Intraarticular Injections

Dimitris Papadopoulos MD Fellow Of Interventional Pain Practice (FIPP)

Updated 09 February, 2011


Intra-articular injections are applied to treat articular pain or/and inflammation of traumatic or degenerative aetiology. It is recommended as a therapeutic option when the conservative treatment with anti-inflammatory drugs has failed.

Bursitis is a common inflammatory condition affecting the bursae. It is treated with intra-articular or intra-bursal injections. Bursitis may cause pain of the joint, as well as limitation of its movement and loading ability. It usually occurs in the knee, hip, shoulder and elbow.


The joint area is prepared with antiseptic solution and local anaesthesia is applied to the needle entry site. The needle is advanced to the joint under fluoroscopic guidance and its proper final point is confirmed by injecting contrast medium. The therapeutic solution -usually containing cortisone and local anaesthetic- is then administered. Cortisone has an anti-inflammatory effect on the joint and limits pain, giving patients the potential to increase their activities and strengthen the muscles that support the painful joint.

Following the intra-articular injection, there may be pain in the acupuncture area or/and the joint itself, until the corticosteroid starts acting.

In this case, the patient may take anti-inflammatory drugs for 3-4 days, such as ibuprophen or aspirin, and apply ice therapy to the painful site. Ice should be placed over a thin wet towel and stay there for 20 minutes, in order to avoid the risk of skin burn. Ice therapy is repeated many times during the day.


Raj, (2008) Raj’s Practical Management of Pain.415. (Benzon, Rathmell, Wu, Turk, Argoff Eds.)Philadelphia: Mosby Elsevier