Can I Keep Getting Cortisone Shots in My Knee?

Q: I’ve been getting cortisone injections in my knee for osteoarthritis every four months. What are the possible side effects, and how long can I continue this?

A: Cortisone is a potent anti-inflammatory drug. When injected into the knee joint, it can help reduce pain, inflammation, and swelling. However, it’s not usually considered a first-line or long-term treatment for osteoarthritis.

Before trying cortisone injections, most experts recommend oral nonsteroidal anti-inflammatory drugs (such as ibuprofen or naproxen) or topical analgesics (such as capsaicin). Other strategies include losing excess weight, which lessens stress on the knee joint, and exercise, which can strengthen the muscles supporting the knee. Padded shoes, canes, and walkers also help decrease the load on your knees when you walk.

If the knee is still painful despite these strategies, a cortisone injection in the joint may help — temporarily. For osteoarthritis, most experts recommend limiting these injections to no more than once every three to four months — and a maximum of roughly four injections in any given joint. Cortisone injections carry some (rare) risks: infection, rupture of tendons around the joint, thinning of the skin near the injection site, and damage to the blood supply of the underlying bone, which can result in bone death. More important, the benefits usually last only four to six weeks. And the injections don’t restore cartilage or slow the progression of osteoarthritis.

Since your arthritis is severe but you’re otherwise healthy, you might want to consider knee replacement. It’s one of the most common orthopedic procedures, and it’s been proven to relieve pain and restore function and mobility.