Corticosteroid injections are one of the most commonly recommended treatments for joint pain and one of the most misunderstood. They can provide genuine, meaningful relief for conditions such as osteoarthritis, shoulder impingement and chronic knee or hip pain. But they are not a cure, and used in isolation, they rarely solve the problem for long.
The short answer is this: corticosteroid injections work best when they are part of a broader plan. Used alongside physiotherapy and chiropractic care, they can be genuinely transformative. Used alone, their benefits tend to fade within weeks.
What Are Corticosteroid Injections?
A corticosteroid injection delivers anti-inflammatory medication directly into a joint or the soft tissue surrounding it. The aim is straightforward: to reduce inflammation, ease swelling and lower pain levels enough for normal movement to become possible again.
They are most commonly used for osteoarthritis of the knee, hip or shoulder; tendinopathy, where a tendon becomes inflamed or degenerates; shoulder impingement syndrome; bursitis; and other forms of persistent joint pain where inflammation is a significant factor.
Injections are not usually the first port of call. Clinicians typically recommend them when more conservative approaches (exercise therapy, manual therapy, or a course of physiotherapy) have not provided adequate relief, or when pain is severe enough to prevent a patient from engaging with those treatments at all. Here at Sundial, we’re adding corticosteroid injections to our treatment options (you can read more here). Find out in this article why we think they fit well with our approach.
How Long Do They Actually Last?
This is one of the most common questions patients ask, and the honest answer is: it varies, but not as long as most people hope.
Evidence from systematic reviews and randomised controlled trials shows that the greatest benefit is felt within the first six weeks after injection. Pain reduction and improved joint function tend to be most noticeable during this window. Beyond that, effects begin to decline. In some patients, meaningful relief continues for up to three months, but this is not universal, and by the three-month mark most patients have returned to baseline levels of pain unless they have also addressed the underlying cause.
This is not a failing of the treatment, it is simply how anti-inflammatory medication works. It calms the fire, but it does not fix what caused the fire in the first place.
What Does the Evidence Say?
The research on corticosteroid injections is clear on two points, and they are worth holding together.
First, for short-term relief, injections are effective. Multiple high-quality studies confirm that they reduce pain and improve function, particularly in the early weeks following the procedure. For someone in significant discomfort (unable to sleep, struggling to walk or unable to lift their arm above their head), this kind of relief can be life-changing, even if it is temporary.
Second, for long-term outcomes, injections are not superior to physical therapies or exercise-based therapy. When researchers follow patients over six to twelve months, those who combine injections with active rehabilitation consistently do better than those who rely on injections alone. The injection provides a window; what you do with that window determines how durable the improvement will be.
Why the Combination Approach Works
The reason a combined approach is so effective comes down to what each treatment is actually doing.
A corticosteroid injection targets inflammation. It does not correct the movement patterns, muscle imbalances or structural issues that caused the joint to become inflamed in the first place.
Chiropractic treatment and physiotherapy address those factors directly, building strength around the joint, improving stability and control and reducing the likelihood of the problem recurring. Chiropractic care works on the mechanical side: restoring joint mobility, reducing tension in surrounding soft tissue, improving posture and identifying the movement problems that are placing excessive strain on the joint.
The practical value of an injection, viewed through this lens, is not simply that it reduces pain. It is that it makes everything else more accessible. Someone who cannot tolerate exercise because of pain may be able to begin a rehabilitation programme once inflammation has settled. Someone whose shoulder is too stiff to respond to manual therapy may find that an injection creates enough mobility for treatment to take effect. The injection buys time and reduces the barrier to the treatments that produce lasting results.
Are There Any Risks?
Corticosteroid injections are generally safe when administered by qualified clinicians (such as Dr Dan Hammond here at Sundial, who is a GP and trained as a chiropractor) and used within the recommended frequency. That said, they are not without limitations and it is important to be clear-eyed about them.
The effects are temporary, which means that without accompanying rehabilitation, patients often find themselves returning for repeat injections without ever addressing the root cause of their pain. Repeated injections into the same joint, particularly when done too frequently, carry a risk of changes to cartilage or tendon tissue over time. For this reason, most clinical guidelines recommend no more than three to four injections per year in the same joint.
This limitation is not a reason to avoid injections where they are appropriate. It is, however, a strong argument for ensuring that any injection is part of a wider plan rather than the entirety of one.
Who Should Consider a Corticosteroid Injection?
An injection is worth discussing with your chiropractor or physio if pain is significantly affecting your daily life or disrupting your sleep, if inflammation appears to be a central feature of your condition, if you have already tried exercise and manual therapy without sufficient improvement, or if you need short-term relief in order to begin or re-engage with a rehabilitation programme.
As with any clinical decision, individual circumstances matter. A GP, musculoskeletal specialist, or experienced chiropractor can assess whether an injection is likely to help in your specific case.
The Bottom Line
Corticosteroid injections are a valuable and legitimate tool in the management of joint pain. The evidence supporting their short-term effectiveness is robust. But they are not a substitute for rehabilitation, and they work best when they are used to enable the treatments of chiropractic care, physiotherapy, and structured exercise that address the underlying causes of pain.
The most effective approach combines the immediate relief an injection can provide with the longer-term work of restoring movement, building strength, and correcting the mechanical factors that caused the joint to become painful in the first place. Patients who follow this integrated path consistently achieve better outcomes, and more durable ones, than those who rely on injections alone.
If you are managing persistent joint pain and are unsure what approach is right for you, speaking with a chiropractor or physiotherapist is a good place to start. They can assess your condition, discuss your options, and help you build a plan that goes beyond managing symptoms.
Frequently Asked Questions
How long do corticosteroid injections last for joint pain?
Corticosteroid injections typically provide meaningful pain relief for between four and twelve weeks. The greatest benefit is usually seen within the first six weeks. How long effects last depends on the condition being treated, the joint involved, and how the patient’s body responds, as well as whether accompanying rehabilitation is undertaken.
Are corticosteroid injections better than physiotherapy?
For short-term pain relief, injections can be more immediately effective. For long-term outcomes, physiotherapy and exercise-based therapy consistently produce better results. The most effective approach uses both: an injection to ease acute pain, followed by physiotherapy to address underlying causes and prevent recurrence.
Can I have chiropractic treatment after a corticosteroid injection?
Yes, and in many cases it is actively recommended. The reduction in pain and inflammation following an injection can make it easier for a chiropractor to work on the underlying mechanical causes of joint dysfunction, and may allow rehabilitation to progress more quickly.
How many corticosteroid injections can you have per year?
Most clinical guidelines recommend a maximum of three to four injections per year into the same joint. More frequent injections may increase the risk of cartilage or tendon tissue changes over time.
Do corticosteroid injections cure joint pain?
No. They reduce inflammation and pain but do not repair damaged tissue or correct biomechanical problems. They are best understood as a short-term relief measure that works most effectively as part of a broader treatment plan.
What conditions are corticosteroid injections used for?
They are most commonly used for osteoarthritis, tendinopathy, shoulder impingement syndrome, bursitis and chronic knee or hip pain.
What is the difference between a corticosteroid injection and a steroid injection?
These terms refer to the same treatment. “Steroid injection” is the common name; “corticosteroid injection” is the more precise clinical term. Both describe anti-inflammatory medication administered directly into a joint or soft tissue.
Are corticosteroid injections safe?
They are considered safe when administered by a qualified clinician and used within recommended frequency limits. Side effects are generally mild and temporary. Repeated or excessive use carries a higher risk of tissue changes, which is why they are typically limited to a few per year in any single joint.
Can Sundial chiropractors or physiotherapists in Brighton advise me about corticosteroid injections?
A chiropractor can assess your condition and advise whether an injection is likely to be appropriate, and can support you in seeking a referral through your GP or a private musculoskeletal specialist. They can also provide the rehabilitation programme needed to make the most of any period of pain relief an injection provides.
This article is intended for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional before beginning any new treatment.
About Matthew Bennett, Chiropractor Brighton
Matthew Bennett is the founder and principal chiropractor at Sundial Clinics Brighton, established in 1991. With over 35 years of clinical experience, Matthew qualified from the Anglo-European College of Chiropractic in 1987 and served as President of the British Chiropractic Association for four years. As a Fellow of the Royal College of Chiropractors and former team chiropractor for Brighton and Hove Albion FC and the British Alpine Ski Team, Matthew combines evidence-based chiropractic treatment with sports performance expertise. His authority in musculoskeletal health has been recognised through national media appearances, expert witness roles and contributions to professional publications. Matthew’s commitment to clinical excellence ensures patients receive the most effective chiropractic care in Brighton.
Sources
1. Coombes BK, Bisset L, Vicenzino B. Effect of Corticosteroid Injection, Physiotherapy, or Both on Clinical Outcomes in Patients With Unilateral Lateral Epicondylalgia: A Randomised Controlled Trial
What it found: It found that while injections produced faster early relief, physiotherapy produced better outcomes at 52 weeks, and the combination group showed benefits beyond either treatment alone. It is published in JAMA, one of the most authoritative medical journals in the world, making it a high-quality citation.
2. Barr S, Cerisola FL, Blanchard V. Effectiveness of Corticosteroid Injections Compared with Physiotherapeutic Interventions for Lateral Epicondylitis: A Systematic Review. Physiotherapy. 2009
What it found: This systematic review found that corticosteroid injections are effective at short-term follow-up, and physiotherapeutic interventions are effective at intermediate and long-term follow-up.
3. Nazari G, MacDermid JC, Bryant D, et al. Comparing the Effect of Physiotherapy and Physiotherapy Plus Corticosteroid Injection on Pain Intensity, Disability, Quality of Life, and Treatment Effectiveness in Patients With Subacromial Pain Syndrome: A Randomised Controlled Trial. Disability and Rehabilitation. 2022.
What it found: In this double-blind, parallel RCT, 50 patients with subacromial pain syndrome were randomly assigned to either a combined group (a single injection three to six days before physiotherapy) or a physiotherapy-alone group. The results showed more effectiveness in the combined group at medium-term follow-up, with mean scores of almost all outcome measures substantially lower in the combined group. The study concluded that a combined approach versus physiotherapy alone may have more medium-term effects on patients’ pain, disability, quality of life and treatment effectiveness.