Steroid vs Gel Injections for Knee Arthritis

A knee injection isn’t something most people rush into. It’s usually considered when the pain has become so intrusive that simple daily activities feel like a battle — climbing stairs, walking the dog, or even sleeping comfortably at night.

But injections aren’t meant to replace the basics. For many people with arthritis, the real breakthrough comes not from a needle, but from a structured physiotherapy approach. That means:

• Hands-on treatment to free up stiff joints and calm irritated tissues.
• Tailored strengthening exercises that protect your knee rather than flare it up
• Building the muscles that act as natural shock absorbers around the joint.

Done well, this combination allows many people to stay active, reduce pain, and delay or even avoid the need for injections altogether.

So when should you consider one? Only after giving these proven approaches an honest try. If your pain is still controlling your life despite consistent physio, exercise, and self-care, then — and only then — a knee injection might be the next step to help you move forward.

Steroid injections are one of the most common treatments offered for knee arthritis, and it’s easy to see why. They often provide rapid relief, sometimes within just a day or two. For many people, that means walking feels easier, climbing stairs isn’t such a battle, and even sleeping through the night becomes possible again.

The results, though, can vary from person to person. Some people notice only a few days of improvement, while others are fortunate enough to get years of benefit. Most people fall somewhere in between, experiencing a few weeks to a few months of reduced pain and swelling. Even if the relief is temporary, it can be a powerful turning point — especially when pain has been constant and draining.

It’s important to know that steroid injections don’t cure arthritis or repair the underlying wear in the joint. They work by calming down the inflammation that makes the knee sore and swollen. There is also some research suggesting that repeated use over the long term may not be ideal for joint health. But used carefully, they can be incredibly helpful.

The real opportunity with a steroid injection comes in what you do next.

That window of reduced pain is the perfect time to focus on gentle physiotherapy, rebuilding strength in the muscles around the knee, and restoring movement. By taking advantage of that pain-free period, you’re setting your knee up to cope better long after the injection has worn off.

Another option for knee arthritis is a gel injection, often known by brand names like Ostenil. Unlike steroid injections, which focus on calming inflammation, gel injections are designed to lubricate the joint and improve its overall health. The substance used is very similar to the fluid your body naturally produces inside the knee, and topping this up can help the joint move more smoothly.

For many people, the benefit of a gel injection is in the longer-term effect. By improving lubrication, these injections can reduce friction in the joint, ease stiffness, and even help preserve the joint surfaces over time. That makes them an appealing choice for people who want not only pain relief but also a way to support the knee’s health in the years ahead.

The results aren’t always immediate. Unlike a steroid injection, which can sometimes bring rapid relief within days, gel injections often take a little longer to “bed in.” Some people notice gradual improvement over several weeks, with benefits that may last for months or even longer.

That’s why in many cases we prefer gel injections: they can offer more than just short-term comfort. When combined with physiotherapy and exercise, they provide a foundation for keeping the knee healthier, more mobile, and better protected against further wear.

While injections can be helpful for many people with arthritis, there are times when they’re not the best option. One of the most important situations is if you’re already on the path towards a knee replacement.

Surgeons are very cautious about operating on a knee that has recently had a steroid injection. The reason is that steroids temporarily dampen your immune response inside the joint. If a replacement is carried out too soon afterwards, the risk of infection around the new implant goes up significantly. For that reason, most surgeons will insist on a six-month gap between a steroid injection and knee replacement surgery.

That means if you’re already considering, or even on the waiting list for, a knee replacement, having a steroid injection could delay your operation. In these cases, it’s often better to look at alternatives — whether that’s physiotherapy to maintain strength while you wait, or a gel injection such as Ostenil, which doesn’t carry the same surgical restriction.

In short, injections can be valuable tools, but timing matters. Making the right choice depends not only on how painful your knee feels now, but also on your longer-term plan for treatment.

Living with knee arthritis can feel like an endless cycle of pain, frustration, and difficult decisions. When you’re told about injections, it’s natural to wonder if they’re the answer or just another stopgap.

The truth is, both steroid and gel injections can play a useful role, but in different ways. Steroids often provide fast relief, creating a short term window to get moving again. Gel injections like Ostenil may not act as quickly, but they can support the joint in the longer term and help preserve its surfaces. And just as important, there are times, such as when a knee replacement is planned, when injections may not be the right choice at all.

What matters most is having a clear plan that fits your situation. For some, that means using an injection to buy time and strength. For others, it means holding off, focusing on physiotherapy, and preparing the knee for surgery. Either way, the goal is the same: to keep you moving, reduce pain, and help you feel in control of your future.

If you’re weighing up injections, remember this: you don’t have to make the decision alone. The best outcomes come when treatment is tailored to you, your knee, your lifestyle, and your goals. With the right advice and support, you can move forward with confidence, knowing each step you take is getting you closer to living the life you want.

Joe Sharp

BSc (Hons) Physiotherapy