Corticosteroid injections for the knee

The fastest option and the cheapest, and the one with the clearest ceiling on how often it can be used. A steroid injection is a way to put out a fire, not a way to run a knee for a decade.

Audience: Written for patients and carers in Malaysia
Last reviewed: 20 September 2026

What it does

A corticosteroid is a powerful anti-inflammatory. Injected into the joint, it suppresses the inflammatory cascade in the synovium, the lining that becomes irritated and swollen in an osteoarthritic knee. Pain and swelling fall quickly because the cause of that particular pain is switched off at source.

Note what it is not doing. It is not lubricating the joint, not replacing anything, and not slowing the underlying wear. When the drug is metabolised, the inflammation is free to return.

When it is the right choice

The knee is warm, swollen and painful even at rest.
You need to be functional quickly, for travel, work or a family event.
A flare is blocking physiotherapy, and settling it lets you start the exercise programme that actually changes the long-term picture.
Before starting hyaluronic acid, to calm a joint that is too inflamed for it.

The limit on how many you can have

This is the part patients are rarely told clearly. Repeated corticosteroid into the same joint has been linked to cartilage thinning over years of use. The practical consensus is a maximum of three to four injections into the same knee per year, spaced at least three months apart.

If you are reaching that ceiling, the injection is managing a problem rather than solving it, and the conversation should move on to a longer-acting option, weight and muscle work, or surgical assessment.

Side effects

Post-injection flare. Increased pain for 24 to 48 hours in a minority of people, before the improvement arrives.
Raised blood sugar. Expect several days of higher readings if you have diabetes.
Facial flushing. Common, harmless, settles in a day or two.
Skin changes. Thinning or a pale patch at the injection site, more likely with repeated injections in the same spot.
Joint infection. Rare but serious. A knee that becomes hot, very swollen and painful with fever after an injection needs same-day medical attention.

What it costs in Malaysia

RM 120 to RM 400 at most private clinics, including the consultation. It is available at government hospitals and Klinik Kesihatan as part of ordinary orthopaedic care. The low price is real, but compare it per month of relief: RM 250 for six weeks is not obviously cheaper than RM 1,200 for nine months.

At a glance

Also known as	Cortisone shot, steroid jab
Common agents	Triamcinolone, methylprednisolone
Onset	1 to 3 days
Duration	4 to 12 weeks
Frequency limit	3 to 4 per knee per year
Cost in Malaysia	RM 120 to RM 400
Time in clinic	About 15 minutes

A useful sequence

Settle the flare with a corticosteroid, use the window of comfort to build quadriceps strength, then move to a long-acting hyaluronic acid before the steroid wears off. That order gets more out of both injections than using either alone.

Questions about steroid injections

How many steroid injections can you have in one knee?

Most doctors limit corticosteroid to three or four injections in the same knee in a year, and space them at least three months apart. The limit exists because repeated steroid has been associated with cartilage loss over time, not because of an immediate risk.

How fast does a steroid injection work on the knee?

Usually within one to three days, sometimes within hours. It is the fastest of the injection options, which is why it is used for a hot, swollen, acutely painful knee.

How long does a knee steroid injection last?

Typically four to twelve weeks. Relief is often dramatic at the start and then fades. If a steroid injection gives you only two or three weeks, that is a signal to discuss a different approach rather than repeat it.

Does a steroid injection raise blood sugar?

Yes, it can, for several days after the injection. If you have diabetes, tell your doctor beforehand, monitor more closely for about a week, and expect readings to run higher than usual during that period.

Steroid or hyaluronic acid, which should I choose?

Steroid if the knee is inflamed and you need relief this week. Hyaluronic acid if the knee is mechanically painful and you want months rather than weeks. They are often used in sequence, steroid first to settle a flare and hyaluronic acid a few weeks later.