How much relief can a joint treatment bring?

Which choices may help for a while?

A steroid shot may ease a sore knee for a short time. Relief is often strongest during the early weeks, then fades. That can still matter if you're sleeping better or walking again.

Don't book more steroid shots just because a date comes up. Long studies disagree about what repeated shots do to the joint. Ask why another one fits your joint and how the clinician will check it.

Even when the first shot helps, another may not. Soreness rises and falls by itself, so one easier week can't prove the shot caused every bit of relief.

Brief help can be useful. It isn't a repair.

What is still uncertain?

Large reviews found little added relief from gel on average. Some people do feel better, but nobody can promise you'll be among them.

The letters PRP stand for platelet-rich plasma. A clinic spins your blood so tiny pieces called platelets collect in a smaller amount of liquid. Those platelets normally help your body stop bleeding and begin healing. The clinician then puts the prepared blood into the joint. Results aren't settled.

Marrow concentrate begins with marrow drawn from your pelvis. The clinic spins it down and puts the saved portion into your joint. Studies haven't clearly shown better walking or less soreness than cheaper choices provide.

The honest part is simple: an average can't predict the relief you'll notice.

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. A 2022 BMJ systematic review and meta-analysis of 169 trials (21,163 participants) found viscosupplementation produced only a small pain reduction versus placebo (SMD -0.08, 95% CI -0.15 to -0.02; about -2.0 mm on a 100 mm VAS), below the minimal clinically important difference, and trial sequential analysis indicated conclusive evidence of clinical equivalence with placebo since 2009.

   Pereira TV, et al. — Viscosupplementation for knee osteoarthritis: systematic review and meta-analysis.. BMJ, 2022. DOI: 10.1136/bmj-2022-069722.

3. A 2025 network meta-analysis restricted to LARGE randomized trials (57 RCTs, 22,795 participants, 18 intra-articular interventions) found treatment effects were larger in the 35 high-risk-of-bias trials than in the 22 low/unclear-risk trials; excluding high-risk trials, triamcinolone had the highest probability of exceeding the minimal important difference at weeks 2 and 6, while hyaluronic acid had no effect on pain (SMD -0.04, 95% CrI -0.19 to 0.11) and higher odds of dropouts due to adverse events (OR 2.01) and serious adverse events (OR 1.86) than placebo.

   Pereira TV, et al. — Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network meta-analysis.. Osteoarthritis Cartilage, 2025. DOI: 10.1016/j.joca.2024.08.014.

4. A network meta-analysis of 43 trials (5,554 patients) reached the OPPOSITE ranking to several PRP-favourable reviews: steroids ranked most likely to be effective for pain and function, with adipose MSC and multiple PRP injections ranked least likely, and steroids and hyaluronic acid showed lower adverse-event rates than placebo.

   Han SB, et al. — Intra-Articular Injections of Hyaluronic Acid or Steroids Associated With Better Outcomes Than Platelet-Rich Plasma, Adipose Mesenchymal Stromal Cells, or Placebo in Knee Osteoarthritis: A Network Meta-analysis.. Arthroscopy, 2021. DOI: 10.1016/j.arthro.2020.03.041.

5. A 2024 network meta-analysis of 48 studies (9,338 knees) at minimum 6-month follow-up ranked PRP first for pain and function (SUCRA 91.5), then BMAC (76.5) and hyaluronic acid (53.1), with corticosteroid (15.2) barely above placebo (13.7) at that time point.

   Jawanda H, et al. — Platelet-Rich Plasma, Bone Marrow Aspirate Concentrate, and Hyaluronic Acid Injections Outperform Corticosteroids in Pain and Function Scores at a Minimum of 6 Months as Intra-Articular Injections for Knee Osteoarthritis: A Systematic Review and Network Meta-analysis.. Arthroscopy, 2024. DOI: 10.1016/j.arthro.2024.01.037.

6. An analysis of 37 randomized PRP trials found no significant difference in qualitative conclusions or outcome scores between industry-affiliated and non-industry-affiliated studies; overall, 19 of 37 (51.4%) reported PRP as favourable and 18 (48.6%) found no difference from comparators.

   Ta CN, et al. — The Influence of Industry Affiliation on Randomized Controlled Trials of Platelet-Rich Plasma for Knee Osteoarthritis.. Am J Sports Med, 2023. DOI: 10.1177/03635465221140917.

7. A systematic review of 105 clinical orthopaedic PRP studies found only 11 (10%) described the preparation protocol well enough to be repeated, and only 17 (16%) reported quantitative metrics on the composition of the final PRP product - so 'PRP' in one trial is frequently not the same product as 'PRP' in another.

   Chahla J, et al. — A Call for Standardization in Platelet-Rich Plasma Preparation Protocols and Composition Reporting: A Systematic Review of the Clinical Orthopaedic Literature.. J Bone Joint Surg Am, 2017. DOI: 10.2106/JBJS.16.01374.

8. A 2025 EFORT Open Reviews synthesis of evidence-based orthobiologics guidance notes that meta-analyses report PRP improving patient-reported outcomes in knee osteoarthritis, lateral epicondylitis and plantar fasciitis, but that the underlying RCTs frequently carry a high risk of bias driven by heterogeneous preparation protocols and inconsistent trial quality.

   Winkler T, et al. — Evidence-based guidelines on orthobiologics.. EFORT Open Rev, 2025. DOI: 10.1530/EOR-2025-0069.

9. The 2025 Cochrane living review of stem cell injections for knee OA (25 trials, 1,341 participants) found stem cell injection MAY slightly improve pain and function up to six months versus placebo (pain 1.2 points better on a 0-10 scale; function 14.2 points better on 0-100), but rated the evidence LOW certainty for both, downgraded for indirectness and suspected publication bias, with up to three larger RCTs withdrawn before reporting results.

   Whittle SL, et al. — Stem cell injections for osteoarthritis of the knee.. Cochrane Database Syst Rev, 2025. DOI: 10.1002/14651858.CD013342.pub2.

10. A network meta-analysis of pharmacologic knee OA treatments found intra-articular treatments were superior to oral NSAIDs, and the authors attributed this at least partly to the integrated placebo effect of the injection itself rather than to the injected substance.

    Bannuru RR, et al. — Comparative effectiveness of pharmacologic interventions for knee osteoarthritis: a systematic review and network meta-analysis.. Ann Intern Med, 2015. DOI: 10.7326/M14-1231.