Joint Injection Side Effects: What's Normal and What's Not

Key Takeaways

• Most side effects from joint injections are mild and temporary, lasting 1-3 days
• Normal reactions include soreness at the injection site, minor swelling, and temporary stiffness
• Warning signs like severe pain, fever, or increasing redness need immediate medical attention
• Different injection types have different side effect profiles
• Following post-injection care instructions significantly reduces your risk of complications

If you’re considering a joint injection for knee pain or arthritis, you probably have questions about what happens after the procedure. Will it hurt? What should you expect? And most importantly, how do you know if something’s wrong?

Let’s walk through what’s normal, what’s not, and when you should contact your doctor.

Common Side Effects: What to Expect

Most people who receive joint injections experience mild, temporary side effects. These are your body’s normal response to the procedure and typically resolve on their own within a few days.

Soreness at the Injection Site

The most common side effect is tenderness or soreness right where the needle entered your skin. This is completely normal and usually feels similar to a bruise.

What’s typical:

• Mild to moderate discomfort for 1-2 days
• Pain that gradually improves, not worsens
• Tenderness when you touch the area

What helps: Apply ice for 15-20 minutes several times during the first 24 hours. Over-the-counter pain relievers like acetaminophen can help if needed.

Mild Swelling

Some swelling in the injected joint is common, especially in the first 24-48 hours. Your joint might feel slightly fuller than usual.

What’s typical:

• Slight puffiness around the joint
• A feeling of tightness or pressure
• Swelling that peaks within 24 hours then gradually decreases

What helps: Keep the joint elevated when resting. Ice can also reduce swelling. Avoid heavy activity for 24-48 hours after your injection.

Temporary Stiffness

Your joint might feel stiff or tight for a day or two after the injection. This usually improves as any swelling goes down.

What’s typical:

• Reduced range of motion for 1-2 days
• Stiffness that’s better with gentle movement
• Gradual improvement each day

What helps: Gentle movement and stretching can help. Don’t completely immobilize the joint, but also avoid vigorous exercise for the first couple of days.

The Post-Injection Timeline

Knowing what to expect day by day can help you feel more confident about the process.

First 24 Hours

• Most common time for soreness and swelling
• You might feel more discomfort than before the injection
• Ice and rest are your best friends

Days 2-3

• Injection site pain should be decreasing
• Swelling should start improving
• You can usually return to normal daily activities

Days 4-7

• Most temporary side effects have resolved
• You should start feeling the benefits of the injection
• For cortisone shots, this is when pain relief typically begins
• For hyaluronic acid injections, relief may take 2-4 weeks

Warning Signs: When to Call Your Doctor

While most side effects are harmless, certain symptoms require immediate medical attention. These could signal an infection or allergic reaction.

Signs of Infection

Joint infections after injections are rare (less than 1 in 10,000 procedures when proper sterile technique is used), but they’re serious.

Call your doctor immediately if you have:

• Fever over 100.4°F (38°C)
• Severe pain that worsens instead of improving
• Increasing redness that spreads beyond the injection site
• Warmth in the joint that increases over time
• Drainage or pus from the injection site
• Chills or feeling generally unwell

Don’t wait: Joint infections need prompt treatment with antibiotics. Early treatment prevents serious complications.

Signs of Allergic Reaction

True allergic reactions to joint injections are uncommon but can occur, especially with certain medications or preservatives.

Seek emergency care if you experience:

• Difficulty breathing or swallowing
• Swelling of the face, lips, or tongue
• Widespread rash or hives
• Dizziness or lightheadedness
• Rapid heartbeat

Less severe reactions like mild itching or localized rash should still be reported to your doctor, but these are usually not emergencies.

Other Concerning Symptoms

Contact your doctor if you notice:

• Pain that’s significantly worse 3-4 days after injection
• Numbness or tingling that doesn’t go away
• Joint that feels hot to the touch days after the procedure
• Inability to bear weight on the joint (for knee or hip injections)

Side Effects by Injection Type

Different types of joint injections have slightly different side effect profiles.

Corticosteroid Injections (Cortisone)

Cortisone shots are very effective for inflammation but can have some unique side effects.

Common:

• Temporary increase in pain (cortisone flare) in first 24-48 hours
• Facial flushing or warmth
• Temporary increase in blood sugar (important for people with diabetes)

Less common:

• Skin lightening or thinning at injection site
• Temporary increase in blood pressure

Good to know: The cortisone flare, where pain temporarily worsens before improving, happens in about 10-25% of patients. It’s uncomfortable but not dangerous and usually resolves within 2 days.

Hyaluronic Acid Injections (Gel Shots)

HA injections like Synvisc, Euflexxa, and Durolane are generally well-tolerated with fewer systemic side effects.

Common:

• Mild swelling (more common than with cortisone)
• Feeling of fullness in the joint
• Temporary warmth in the injected area

Rare:

• Pseudo-septic reaction (inflammatory response that mimics infection but isn’t one)
• Allergic reaction in patients sensitive to bird proteins (for some brands derived from rooster combs)

Good to know: Newer synthetic HA products have lower rates of allergic reactions than older animal-derived versions.

PRP (Platelet-Rich Plasma) Injections

Because PRP uses your own blood, allergic reactions are extremely rare.

Common:

• More significant swelling than other injection types
• Soreness lasting 3-5 days
• Bruising at the injection site

Good to know: PRP side effects are typically more pronounced but still temporary. The inflammation is actually part of how PRP works to promote healing.

How to Minimize Your Risk of Side Effects

While you can’t eliminate all side effects, these steps can reduce your risk and severity:

Before Your Injection

• Inform your doctor about all medications you’re taking, especially blood thinners
• Mention any allergies you have, including to local anesthetics
• Ask if you should stop certain medications like aspirin or NSAIDs before the procedure
• Ensure the procedure is done using imaging guidance when appropriate, which improves accuracy and reduces complications

During Your Injection

• Choose a provider who uses sterile technique with single-use needles and proper skin preparation
• Speak up if you feel faint or dizzy during the procedure
• Ask about the specific injection brand and any additives or preservatives

After Your Injection

• Rest the joint for 24-48 hours (no heavy lifting, running, or strenuous activity)
• Apply ice as directed to reduce swelling and discomfort
• Avoid hot tubs, swimming pools, and baths for 24 hours to reduce infection risk
• Keep the injection site clean and dry
• Take pain relievers as recommended by your doctor (usually acetaminophen rather than NSAIDs, which might reduce injection effectiveness)

Special Considerations for Seniors

If you’re over 65, there are a few additional factors to keep in mind:

Medication Interactions

Older adults often take multiple medications, which can affect how your body responds to injections:

• Blood thinners may increase bruising
• Diabetes medications may need adjustment around cortisone injections
• Immunosuppressive drugs may slightly increase infection risk

Always bring a complete medication list to your appointment.

Healing Timeline

Healing may take slightly longer as we age, so don’t be alarmed if side effects take an extra day or two to resolve compared to younger patients.

Medicare Coverage Note

Most joint injections are covered by Medicare Part B when medically necessary. Make sure your provider is Medicare-participating to avoid surprise bills, and confirm that proper documentation requirements are met.

The Bottom Line

Joint injections are generally safe procedures with a low risk of serious complications. Most side effects are mild, temporary, and manageable with simple home care.

Remember:

• Soreness, mild swelling, and stiffness for 1-3 days is normal
• Worsening pain, fever, or signs of infection need immediate attention
• Following post-injection care instructions reduces your risk
• Different injection types have different side effect profiles

If you have concerns about any symptoms after your injection, it’s always better to call your doctor than to worry. They can help you determine whether what you’re experiencing is normal or requires further evaluation.

Frequently Asked Questions

How long do side effects from joint injections last?

Most common side effects like soreness and mild swelling resolve within 2-3 days. Rare complications like infection typically show symptoms within 1-2 weeks after the injection.

Can I drive myself home after a joint injection?

Most people can drive themselves home, but if you receive sedation or have a lower extremity injection (knee, hip, ankle), you may want to arrange a ride. Ask your doctor’s office beforehand.

When can I return to exercise after a joint injection?

Avoid strenuous exercise for 24-48 hours after the injection. You can return to light activity as tolerated, usually within 2-3 days. Your doctor may provide specific guidelines based on your injection type.

Are side effects worse with repeated injections?

Not necessarily. Most people tolerate repeat injections well. However, frequent cortisone injections (more than 3-4 per year in the same joint) can increase the risk of cartilage or tendon damage over time.

What should I do if I think I’m having an allergic reaction?

Call 911 or go to the emergency room immediately if you experience difficulty breathing, facial swelling, or widespread hives. For mild symptoms like localized itching, contact your doctor’s office for guidance.

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Last medically reviewed: March 2025

Disclaimer: This article is for educational purposes only and is not a substitute for professional medical advice. Always consult your healthcare provider about questions specific to your condition and treatment.