Several types of injections are used to treat pain, and the right one depends on where your pain is and what’s causing it. The most common categories include corticosteroid injections, local anesthetic injections, nerve blocks, hyaluronic acid injections, and platelet-rich plasma (PRP) therapy. Some target inflamed joints, others interrupt pain signals from specific nerves, and others aim to help damaged tissue heal.
Corticosteroid Injections
Corticosteroid injections are the most widely used type of pain injection. They deliver a powerful anti-inflammatory medication directly to the source of pain, whether that’s a joint, the space around the spinal cord, or soft tissue. The steroids most commonly used include methylprednisolone, dexamethasone, and betamethasone, often mixed with a local anesthetic like lidocaine for immediate but temporary relief while the steroid takes effect over the following days.
These injections treat a broad range of conditions: knee and hip arthritis, shoulder bursitis, lower back pain from herniated discs, and inflamed tendons. The steroid reduces swelling and calms the immune response in the area, which lowers pain and can improve mobility. Relief typically lasts weeks to a few months, and the injection can be repeated a limited number of times per year to avoid weakening surrounding tissue.
Epidural Steroid Injections for Back and Leg Pain
Epidural steroid injections place corticosteroid medication into the epidural space surrounding the spinal cord. They’re one of the go-to treatments for sciatica caused by a herniated disc, where a bulging disc presses on a nerve root and sends pain radiating down the leg. In clinical studies of patients with sciatica from disc herniation, between 60% and 86% of those who received epidural steroid injections reported their pain dropped by more than half.
The relief from an epidural is often temporary, but that’s partly the point. The window of reduced pain creates an opportunity for focused physical therapy and core strengthening, which can address the underlying problem. Many patients find that the combination of injection plus rehabilitation provides longer-lasting improvement than either approach alone.
Joint Injections
When pain originates inside a joint, injections can be placed directly into the joint space. This is common for osteoarthritis in the knee, hip, shoulder, and sacroiliac (SI) joint at the base of the spine. For SI joint injections specifically, research shows that about 55% of patients who respond well to the initial anesthetic achieve at least 50% pain relief at two to four weeks.
Facet joint injections target the small joints along the back of the spine that can become arthritic and painful. These injections serve a dual purpose: they’re both diagnostic and therapeutic. If injecting the joint relieves your pain, it confirms that specific joint as the source. If the relief is short-lived, your doctor may recommend a more lasting procedure called radiofrequency ablation, which uses heat to disable the tiny nerves supplying that joint.
Nerve Blocks
Nerve blocks work by delivering anesthetic (and sometimes a steroid) directly around a specific nerve or group of nerves to interrupt pain signals. They can be used almost anywhere in the body. A suprascapular nerve block, for instance, numbs the main nerve supplying the shoulder and is sometimes given before physical therapy sessions for frozen shoulder so you can stretch further without pain.
A stellate ganglion block targets a cluster of nerves in the neck and is used for conditions like complex regional pain syndrome (CRPS) in the arm or hand, nerve pain after shingles, phantom limb pain, and certain vascular conditions like Raynaud disease. It has also shown benefit for cluster headaches and, more recently, post-traumatic stress disorder.
Nerve blocks can be a single treatment, part of a series, or a diagnostic step before a longer-lasting procedure. The key advantage is precision: rather than medicating your whole body, the injection targets only the nerves responsible for your pain.
Trigger Point Injections for Muscle Pain
Trigger points are tight, painful knots that form in muscles and can refer pain to other areas of the body. Trigger point injections place a small amount of local anesthetic directly into the knot, which relaxes the muscle and breaks the pain cycle. They’re commonly used for myofascial pain syndrome, tension headaches originating from neck muscles, and chronic muscle spasms.
Interestingly, research has consistently shown that adding a corticosteroid to the anesthetic doesn’t improve outcomes. In randomized trials, patients who received lidocaine alone had the same pain relief as those who received lidocaine plus a steroid, both at the time of injection and at one and three month follow-ups. Some studies have even found that the physical act of needling the trigger point itself provides relief regardless of what’s injected. This means the procedure works primarily by disrupting the taut muscle band, not through the medication’s anti-inflammatory effects.
Hyaluronic Acid Injections for Knee Arthritis
Hyaluronic acid injections, also called viscosupplementation, take a different approach from steroids. Instead of reducing inflammation, they supplement the natural lubricating fluid inside the knee joint that breaks down with osteoarthritis. The goal is to improve cushioning and reduce friction between the bones.
There are currently 12 FDA-approved viscosupplementation products in the United States. Some require just a single injection (Synvisc-One, Durolane, Monovisc, Gel-One), while others require a series of weekly injections over three to five weeks (Euflexxa, Hyalgan, Orthovisc, Supartz FX, Synvisc, Gelsyn-3, Genvisc 850). Single-injection options are more convenient and mean fewer office visits, though they contain the same type of gel-like substance. These injections are typically considered after oral pain relievers and physical therapy haven’t provided enough relief, and they can be repeated every six months.
Platelet-Rich Plasma (PRP) Therapy
PRP injections use a concentrated portion of your own blood. A small blood draw is spun in a centrifuge to separate the platelets, which contain growth factors that promote tissue repair. The concentrated platelets are then injected into the painful area. Because it uses your own biology, PRP carries minimal risk of allergic reaction.
PRP is used across a wide range of musculoskeletal conditions. For knee and ankle osteoarthritis, it has emerged as a viable option for postponing surgery. For tendon problems, it has shown benefits in lateral epicondylitis (tennis elbow), plantar fasciitis, patellar tendinopathy (jumper’s knee), and rotator cuff tendinopathy, with improvements in pain and function lasting 12 months or longer in some studies. It’s also being used for lower back pain from disc degeneration, facet joint problems, and sacroiliac joint pain, as well as for frozen shoulder and myofascial pain syndrome.
PRP is not yet universally covered by insurance, and the evidence, while promising, varies by condition. It tends to work best for chronic tendon injuries and mild to moderate joint arthritis rather than severe structural damage.
What to Expect During and After
Most pain injections are outpatient procedures that take 15 to 30 minutes. Depending on the location, your doctor may use ultrasound or fluoroscopy (a type of live X-ray) to guide the needle precisely to the target. You’ll typically feel pressure and a brief sting. For deeper injections like epidurals or nerve blocks, a local anesthetic numbs the skin first.
Temporary soreness at the injection site is the most common side effect, occurring in roughly 32% to 74% of patients depending on the type of spinal injection. Radiating pain after the procedure happens in about 9% to 35% of cases, particularly with injections near nerve roots, but resolves on its own. Temporary numbness or tingling occurs in 2% to 18% of cases. Serious complications like infection or lasting nerve damage are rare. In one prospective study of nearly 300 spinal injections, no persistent neurological problems, infections, or severe systemic reactions occurred.
After a corticosteroid injection, plan on resting the affected area for one to two days. For lower-body injections, you can begin light activity like cycling or bodyweight exercises after 24 to 48 hours, then gradually return to full activity as your symptoms allow. This rest period helps the medication stay concentrated at the injection site rather than being flushed into the bloodstream by movement. Applying ice to the area for the first day can help with any post-injection soreness.