What can a doctor put into a sore joint?

What are the common kinds of shots?

A steroid shot can calm swelling for a limited time. Relief may start early, then fade during the following weeks or months.

Hyaluronic acid is the thick substance used in a gel shot. Results vary, and health plans don't always pay for this kind of care.

The letters PRP refer to platelet-rich plasma. A doctor makes it by spinning a tube of your own blood.

Plasma is the liquid portion, while platelets are tiny parts carrying healing signals. Concentrated PRP places a higher share of platelets in the prepared portion.

What does the doctor check first?

Tell the doctor when soreness started and which actions now make it worse. Mention any swelling, old injuries, and care that didn't help enough.

During the exam, your doctor checks movement, strength, and tender areas carefully. Sometimes an X-ray gives a closer look at the bones.

The soreness may start inside the joint or in nearby tissue. A painful tendon can need very different care from swelling inside the joint.

That is why a full exam comes before any shot. It lowers the chance of treating the wrong cause of soreness.

What if the joint stays sore?

For lasting soreness, QC Kinetix offers biologic therapies made with your own blood. A medical provider prepares and gives these non-surgical treatments inside the clinic.

The clinic calls PRP and concentrated PRP regenerative treatments. In this case, your blood supplies the portion that the doctor prepares.

Both forms begin when a machine spins some of your blood. The concentrated form collects more platelets in the same amount of liquid.

Surgery may still deserve discussion when joint wear is severe. The clinic exam doesn't take that choice away from you.

Sources

1. The 2019 ACR/Arthritis Foundation OA guideline makes a STRONG recommendation for intra-articular glucocorticoid injection in knee OA, alongside strong recommendations for exercise, weight loss, self-management, tai chi, cane use, bracing and NSAIDs; intra-articular steroid injection for HAND OA is only conditionally recommended.

   Kolasinski SL, et al. — 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Management of Osteoarthritis of the Hand, Hip, and Knee.. Arthritis Rheumatol, 2020. DOI: 10.1002/art.41142.

2. A clinical review of peripheral joint injections frames them as a treatment for joint-mediated pain (arthritis, tendinopathy, bursitis) that has NOT responded to conservative management, and states plainly that these injections are typically not curative - their objective is to reduce pain enough to allow physical and pharmacologic rehabilitation to work.

   Marcolina A, et al. — Peripheral Joint Injections.. Phys Med Rehabil Clin N Am, 2022. DOI: 10.1016/j.pmr.2022.01.005.

3. The 2015 Cochrane review of 27 trials (1,767 participants) found intra-articular corticosteroid better than sham for knee OA pain (SMD -0.40, 95% CI -0.58 to -0.22; NNTB 8), but the benefit decayed with time: moderate at 1-2 weeks, small at 13 weeks, and no evidence of any effect at 26 weeks. All outcomes were graded LOW quality.

   Jüni P, et al. — Intra-articular corticosteroid for knee osteoarthritis.. Cochrane Database Syst Rev, 2015. DOI: 10.1002/14651858.CD005328.pub3.

4. 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.. Clin Orthop Relat Res, 2022. DOI: 10.1097/CORR.0000000000002055.

5. A 2022 BMJ systematic review and meta-analysis of 169 trials (21,163 participants) found viscosupplementation produced only a small pain reduction versus placebo (SMD -0.08, 95% CI -0.15 to -0.02; about -2.0 mm on a 100 mm VAS), below the minimal clinically important difference, and trial sequential analysis indicated conclusive evidence of clinical equivalence with placebo since 2009.

   Pereira TV, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

6. A 2025 network meta-analysis restricted to LARGE randomized trials (57 RCTs, 22,795 participants, 18 intra-articular interventions) found treatment effects were larger in the 35 high-risk-of-bias trials than in the 22 low/unclear-risk trials; excluding high-risk trials, triamcinolone had the highest probability of exceeding the minimal important difference at weeks 2 and 6, while hyaluronic acid had no effect on pain (SMD -0.04, 95% CrI -0.19 to 0.11) and higher odds of dropouts due to adverse events (OR 2.01) and serious adverse events (OR 1.86) than placebo.

   Pereira TV, et al. — Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis.. Osteoarthritis Cartilage, 2025. DOI: 10.1016/j.joca.2024.08.014.

7. Medicare Part B claims show hyaluronic acid injections rose from 1,090,503 services in 2012 to 1,209,489 in 2018 and total costs from $290.10 million to $325.02 million (2020 dollars) - utilisation and spending both increased despite the AAOS recommendation against routine use.

   Zhu KY, et al. — Hyaluronic Acid Injections for Knee Osteoarthritis: Has Utilization Among Medicare Beneficiaries Changed Between 2012 and 2018?. J Bone Joint Surg Am, 2022. DOI: 10.2106/JBJS.21.00832.

8. The RESTORE randomized trial (288 participants, leukocyte-poor PRP, 3 weekly injections) found no significant difference from saline placebo at 12 months in knee pain (-2.1 vs -1.8 points; difference -0.4, 95% CI -0.9 to 0.2) or in medial tibial cartilage volume (-1.4% vs -1.2%), with 29 of 31 secondary outcomes also showing no between-group difference.

   Bennell KL, et al. — Effect of Intra-articular Platelet-Rich Plasma vs Placebo Injection on Pain and Medial Tibial Cartilage Volume in Patients With Knee Osteoarthritis: The RESTORE Randomized Clinical Trial.. JAMA, 2021. DOI: 10.1001/jama.2021.19415.

9. A 2024 network meta-analysis of 48 studies (9,338 knees) at minimum 6-month follow-up ranked PRP first for pain and function (SUCRA 91.5), then BMAC (76.5) and hyaluronic acid (53.1), with corticosteroid (15.2) barely above placebo (13.7) at that time point.

   Jawanda H, et al. — Platelet-Rich Plasma, Bone Marrow Aspirate Concentrate, and Hyaluronic Acid Injections Outperform Corticosteroids in Pain and Function Scores at a Minimum of 6 Months as Intra-Articular Injections for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.. Arthroscopy, 2024. DOI: 10.1016/j.arthro.2024.01.037.

10. A systematic review of 105 clinical orthopaedic PRP studies found only 11 (10%) described the preparation protocol well enough to be repeated, and only 17 (16%) reported quantitative metrics on the composition of the final PRP product - so 'PRP' in one trial is frequently not the same product as 'PRP' in another.

    Chahla J, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature.. J Bone Joint Surg Am, 2017. DOI: 10.2106/JBJS.16.01374.

11. FDA's HCT/P guidance sets out the minimal-manipulation and homologous-use criteria that decide whether a human cell or tissue product is regulated solely under 21 CFR Part 1271 (section 361) or requires a biologics licence; cell-based orthopaedic injections that fall outside those criteria are unapproved drugs and biological products, and no cell-based product is FDA-approved to treat osteoarthritis.

    U.S. Food and Drug Administration — Regulatory Considerations for Human Cells, Tissues, and Cellular and Tissue-Based Products: Minimal Manipulation and Homologous Use - Guidance for Industry and FDA Staff. U.S. Food and Drug Administration, 2020.

12. A systematic review of eight studies (299 knees, mean follow-up 12.9 months) found BMAC improved 34 of 36 patient-reported outcomes from baseline, but all three comparative studies failed to show BMAC superior to other biologic injections or to placebo - a finding the authors weigh against its high cost.

    Keeling LE, et al. — Bone Marrow Aspirate Concentrate for the Treatment of Knee Osteoarthritis: A Systematic Review.. Am J Sports Med, 2022. DOI: 10.1177/03635465211018837.

13. The 2025 Cochrane living review of stem cell injections for knee OA (25 trials, 1,341 participants) found stem cell injection MAY slightly improve pain and function up to six months versus placebo (pain 1.2 points better on a 0-10 scale; function 14.2 points better on 0-100), but rated the evidence LOW certainty for both, downgraded for indirectness and suspected publication bias, with up to three larger RCTs withdrawn before reporting results.

    Whittle SL, et al. — Stem cell injections for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2025. DOI: 10.1002/14651858.CD013342.pub2.

14. A meta-analysis of 14 placebo cohorts (1,076 patients) found intra-articular NORMAL SALINE alone produced statistically and clinically meaningful improvement in VAS pain and WOMAC scores lasting up to 6 months - meaning a large share of the improvement people attribute to an injection is not attributable to the drug in the syringe.

    Saltzman BM, et al. — The Therapeutic Effect of Intra-articular Normal Saline Injections for Knee Osteoarthritis: A Meta-analysis of Evidence Level 1 Studies.. Am J Sports Med, 2017. DOI: 10.1177/0363546516680607.

15. A study using fluoroscopy as the reference standard confirmed that injectate placed into the suprapatellar recess under ultrasound guidance disperses into the tibiofemoral joint after a brief bout of walking, and that blinded radiologist review corroborated the interventionalist's reading of correct needle placement.

    Varlotta C, et al. — Accuracy of ultrasound-guided knee injections confirmed by fluoroscopy.. Interv Pain Med, 2023. DOI: 10.1016/j.inpm.2022.100174.

16. 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.. MMWR Morb Mortal Wkly Rep, 2017. DOI: 10.15585/mmwr.mm6629a3.