Gel vs. Steroid Knee Treatment

The pros and cons of knee injections

The pros and cons of knee injections

Just as no two knees are the same, not all knee injections are the same. What makes sense for someone else with osteoarthritis and chronic knee pain may not be what's best for you.

Here are a few basics to know if you’re on the path to having non-surgical treatments. Discuss these options with your doctor.

Gel injections

Infographic showing gel versus steroid injections for knee osteoarthritis.

Gel injections

Gel injections are delivered with a syringe and needle into the knee in a physician’s or healthcare provider’s office.

In the medical profession, these gel injections are collectively known as viscosupplementation. They’re also referred to as hyaluronic acid (HA) injections or hyaluronic formulation injections. 

Gel injections usually aren’t considered as a treatment option until a patient has failed other conservative treatments, such as weight loss, exercise or over-the-counter medications known as NSAIDs (nonsteroidal anti-inflammatory drugs).

Gel injections are intended to provide supplemental fluid in the knee, which helps provide lubrication between the bones. Because the knee’s synovial fluid can break down due to OA, replacing the lost fluid can help provide pain relief and improve functionality.  

Many patients who receive gel injections for their knee OA say they have less pain and better knee functionality. Some patients even tout the results from specific brands of gel shots that are no longer covered by their health insurer.

But studies haven’t fully proven if hyaluronic substances really work for knee OA, according to a 2015 article in the New England Journal of Medicine.

Cortisone injections

Cortisone injections can be delivered into knee joints, as well as hips, ankles, elbows, spine, shoulders and wrists. These injections typically include a blend of corticosteroid medication and a local anesthetic (numbing agent). They tend to cost less than gel injections and are more commonly used.

Cortisone shots are intended to help reduce inflammation. They aren’t meant to replace synovial fluid that helps lubricate the knee. 

Instead, cortisone is primarily designed to address symptoms from inflammation. When successful, a cortisone shot can provide pain relief that lasts a month and up to six months. Results will vary based on a patient’s severity of OA and other factors, such as excess weight and activity level. 

Most health insurance companies cover cortisone injections that are considered medically necessary to treat pain and inflammation in the knee due to OA. Your doctor can guide you through a diagnosis and treatment plan that may or may not include injections.

It’s always a good idea to check with your insurance provider if your doctor recommends any type of knee injections because a health insurance company may have changed its coverage requirements since you enrolled in the plan.