This is an injection placed directly inside the knee joint, usually combining a local anaesthetic and a steroid, to help diagnose and treat pain coming from within the joint itself, though individual results vary.

This procedure may help if you have:

• Chronic knee pain, often from osteoarthritis or joint inflammation
• Imaging findings suggesting the joint itself is the source of pain
• Not had lasting relief from physiotherapy, medication, or activity modification

It isn't possible to guarantee how any individual will respond. As a general guide:

• Local anaesthetic: works within minutes and wears off after a few hours — an early sign of good response.
• Steroid: starts working after a few days and the effect can last for weeks or sometimes several months.

This procedure is generally considered safe when performed under X-ray guidance, though as with any medical procedure benefit cannot be guaranteed and complications rarely occur.

Common, minor effects:

• Temporary soreness or bruising at the injection site
• Brief flare of your usual joint pain before it settles
• Temporary rise in blood sugar for 1-2 days after the steroid, particularly if you have diabetes

Rare, more serious risks:

• Infection at the skin injection site, or rarely a deeper joint infection (septic arthritis) which can risk damage to the joint and needs prompt treatment
• Bleeding at the injection site
• Allergic reaction to the local anaesthetic, steroid, or contrast dye
• Joint damage from repeated steroid injections over time (your doctor will advise on safe frequency)
• No improvement in pain, or relief that doesn't last

• Tell us about any blood-thinning medication (e.g. warfarin, Xarelto, Plavix) well in advance — special arrangements may be needed and you may be asked to pause these under guidance
• Tell us if you are, or might be, pregnant — this procedure uses X-ray guidance
• Tell us about any allergies, including to contrast dye, local anaesthetics, or reactions to previous injections or anaesthesia
• You will usually be asked to fast for 6 hours beforehand if sedation is planned
• Bring a list of your current medications
• Arrange for someone to drive you home afterwards

• The skin over the treatment area is cleaned with antiseptic
• Local anaesthetic numbs the skin before the main needle is placed
• Live X-ray (fluoroscopy) guides the needle precisely to each target
• The procedure usually takes 15-20 minutes

• You will be monitored briefly in recovery before going home
• Some soreness at the injection sites is common for 1-3 days — simple pain relief (e.g. paracetamol) usually helps
• You may remove the small dressing after 24 hours, keeping the area clean and dry
• Avoid strenuous activity or heavy lifting for 24-48 hours
• If you were sedated, avoid driving, operating machinery, or making important legal or financial decisions for 24 hours
• Continue your regular medications unless specifically advised otherwise

Contact your GP, Total Pain Clinic, or your nearest Emergency Department if you notice:

• Increasing joint swelling, warmth, redness, or discharge — possible signs of joint infection
• Fever or feeling generally unwell
• Inability to bear weight or use the joint normally
• Severe pain not settling with simple pain relief

A review appointment is usually arranged 2-4 weeks after your procedure to discuss how you responded and plan next steps — please call Total Pain Clinic reception to schedule this if it hasn't already been arranged. Please ask your doctor any questions before you proceed; you will be asked to sign a consent form if you agree to go ahead.