When should a sore joint be checked first?

Which symptoms call for help now?

Please seek prompt care if you have a fever and the joint becomes very hot or swollen. Those signs can point to an infection.

Call quickly when soreness grows worse for days after a joint procedure. A doctor needs to check that change.

After an injury, don’t wait if the joint swells fast or looks out of place. Sudden weakness or numbness also needs quick attention.

Being unable to bear weight means you can’t stand or take steps on that leg. Please arrange a prompt exam for that.

What should you tell the doctor?

Bring every prescription, store-bought medicine, and vitamin you use. Your full list helps the doctor avoid harmful drug effects.

Please mention diabetes, blood thinners, bleeding trouble, or any current infection. Each one can change what is safe for you.

A cortisone procedure within three months before joint replacement has been linked with more infection risk, so please ask your surgeon whether you need to avoid it during that time. Don’t book it until you have that answer.

Please don’t stop a prescribed medicine on your own. The doctor who knows your health can guide that choice.

What is a routine visit like?

The doctor will ask about the first ache and which movements bring it on. You can explain what the soreness stops you doing.

Next comes an exam of motion, strength, warmth, and swelling. It’s a calm and fairly simple exam.

The doctor may review an x-ray or another scan when the exam leaves a question. You won’t need one at every visit.

Before you leave, please ask what soreness is normal afterward and when to call. You deserve an answer in plain words.

Sources

1. 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.

2. In a 2-year double-blind RCT of 140 patients with symptomatic knee OA and ultrasound synovitis, 40 mg intra-articular triamcinolone every 12 weeks produced significantly greater cartilage volume loss than saline (index compartment cartilage thickness change -0.21 mm vs -0.10 mm; between-group difference -0.11 mm, 95% CI -0.20 to -0.03) with no significant difference in knee pain.

   McAlindon TE, et al. — Effect of Intra-articular Triamcinolone vs Saline on Knee Cartilage Volume and Pain in Patients With Knee Osteoarthritis: A Randomized Clinical Trial.. JAMA, 2017. DOI: 10.1001/jama.2017.5283.

3. 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.

4. The RUbICOn mixed-methods HTA study, commissioned specifically to address uncertainty about recurrent injections, combined a UK primary-care cohort (2005-2020) linked to hospital data with a safety analysis, patient and clinician interviews, and a three-round Delphi to set research priorities - the current formal acknowledgement that the long-term risks and benefits of repeat injections remain unresolved.

   Whitehouse MR, et al. — RecUrrent Intra-articular Corticosteroid injections in Osteoarthritis: the RUbICOn mixed-methods study.. Health Technol Assess, 2025. DOI: 10.3310/LFAJ9337.

5. A JBJS Reviews synthesis notes that although severe complications of corticosteroid injection - infection, tendon rupture, osteonecrosis - are rare, less severe skin reactions and flare responses are not, and that effects on blood glucose matter particularly for patients with diabetes.

   Honcharuk E, et al. — Complications Associated with Intra-Articular and Extra-Articular Corticosteroid Injections.. JBJS Rev, 2016. DOI: 10.2106/JBJS.RVW.16.00004.

6. 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.