatment continuum, and — when arthritis is advanced — what modern joint replacement involves. If repeated injections are no longer carrying you, that's often the moment to talk about what's next.