The Dark Side of Knee Injections Doctors Rarely Mention

Added: 2026-05-15

[00:00:00]Here are 20 side effects to know before getting injections to help knee pain.

[00:00:05]Number one is pain and swelling at the injection site. Kind of obvious, right?

[00:00:11]If you get a needle poked into your body somewhere, it's probably going to be painful, at least a little bit. And you might get swelling because they're injecting something in there and the physical space that it takes up might bring some swelling to the area. Um, but you could also have like an adverse reaction, a minor one, where you get a little bit of pain that lasts for a while, you know, for a few hours or maybe a day or two, or some swelling that lasts for a day or two that's as a direct result of having the injection, of having the needle pierce your skin and go into your tissues, into your knee joints. Um, and so you could have that immediate that immediate side effect.

[00:00:48]And so that side effect is the most common and it's likely to happen, but it's relatively minor. The second side effect is going to be an allergic reaction. There are some people that are allergic to steroid medications. And so if your doctor's giving you a steroid injection for the first time and you've never had any steroid medications before, just watch out because you might get an allergic reaction where you get redness, hives, um, fever symptoms.

[00:01:14]There's all kinds of symptoms associated with allergic reactions. And so just be careful to note if you are having one.

[00:01:20]Number three is changes to the skin at the injection site. So these are a little bit more delayed. You can have changes in the coloration of your skin, like it might get a little lighter or a little darker depending on how you tend to react to it and your skin color. And you can also have thinning of the skin in the area. This is especially of concern if you already kind of have thin skin, especially if you're older in age, because it might make your skin a little bit more susceptible to breaking or tearing in the area. Number four, face redness. Some people react by having facial redness that lasts for anywhere from a few hours to a few days. It's temporary, and there typically isn't pain associated with it, but it's just like your face looks flushed. Number five, this one's a little more common that I've seen in patients. It's mood swings. And they're reporting this to me. They're telling me, you know, I I was getting in a fight with my spouse, or I was irritable about something that usually doesn't bother me. And in the moment when they're going through an emotional mood swing, they may not realize that it's because of a reaction to a medication like an injection that they got, but it could be related to that.

[00:02:27]Number six is insomnia, or losing sleep.

[00:02:31]The medication can actually affect your sleep patterns. And some people, despite getting a relief of pain, because that's what a corticosteroid injection is supposed to do in the knee joint, it might keep you up at night. Number seven is weight gain. Corticosteroids are known to increase appetite in some people, as well as increase water retention. Both of these combined could set up the situation where if you step on the scale, you might be gaining a few pounds while taking corticosteroid injections. Number eight is fatigue.

[00:03:04]This happens because steroids can affect your adrenal glands, which are very connected to your energy levels. And they can decrease the effect of your adrenal glands, which means that you'll feel tired and slow, and you might feel fatigued. And adrenal fatigue is connected to number nine, which is muscle weakness. If you're feeling fatigued already, then you might also feel weakness in your entire body, almost like you're starting to get sick.

[00:03:27]Number 10, in women, it might affect your menstrual cycle. Could affect the flow or the timing of your cycle, which can be very confusing. But if you just had an injection for knee pain, you can connect those dots and understand that that's probably why you're having these changes. Number 11 is the risk of an infection. If you have an injection at any part of your body, you always run a risk of of Usually medical facilities, medical professionals are pretty good about keeping things sterile enough for you to not get an infection. But, it runs the risk runs even higher if you've already had a surgery in your knee, especially a joint replacement surgery, because you don't want to get infection in that.

[00:04:06]That means you you you can potentially have to have a revision of your knee replacement. In other words, you're going to have to have a second joint replacement if it becomes infected.

[00:04:15]Usually, doctors will stop you from having an injection in this situation, but you need to know this as well. Make sure you're not getting your replaced knee injected again. And even if you have don't have a a knee joint replacement, you can still run the risk of an infection. The chances are low, but just be aware. Number 12, steroids can spike your blood sugar. This is especially concerning if you're an uncontrolled diabetic. If you don't do a great job of managing your blood sugar levels, if you go get an injection for your knee joint pain, this can elevate your blood sugar and potentially cause some side effects that could be harmful, potentially even cause death, if you're not careful. So, just make sure that you let your doctor know that you have diabetes if you haven't already. And they they should be asking, but you need to communicate effectively with your doctor to make sure that you're as healthy as possible while dealing with this knee problem. Number 13 is if you have a fracture or potential fracture, a broken bone in your knee joint or nearby, you shouldn't be getting an injection because corticosteroid will stop the healing process of a fracture.

[00:05:22]So, if you have a broken bone and it's trying to heal on its own, it will stop the healing from happening. So, you don't want to have an injection for pain if there's a fracture. Your doctor will likely take x-rays and make sure that you don't have a fracture, but if you had an injury, a traumatic injury recently, especially like a fall, a car accident, and that's part of the reason why you have knee pain, there's a potential risk that you do have a fracture. So, just be careful. Number 14 is an increased risk of blood clots. If you are currently on blood thinners because of a risk of blood clots, then getting an injection, a steroid injection in your knee can up that risk.

[00:06:01]So, just communicate with your doctor and make sure you let them know you're on a blood thinner like warfarin is a common one, so that you don't get any sort of deep vein thrombosis, DVTs, or pulmonary embolisms, the kind of the clots that go up into your lungs. You need to be careful about that. Number 15 is an increase in blood pressure.

[00:06:19]If you have high blood pressure and you're not the greatest at controlling it or measuring it, then I would be careful taking steroid injections for your knee because it is known to increase blood pressure. You got to make sure to manage that blood pressure because there's a risk of heart attacks and strokes and other things, and it may not be worth the pain relief that you're seeking to get. Number 16, injections for knee pain can weaken bones. If you're older in age and if you're at risk for osteoporosis, this is especially concerning because weakened bones means you're more susceptible to fractured bones. This can happen at the hips, at the knees. You got to make sure that you're safe. Talk to your doctor about measuring your bone density before getting a knee injection. Number 17, there's an increased risk of rupturing a tendon, of tearing your tendons. Tendons connect muscles to bones. They're very important for transmitting the force of your muscles to get your joints to move.

[00:07:16]If you tear that tendon, it means you're not going to be able to move your joint normally until it heals. Steroids are known to break down collagen, which is one of the building block structures that makes up tendons as well as other things. That leads me into number 18, you can also tear ligaments. Ligaments connect bones to bones. They're almost the same exact structure as a tendon, they just connect differently. A tendon connects a muscle to a bone, but a ligament connects a bone to a bone. So, any any in your knee joint, you have lots. Some of the most common ones are your ACL, the anterior cruciate ligament, and your MCL, the medial collateral ligament. You have a bunch of other ones as well, and they're all important for connecting your bones together at your knee joints and keeping it stable. And if you were to tear one of those because of repeated injections, that could be very, very troublesome for you for the near future as well as the long term. Number 19 is it can also damage cartilage. Collagen is also heavily found in cartilage, and this is one of the most important structures in keeping your knees healthy for the long term. It's the thing that gets destroyed, injured, and damaged as you develop osteoarthritis in your knee. And so, you need to make sure that you keep your cartilage as healthy as possible.

[00:08:29]There was a recent study that came out that compared corticosteroid injections for knee pain to hyaluronic acid injections for knee pain. And what they found was that corticosteroid injections were more likely to damage cartilage compared to hyaluronic acid injections.

[00:08:47]And so, there's beginning to be a shift in the thinking in the medical research as to how effective, how helpful corticosteroid injections are for knee problems, especially those like osteoarthritis.

[00:09:00]Number 20, steroid injections can potentially give you a false sense of relief. They take away pain, and often times when people have less pain, they end up doing more things. They're they're more active. But if you don't have the root problem of your knee pain fixed, very often it's a muscle imbalance between the glutes and the thigh muscles, the quad muscles very often the front of the thigh, that problem continues because an injection doesn't make your thigh muscles any weaker or your glute muscles any stronger in order to fix the imbalance. And so, you can keep going with less pain, meanwhile you're feeding into the muscle imbalance and just delaying the problem and allowing it to get worse cuz it'll fester.

[00:09:46]And later on when the effects of the medication wear off, you could potentially be worse in your muscle imbalance, which means there's going to be more pressure through your joint, more damage to the to the cartilage, more tension on the ligaments and tendons, and you may not be better off.

[00:10:01]Now, with all that said, here's my honest recommendation about how to go forward with using steroid injections for knee pain relief.

[00:10:10]I would use it as a last resort. If you've tried over-the-counter pain medications, if you've tried prescription oral pain medications, and you're still not finding relief, then you might go to injected medications, injections. However, during that process, as you're starting out with the over-the-counter and the the prescription oral medications, you should be working on fixing the root muscle imbalance so that you can get the long-term relief. The thing is that fixing the root muscle imbalance rarely gives you that instantaneous big massive relief that can allow you to sleep better at night and walk a little bit longer and be a little less grumpy because you're not in as much pain. So, that's when you might use medications.

[00:10:51]And sometimes the oral medications might just not be as effective as the injected medication. So, if you've tried the easier, less invasive stuff, then you might go to the heavier, more direct stuff like the injections, but just please please don't rely on pain medications or injections as a solution to fix your knee problem. That doesn't fix the root problem. You've got to get to the root by fixing the muscle imbalances.