I was very disappointed with my latest steroid injection for knee pain. The first one I had worked great. This second one increased my pain at first. After a few days the pain level just went back to what it was before the injection. Why didn’t I get the same pain relief as the first time?

From time to time, patients report uneven results with steroid injections. There’s been some question about whether the results are based on the type of steroid used. Some doctors questioned if maybe one type of steroid worked better than another.

A recent study comparing two commonly used steroids showed no difference between them. Patients with knee arthritis or shoulder rotator cuff problems received either methylprednisolone or betamethasone. The steroid was mixed with lidocaine (a type of novocaine).

The authors of the study suggest that immediate pain relief is obtained with steroid injections when the injection is done correctly. The correct placement of the needle into the joint is important.

Typically patients experience immediate pain relief. This is a sign that the placement was correct. There is often a slight increase in pain about three days after the injection. The pain subsides and by the end of three weeks, patients report overall improved pain.