Joint injections at PHI are performed by board-certified physicians Dr. Faisal Lalani and Dr. Nadiv Samimi in our affiliated surgical suite under ultrasound guidance. They treat osteoarthritis, bursitis, tendinitis, and other sources of hip, knee, and shoulder pain, with corticosteroid, hyaluronic acid (Orthovisc), and regenerative options including PRP and stem cell therapy.
What Joint Injections Do
Joint injections deliver medication directly into a joint to reduce inflammation, lubricate the joint, or stimulate tissue repair. The right injection depends on what is causing your pain.
Corticosteroid injections reduce inflammation in the joint. They produce relatively fast relief, typically within a few days, that lasts weeks to months. They are the most established option for sudden flare-ups of arthritis, bursitis, or post-injury inflammation.
Hyaluronic acid injections (commonly known as viscosupplementation, with Orthovisc as the product option for the knee) replenish the natural lubricating fluid in a joint that has been depleted by arthritis. Used primarily for knee osteoarthritis, the relief is slower to start than cortisone but typically lasts longer.
Regenerative injections (PRP, A2M, stem cell therapy) use your body’s own healing factors or biologic preparations to support tissue repair rather than just reducing inflammation. Relief takes longer to develop but addresses the underlying degeneration rather than the symptom alone.
Your physician will recommend which option fits based on your imaging, symptom pattern, prior treatments, and goals.
How the Procedure Works
Joint injections are performed in our affiliated surgical suite under ultrasound guidance. Image guidance significantly improves accuracy compared to landmark-based injections, particularly for joints like the hip and shoulder where the target is deep or difficult to feel from the surface.
You are positioned comfortably, and the injection site is cleaned and numbed with a local anesthetic. The physician advances a thin needle into the joint, confirms position with imaging, and delivers the medication. The procedure typically takes 10 to 15 minutes.
You leave the same day. Most patients drive themselves home and return to most activities within 24 to 48 hours.
Three Joints We Treat
Hip Injections
The hip is one of the most challenging joints to inject without imaging because the joint capsule is deep beneath several layers of muscle and tissue. PHI performs all hip injections under image guidance. Conditions commonly treated include hip osteoarthritis, trochanteric bursitis, labral tears in selected patients, and post-injury hip pain. For significant hip arthritis, regenerative options including PRP and stem cell therapy are often discussed alongside or in place of cortisone.
Knee Injections
The knee is the most commonly injected joint and the most commonly affected by osteoarthritis. PHI offers the full range of knee injection options. Conditions commonly treated include knee osteoarthritis, patellofemoral pain, knee bursitis, post-injury knee pain, and persistent pain following a meniscus or ligament injury. The right choice depends on your stage of disease, prior treatments, and activity goals.
Shoulder Injections
The shoulder is a complex joint with multiple structures that can generate pain. Image guidance is particularly valuable because surface landmarks alone often misidentify the precise target. Conditions commonly treated include shoulder osteoarthritis, subacromial bursitis, rotator cuff tendinopathy, frozen shoulder, and persistent post-injury pain. For rotator cuff or labral injuries, PRP is frequently discussed as an alternative or adjunct to cortisone.
Orthovisc and Hyaluronic Acid for Knee Arthritis
Orthovisc is a hyaluronic acid product used specifically for treating knee osteoarthritis. Hyaluronic acid is a natural component of the synovial fluid that lubricates and cushions your knee. In an arthritic knee, this fluid becomes depleted and less effective.
Hyaluronic acid injections replenish this lubricating fluid. The relief develops gradually over several weeks rather than immediately, but typically lasts longer than a corticosteroid injection. Many patients report relief lasting six months or more from a single course.
At PHI, the hyaluronic acid product used for the knee is Orthovisc. Your physician will recommend the dosing schedule that fits your knee. Hyaluronic acid is most appropriate for patients with mild to moderate knee osteoarthritis who want longer-lasting relief than cortisone provides, or who want to avoid the cumulative effects of repeated steroid injections. It is less effective for end-stage arthritis where the cartilage damage is severe.
When Joint Injections Are the Right Option
A joint injection fits when
- Conservative treatments like rest, anti-inflammatory medication, and physical therapy have not provided adequate relief
- Imaging or examination identifies a specific joint as the source of pain
- You want non-surgical relief, either as a long-term approach or to delay a planned surgery
- You have a clear functional goal, such as returning to a sport or getting through a high-demand period
Not the right starting option when
- Your pain is mechanical instability rather than inflammation, which the injection will not address
- You have end-stage arthritis where joint replacement is the more appropriate option
- You have an active joint infection or a contraindication to corticosteroids
For patients with significant degeneration, your physician may recommend skipping cortisone and starting with a regenerative protocol instead. Repeated cortisone injections in a degenerating joint can accelerate cartilage loss in some cases. A regenerative approach addresses the tissue rather than the symptom.
Why Patients Choose PHI for Joint Injections
Image-guided ultrasound
Every injection is performed under ultrasound guidance, which is particularly important for the hip and shoulder where the target is deep. Image guidance is standard at PHI, not optional.
Two board-certified physicians
Dr. Faisal Lalani and Dr. Nadiv Samimi, both trained in interventional pain at Cedars-Sinai, with a specific emphasis on ultrasound-guided procedures.
Full range of options under one roof
Many practices offer cortisone only. PHI offers corticosteroid, hyaluronic acid, PRP, A2M, and stem cell, and recommends the right one for your situation rather than what the practice happens to offer.
Honest framing of tradeoffs
Cortisone is fast but cumulative. Hyaluronic acid is longer-lasting but slower to start. Regenerative options work differently and take longer to evaluate. We tell you what fits your goals.
Concierge model
Single-physician continuity from consultation through follow-up, with direct access to your physician.
Concierge, coordinated care
Single-physician continuity from consultation through treatment and return to activity. Patients receive clear guidance and transparent pricing at consultation.
What to Expect: Before, During, and After
Consultation and prep
Your physician reviews your imaging, history, and current medications at consultation. Some medications, including certain blood thinners, may need to be paused; you will receive specific instructions.
The injection
The injection itself takes 10 to 15 minutes. You are awake throughout. Most patients describe a brief stinging or pressure sensation.
Recovery
You rest briefly and then leave. Most patients drive themselves home and resume most normal activities within 24 to 48 hours. High-impact activity should be paused for the rest of the day.
Onset
With cortisone, the local anesthetic often produces immediate relief that wears off within hours, and the corticosteroid takes 2 to 5 days to begin reducing inflammation. With hyaluronic acid, relief develops gradually over 2 to 4 weeks. With regenerative protocols, the timeline is longer still.
Duration
Relief duration varies by joint, condition, and injection type. Cortisone typically provides relief lasting weeks to several months. Hyaluronic acid in the knee often provides relief lasting six months or longer. Your physician will set realistic expectations for your specific protocol.
Frequently Asked Questions
Cortisone injections in the same joint can have cumulative effects on cartilage and surrounding tissue, so they are spaced and monitored. If you require frequent injections to control pain, your physician will discuss longer-lasting options including hyaluronic acid or regenerative protocols.
Cortisone typically provides relief lasting weeks to several months. Hyaluronic acid in the knee often provides relief lasting six months or longer. Regenerative options work over a longer time horizon, and the duration depends on how well the underlying tissue responds.
Yes. Joint injections are performed under local anesthesia. You remain awake throughout.
Most patients describe a brief stinging or pressure sensation rather than pain. The local anesthetic numbs the skin along the needle path, and the injection itself is quick.
Yes. Most patients drive themselves home.
This depends on your specific joint, the severity of your condition, your goals, and your prior treatment history. Cortisone is fastest but cumulative. Hyaluronic acid is longer-lasting but limited primarily to the knee. PRP and other regenerative options address the tissue rather than the symptom. Your physician will recommend the right option after a full evaluation, and patients sometimes use these in sequence or combination.
For some patients, yes. Patients with mild to moderate arthritis can often delay joint replacement for years through a combination of injections, physical therapy, and lifestyle adjustments. Patients with severe end-stage arthritis may eventually need surgery regardless. Your physician will give you an honest assessment based on your imaging and symptoms.
Insurance coverage and payment options may vary. We provide documentation for you to seek reimbursement through your out-of-network benefits, which may apply to certain services. All pricing is disclosed at consultation.
Joint injections are well-established procedures with strong safety profiles when performed under image guidance. Risks include temporary increase in pain, bleeding or infection at the injection site, and rare allergic reactions. Cortisone has additional considerations including temporary blood sugar elevation in patients with diabetes. Your physician will review the full risk profile at consultation.
A standard joint injection delivers medication, cortisone or hyaluronic acid, to reduce inflammation or replenish lubrication. PRP and stem cell therapy use biologic preparations to support tissue repair and address the underlying degeneration. They take longer to produce results but work on the cause rather than the symptom. Many patients use them in combination or sequence.
Insurance coverage and payment options may vary. All pricing is disclosed at consultation.
Yes. PHI regularly treats patients from outside Los Angeles, including Las Vegas, Palm Springs, London, and other international locations.