Joint Injections in Southlake, TX
Cortisone injections for knees, shoulders and hands, done in the office rather than after a six-week referral wait.
We see patients age 16 and older.
We do corticosteroid joint injections in the office, at your appointment, without sending you across town for a separate orthopedic visit six weeks out. For the right problem it is a five-minute procedure that buys enough relief to do the physical therapy that actually lasts.
Joints we inject
- Knee. The most common by a wide margin, usually for osteoarthritis or a flare of it.
- Shoulder. Subacromial injections for impingement and rotator cuff tendinopathy, and glenohumeral injections for adhesive capsulitis.
- Hand and wrist. Thumb base arthritis, trigger finger, and de Quervain’s tenosynovitis, all of which respond well.
- Elbow. Lateral and medial epicondylitis, where injections help short term.
- Bursae. Trochanteric bursitis at the hip and olecranon bursitis at the elbow.
Hip joint injections need imaging guidance and we refer those out.
What an injection is for
A cortisone injection reduces inflammation. It does not rebuild cartilage and it does not fix the underlying joint.
That sounds like a limitation and it is, but it misunderstands the goal. The point is to break the cycle where pain stops you moving, not moving weakens the muscles around the joint, and weaker muscles load the joint harder. An injection that gives you eight weeks of relief is eight weeks in which strengthening actually works.
Which is why we do not give an injection on its own. It comes with a plan, usually physical therapy, and we would rather you use the window than come back for another injection in twelve weeks.
What happens at the visit
We examine the joint first and confirm the pain is coming from where you think it is. A surprising amount of what people call knee pain is referred from the hip, and injecting the knee for that does nothing.
X-rays help when we suspect arthritis or after an injury. MRI rarely changes early treatment for knee pain and routinely finds meniscus tears that were never causing symptoms. More on that reasoning on our knee and joint pain page.
Then we clean the skin, numb it, inject, and put a small dressing on. You can drive home. Take it easy on that joint for 48 hours, then get back to normal activity.
When we do not inject
- Any suspicion of infection in the joint, which is an emergency, not an injection
- Broken skin or a skin infection over the site
- Certain blood thinners at certain levels, which we check first
- Poorly controlled diabetes, where the blood sugar rise carries real risk
- A joint already injected three or four times in the past year
If your knee is hot, swollen, exquisitely painful and you have a fever, do not wait for an appointment with us. That needs the emergency department the same day.
When you need a surgeon instead
Mechanical locking, giving way, a suspected fracture, or pain that has not responded to a genuine trial of therapy, medication and injection. We refer, send the records with the referral, and keep managing everything else here.
Joint problems are followed through our chronic condition management program. Read about our primary care Southlake practice.
The days after
Expect a few things so none of them alarm you.
- A steroid flare. Roughly one person in twenty has more pain for a day or two before it improves. Ice and your usual pain reliever handle it.
- Facial flushing. Common, harmless, resolves in a day or two.
- A blood sugar rise if you have diabetes. Usually for three to seven days. Check more often during that window.
- Skin changes at the site. A small pale or dimpled patch occasionally develops. It is cosmetic and usually fades.
Call us for anything that suggests infection: increasing pain after day three, warmth and redness spreading from the site, or a fever. That is uncommon but it needs to be seen the same day.
Alternatives we discuss first
An injection is not always the right next step, and sometimes it is not needed at all.
Topical NSAIDs work well for knees and hands and skip most of the stomach and kidney risk of oral anti-inflammatories, which matters if you have kidney disease or take a blood thinner. A short course of an oral NSAID helps many flares. Physical therapy outperforms nearly everything for knee and hip osteoarthritis over the medium term, and it is the most underused referral we make.
Weight matters mechanically. Every pound off the body takes roughly four pounds of load off the knee with each step, which is why our medical weight management work overlaps so heavily with joint care.
Questions about your own case?
These pages describe how we treat this generally. What matters is your history, your labs and your medications, and that takes a visit. We are taking new patients now and most major insurance is accepted.
Questions patients ask
Does the injection hurt?
There is a pinch and a few seconds of pressure. We use a numbing spray or local anesthetic first. Most people describe it as easier than they expected and it takes a couple of minutes.
How fast does it work and how long does it last?
Local anesthetic in the injection often gives relief within an hour. The steroid itself takes two to five days to take effect. Relief typically lasts six weeks to three months, sometimes longer.
How often can I have one?
Generally no more than three or four times a year in the same joint, spaced at least three months apart. Repeated frequent injections into one joint can weaken cartilage and tendon over time.
Will it raise my blood sugar?
It can, for several days, and this matters if you have diabetes. We tell you what to expect, and if you monitor at home we ask you to check more often for about a week.
What if the injection does not help?
That is useful information. It usually means the pain is coming from somewhere other than joint inflammation, and we look again rather than repeating the same injection.
Related care at Magnolia
2111 Kirkwood Blvd, Ste 110C, Southlake. Free parking directly in front.