First-Time Injection Guide: What to Expect Before, During & After

Your Complete First-Time Injection Guide

Getting your first joint injection can feel intimidating, but knowing what to expect makes the experience much easier. This guide walks you through every step—from preparation to recovery—so you can feel confident and get the best results.

Before Your Appointment

1 Week Before

Medical Preparation:

Confirm your appointment time and location
Verify insurance coverage and any prior authorization
Ask about stopping blood thinners (if applicable—consult your doctor)
Fill any prescribed medications you’ll need after

Questions to Ask When Scheduling:

How long will the appointment take?
Should I eat beforehand?
Can I drive myself home?
What should I wear?

1-2 Days Before

Practical Preparation:

Arrange transportation if you prefer not to drive after
Wear or bring loose, comfortable clothing (shorts for knee, loose shirt for shoulder)
Avoid applying lotions or creams to the injection area
Get good sleep—it helps with pain tolerance

Medication Considerations:

Continue taking your regular medications unless told otherwise
Ask about NSAIDs (ibuprofen, naproxen)—some doctors prefer you stop 1-2 days before
Blood thinners: Follow your doctor’s specific instructions (varies by medication and procedure)

Day Of

Morning of Your Appointment:

Eat a light meal (you won’t be sedated, and eating helps prevent lightheadedness)
Stay hydrated
Take allowed medications as usual
Arrive 10-15 minutes early for paperwork

What to Bring:

Insurance card
Photo ID
List of current medications
Questions you want to ask
Someone to take notes (optional but helpful)

During the Procedure

Check-In Process (10-15 minutes)

When you arrive:

Complete any remaining paperwork
Review consent forms
Confirm allergies (especially important for HA injections—bird/egg allergies)
Discuss any last-minute questions

The Injection Room

What You’ll See:

Exam table or chair
Sterile supplies
Ultrasound or fluoroscopy machine (for guided injections)
The injection medication

Positioning:

Knee: Sitting or lying down with knee slightly bent
Hip: Lying on your side or back
Shoulder: Sitting up or lying on unaffected side

The Procedure (15-30 minutes total)

Step 1: Preparation

Area is cleaned with antiseptic
Sterile drape placed around injection site
If using guidance, ultrasound gel or positioning occurs

Step 2: Numbing (Optional)

Some providers apply numbing spray or inject local anesthetic
This feels like a brief pinch or cold sensation
Makes the main injection more comfortable

Step 3: The Injection

If fluid is present, it may be aspirated (drained) first
The medication is slowly injected into the joint
You may feel pressure but shouldn’t feel sharp pain
Deep breaths help you stay relaxed

Step 4: Completion

Needle is removed
Small bandage applied
You may be asked to bend/move the joint gently

What It Actually Feels Like

Honest Patient Descriptions:

“A brief pinch, then pressure—easier than expected”
“The numbing shot was the worst part, then I barely felt anything”
“Weird pressure sensation, but not painful”
“Less uncomfortable than getting blood drawn”

Pain Scale: Most patients rate it 2-4 out of 10. Anxiety often makes it seem worse than it is.

Immediately After

First 30 Minutes

In the Office:

Stay seated for 5-10 minutes
Report any unusual symptoms (dizziness, significant pain, allergic reactions)
Receive post-care instructions
Schedule follow-up if needed

Heading Home:

You can usually drive yourself (unless you feel lightheaded)
The joint may feel “full” or slightly numb
Some temporary improvement from any numbing agent used

First 24-48 Hours

Normal Experiences:

Mild soreness at injection site
Slight swelling
The joint feeling “different”
Temporary stiffness

Activity Restrictions:

Avoid strenuous activity for 24-48 hours
No running, jumping, or heavy lifting
Walking and gentle movement are usually fine
Ice the area for 15-20 minutes if swollen

Pain Management:

Acetaminophen (Tylenol) is usually recommended
Ask about NSAIDs—some doctors prefer you wait
Ice as needed
Rest the joint when possible

Warning Signs (Rare but Important)

Contact your doctor immediately if you experience:

Severe or worsening pain
Significant swelling, redness, or warmth
Fever over 100.4°F
Drainage from injection site
Inability to bear weight (if you could before)

These symptoms are rare but could indicate infection, which requires prompt treatment.

The Recovery Timeline

Days 1-3: Initial Recovery

What to Expect:

Injection site soreness (normal)
Possible “flare” reaction (temporary increase in symptoms)
Begin returning to normal activities

What to Do:

Continue icing as needed
Gentle range of motion exercises
Avoid high-impact activities
Take pain relievers as directed

Days 4-7: Adjustment Period

What to Expect:

Soreness improving
May not feel full benefit yet (especially HA)
Gradually returning to normal routine

What to Do:

Resume light exercise
Continue any physical therapy
Listen to your body—don’t push too hard

Weeks 1-4: Seeing Results

For Cortisone Injections:

Often feel improvement within 2-7 days
Maximum benefit usually by 1-2 weeks
Relief typically lasts 6-12 weeks

For HA (Gel) Injections:

May take 2-4 weeks for full effect
Gradual improvement rather than sudden
Relief typically lasts 6-12 months

Long-Term Results

Maximizing Your Results:

Follow through with recommended physical therapy
Maintain healthy weight
Stay active within your comfort level
Use proper joint protection techniques
Keep follow-up appointments

Special Situations

If You Have Bird/Egg Allergies

Before HA Injections:

Tell your doctor about any allergies
Some HA products are derived from rooster combs (avian source)
Non-avian alternatives are available (Euflexxa, Durolane, etc.)
Your doctor will select an appropriate product

If You’re on Blood Thinners

Common Medications Affected:

Warfarin (Coumadin)
Aspirin
Clopidogrel (Plavix)
Direct oral anticoagulants (Eliquis, Xarelto)

What to Know:

Your doctor will advise whether to continue or pause
Risks and benefits are weighed individually
Guided injections reduce bleeding risk
More bruising may occur, which is usually harmless

If You Have Diabetes

Blood sugar may temporarily increase after cortisone
Monitor more frequently for 1-2 weeks after injection
HA injections don’t typically affect blood sugar
Inform your diabetes care team about the injection

Frequently Asked Questions

”Will it hurt?”

Most patients find injections less painful than expected. On a scale of 1-10, the average is 2-4. Numbing options are available, and the actual injection takes only seconds.

”Can I drive home?”

Usually yes, unless you feel lightheaded or the injection was in a joint that affects driving. Many patients prefer having someone with them for the first time.

”When can I exercise again?”

Light walking is fine immediately. Wait 24-48 hours for strenuous activity. Your doctor will give specific guidance based on your situation.

”What if it doesn’t work?”

Not everyone responds to every treatment. If one injection doesn’t help, options include:

Trying a different type of injection
Different HA brand
Combination with other treatments
Discussing next steps with your doctor

”How often can I get injections?”

Cortisone: Usually limited to 3-4 per year per joint
HA injections: Typically every 6-12 months
Your doctor will recommend appropriate intervals

Checklist: First Injection Prep

1 Week Before:

Appointment confirmed
Insurance verified
Blood thinner instructions received (if applicable)
Questions list started

Day Before:

Comfortable clothing ready
Transportation arranged
Good night’s sleep planned
Medications reviewed

Day Of:

Light meal eaten
Insurance card and ID packed
Arrived 10-15 minutes early
Questions ready to ask

After Procedure:

Received written instructions
Know warning signs to watch for
Follow-up scheduled if needed
Emergency contact number saved