Injections are not a first-line treatment for most musculoskeletal conditions. They are a tool, used in selected cases, alongside accurate diagnosis and structured rehabilitation.

How injections fit into a treatment plan

An injection is rarely the answer on its own. The conditions injections help with most are also conditions that respond best to a combined plan: load management, structured rehabilitation, and time. The injection is what makes the rehabilitation possible when pain or stiffness is otherwise blocking progress.

Each injection has its own evidence base, its own indications, and its own risks. Some are well established. Some are emerging. Some are useful for one condition and not another. The discussion before any procedure covers why this injection, why now, and what the alternative looks like.

Where image guidance improves accuracy and safety, ultrasound is used. For deep or technically demanding injections, referral for image-guided injection at a partner radiology provider may be appropriate.

Injection	Commonly used for	What the evidence says
Cortisone (corticosteroid)	Inflammatory and pain-driven conditions: bursitis, osteoarthritis flares, some nerve entrapments	Useful short-term relief; the effect is often weeks to months
Platelet-rich plasma (PRP)	Selected tendinopathies where a loading programme alone has not progressed	Evidence is mixed and still evolving; not a quick fix (not Medicare-subsidised)
Viscosupplementation	Mild-to-moderate knee osteoarthritis	May help selected patients as part of a wider plan (not Medicare-subsidised)

Before any injection

You will have a full diagnostic assessment first. Injections are not booked in isolation. A specialist consultation establishes the diagnosis, reviews imaging, and determines whether an injection is the right next step.

Cortisone injections

Corticosteroid injections deliver a targeted anti-inflammatory dose to a joint, bursa, or tendon sheath. They can settle inflammation enough to allow rehabilitation to progress, sleep to return, or daily function to improve while a longer-term plan takes effect.

When cortisone may help

Diagnostic and therapeutic intervention
Subacromial bursitis and rotator cuff impingement, as part of a wider shoulder plan
Trigger finger and tenosynovitis
De Quervain's tenosynovitis
Carpal tunnel syndrome, in selected cases
Greater trochanteric bursitis
Glenohumeral joint inflammation, including in adhesive capsulitis
Selected joint osteoarthritis flares

Evidence based limitations of cortisone

The evidence does not support repeated cortisone for most tendinopathies. Repeated injections into a tendon may impair tendon health over time. For chronic tendon pain (Achilles, patellar, gluteal, common extensor), a structured loading programme is the cornerstone of care; cortisone is a last resort, if used at all.

Risks and limitations

Temporary post-injection flare in the first 24 to 48 hours
Skin and subcutaneous fat changes at the injection site (uncommon)
Transient rise in blood glucose, relevant if you have diabetes
Small infection risk (very low with sterile technique)
Effect is often weeks to months, not permanent

The number of cortisone injections to a single site is kept low and timed conservatively, in line with current evidence.

Platelet-rich plasma (PRP)

PRP uses a small sample of your own blood, processed to concentrate platelets and growth factors, then injected into the injured tissue. The aim is to support the body's own healing response in conditions where inflammation alone is not the underlying problem.

When PRP may help

Selected tendinopathies, including patellar and lateral elbow tendinopathy, where loading programmes alone have not progressed
Knee osteoarthritis, in selected cases, as part of a wider plan
Selected partial tendon and muscle injuries

What PRP is not

PRP is not a quick fix. Recovery after the injection typically requires a structured rehabilitation programme over weeks to months. The evidence base is mixed and continues to evolve; cases are selected carefully.

What to expect

A small amount of blood is taken, processed in clinic, and the resulting PRP is injected under ultrasound guidance. The procedure takes around 30 to 45 minutes. Mild post-procedure soreness is common for two to three days. Anti-inflammatory medications are usually avoided for a defined window before and after, since they may blunt the desired healing response.

PRP is not currently subsidised by Medicare or most private health funds. Costs and item numbers are discussed before booking.

Viscosupplementation

Hyaluronic acid joint injections aim to improve lubrication and shock absorption in osteoarthritic joints. They are most studied in knee osteoarthritis, where they may reduce pain and improve function in selected patients as part of a wider plan that prioritises strength, conditioning, and weight management.

Where it may have a role

Mild to moderate knee osteoarthritis
Hip osteoarthritis, in selected cases under image guidance
Other osteoarthritic joints, where the evidence supports its use

Viscosupplementation does not change the underlying joint structure. It is one tool among several. The first-line treatments for osteoarthritis remain education, structured exercise, and weight management. See the osteoarthritis clinic for the wider plan.

What to expect on the day

Consent and questions

Indications, alternatives, risks, and expected outcomes are reviewed before any procedure. You will be asked to confirm consent in writing.
Preparation

The skin is cleaned and draped. Ultrasound is set up for image-guided procedures. Local anaesthetic is used where appropriate.
The injection

Most injections take a few minutes. Many patients describe brief pressure rather than sharp pain.
After

You rest briefly in clinic. Driving home is generally fine for most procedures, with exceptions discussed in advance. A clear written plan covers post-injection activity, expected response, and follow-up timing.

Anticoagulation and immune-modifying medications

If you take blood thinners (warfarin, apixaban, rivaroxaban, clopidogrel, or similar) or immune-modifying medications, mention this at booking. Most injections proceed safely with appropriate planning, but the consultation needs to occur with this information in hand.

Common questions

Do I need a referral for an injection?

You need a specialist consultation first to confirm the diagnosis and discuss whether an injection is appropriate. A GP referral lets you access the Medicare specialist rebate. See the Medicare rebates page for detail.

Will I be able to drive home?

For most peripheral joint and soft tissue injections, yes. For some procedures or if local anaesthetic is used in volumes that affect a limb, alternative transport may be advised. This is discussed at booking.

How quickly will it work?

Cortisone usually takes two to seven days to take effect, sometimes longer. PRP and structured loading-based responses develop over weeks to months.

How many injections can I have?

This depends on the injection, the condition, and how you have responded. Cortisone is kept conservative. PRP is typically a series of one to three. Viscosupplementation is given as a single dose or short course depending on the product.

Are injections covered by Medicare?

The specialist consultation and many injection procedures attract Medicare rebates. PRP is not subsidised. Costs are discussed in the consultation before any booking is made.

Injection therapies