# Common questions about knee treatment have direct answers *Plain Answers | Knee Injections Surprise* > Direct answers to knee injections Surprise questions about cortisone, gel, blood-based care, repeat use, blood sugar, and nearby visits. ## Knee soreness can bring several practical questions The ache may be mild early and sharper after a walk. These answers cover common choices, usual reactions, and signs that need quick care. No short answer can find the cause in one knee. An exam and a review of your health are still needed. ## Sources 1. A 2024 AJR review of corticosteroid injection side effects lists local effects (post-injection flare, skin hypopigmentation and atrophy, infection, tendon rupture, accelerated osteoarthritis progression, osseous injury) and systemic effects (adrenal suppression, facial flushing, hypertension, hyperglycaemia, osteoporosis), and calls for targeted pre-injection counselling for specific populations. Kamel SI, et al. — [Local and Systemic Side Effects of Corticosteroid Injections for Musculoskeletal Indications.](https://pubmed.ncbi.nlm.nih.gov/38117096/). *AJR Am J Roentgenol*, 2024. DOI: 10.2214/AJR.23.30458. 2. A review of systemic absorption after locally injected glucocorticoid found substantial individual variability, and established that both intra-articular and epidural injections can produce systemic effects lasting WEEKS - while noting there are no guidelines addressing systemic absorption or overall systemic risk. Stout A, et al. — [Systemic Absorption and Side Effects of Locally Injected Glucocorticoids.](https://pubmed.ncbi.nlm.nih.gov/30925034/). *PM R*, 2019. DOI: 10.1002/pmrj.12042. 3. A JBJS Reviews synthesis notes that although severe complications of corticosteroid injection - infection, tendon rupture, osteonecrosis - are rare, less severe skin reactions and flare responses are not, and that effects on blood glucose matter particularly for patients with diabetes. Honcharuk E, et al. — [Complications Associated with Intra-Articular and Extra-Articular Corticosteroid Injections.](https://pubmed.ncbi.nlm.nih.gov/28060786/). *JBJS Rev*, 2016. DOI: 10.2106/JBJS.RVW.16.00004. 4. A review of ten studies found single local corticosteroid injections caused a significant but TRANSIENT rise in blood glucose in patients with diabetes, with no adverse reactions or complications reported, and concluded such injections are most likely safe in people whose diabetes is well controlled. Waterbrook AL, et al. — [Blood Glucose Levels After Local Musculoskeletal Steroid Injections in Patients With Diabetes Mellitus: A Clinical Review.](https://pubmed.ncbi.nlm.nih.gov/28394710/). *Sports Health*, 2017. DOI: 10.1177/1941738117702585. 5. A Danish register study of all intra-articular procedures performed on Funen over eight years measured the frequency of septic arthritis within 14 days of a glucocorticoid injection as LOW, under a local protocol using a non-touch sterile technique with patients advised to seek care on suspicion of infection. Petersen SK, et al. — [Low frequency of septic arthritis after arthrocentesis and intra-articular glucocorticoid injection.](https://pubmed.ncbi.nlm.nih.gov/31146626/). *Scand J Rheumatol*, 2019. DOI: 10.1080/03009742.2019.1584329. 6. A 2017 MMWR outbreak report describes 41 cases of septic arthritis following intra-articular injections given during 250 patient visits at a single New Jersey outpatient practice, 30 (73%) of whom needed surgery; recovered organisms were oral flora and the investigation found multiple breaches of infection-prevention practice. Ross K, et al. — [Outbreak of Septic Arthritis Associated with Intra-Articular Injections at an Outpatient Practice - New Jersey, 2017.](https://pubmed.ncbi.nlm.nih.gov/28749922/). *MMWR Morb Mortal Wkly Rep*, 2017. DOI: 10.15585/mmwr.mm6629a3. 7. In a 2-year double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, 40 mg intra-articular triamcinolone every 12 weeks produced significantly greater cartilage volume loss than saline (index compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with no significant difference in knee pain. McAlindon TE, et al. — [Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.](https://pubmed.ncbi.nlm.nih.gov/28510679/). *JAMA*, 2017. DOI: 10.1001/jama.2017.5283. 8. A 2-year double-blind RCT of triamcinolone every 3 months versus saline found NO difference in joint space loss between groups and significantly improved pain and stiffness with repeated steroid injections, and the authors concluded that long-term intra-articular steroid injection is safe for the anatomical structure of the knee. Raynauld JP, et al. — [Safety and efficacy of long-term intraarticular steroid injections in osteoarthritis of the knee: a randomized, double-blind, placebo-controlled trial.](https://pubmed.ncbi.nlm.nih.gov/12571845/). *Arthritis Rheum*, 2003. DOI: 10.1002/art.10777. 9. A meta-analysis found ipsilateral intra-articular corticosteroid injection within 3 months BEFORE joint arthroplasty was associated with increased periprosthetic joint infection risk, and the authors recommend against performing arthroplasty on a joint injected within that window - while injections given at any time overall showed no such association. Lai Q, et al. — [Prior Intra-articular Corticosteroid Injection Within 3 Months May Increase the Risk of Deep Infection in Subsequent Joint Arthroplasty: A Meta-analysis.](https://pubmed.ncbi.nlm.nih.gov/34919065/). *Clin Orthop Relat Res*, 2022. DOI: 10.1097/CORR.0000000000002055. 10. A safety review of intra-articular PRP in knee OA found significantly higher rates of mild knee pain and swelling than hyaluronic acid (p<0.001), driven specifically by leukocyte-RICH formulations; leukocyte-poor PRP showed a safety profile similar to HA. No severe adverse events were reported in any group. PM&R authors — [Assessment of adverse events and safety associated with intra-articular platelet-rich plasma injections compared with hyaluronic acid and saline in knee osteoarthritis.](https://pubmed.ncbi.nlm.nih.gov/42101047/). *PM&R*, 2026. DOI: 10.1002/pmrj.70141. ## Are cortisone shots bad for you? Cortisone can cause a flare, which is a short rise in soreness after the shot. Flushing, skin change, higher blood sugar, or rarely infection can also occur. One long trial found cartilage loss with repeated cortisone, while another did not. Your health, earlier relief, and planned surgery help decide whether another shot makes sense. ## Is a cortisone shot better than a gel shot? Cortisone often eases soreness for weeks, though the relief may be shorter or longer. Gel studies found an average change too small for many people to notice. Both use a needle and can cause soreness, swelling, bleeding, or infection. Compare cost, blood sugar concerns, and what you want to improve in walking or stairs. ## Why does my knee hurt worse after gel? The needle and gel can cause a short rise in soreness or swelling. That reaction should start settling instead of getting worse each day. Growing heat, swelling, pain, fever, or feeling ill needs prompt medical care. An online answer can’t tell a usual reaction from infection in your knee. ## How painful is PRP in the knee? Platelet-rich plasma, or PRP, comes from your blood after spinning gathers platelets, blood parts that carry natural growth factors. The needle can sting, and soreness or swelling may last several days. Ask whether the PRP keeps white blood cells, since that may affect short-term soreness. Get clear limits for walking, driving, and exercise during the first days. ## How often can you get cortisone shots? There isn’t one schedule that fits every knee. Blood sugar, planned surgery, earlier shots, and cartilage concerns can all change the answer. Tell the doctor how much the last shot helped and how long relief lasted. If each shot helps less, ask about a different choice. ## Where can I get a cortisone shot? The office listed near Surprise is in Peoria. A doctor there can examine the knee and decide whether cortisone fits your health and symptoms. Take medicine names, earlier shot dates, and any surgery plans. Seek urgent care instead for fever, sudden loss of movement, or fast-rising heat and swelling. ## Ongoing soreness deserves a closer look What if the soreness doesn’t settle? QC Kinetix offers consultations and regenerative treatments, clinic care using material prepared from your own body. One choice is platelet-rich plasma, or PRP, made by spinning your blood to collect platelets, blood parts that carry natural growth factors. A doctor can review your knee and help you compare non-surgical choices. Book a free consultation: --- Steady help for a sore knee. Plain help for knee soreness, care at home, treatment choices, and changes that need a prompt exam. Plain help with knee soreness, care at home, treatment choices, and urgent warning signs. This site is operated by the owners of the QC Kinetix Phoenix-area clinics, including the Peoria office recommended here, and the business may benefit when a reader books a consultation. Copyright 2026 The Surprise Knee Risk Desk. This is general education; it is not medical advice about an individual joint.