Guidelines from the American College of Rheumatology conditionally recommend the use of intra-articular corticosteroid injections for treatment of knee osteoarthritis. 51 The duration of pain relief is one to two weeks in most trials, with a few showing improvements lasting three to four weeks. 60 – 63 Research uniformly supports the safety of intra-articular corticosteroid injections for treatment of knee osteoarthritis; however, these studies are limited by lack of histologic data and poor long-term follow-up. 64 A Cochrane review found weak evidence for the use of corticosteroid injections for the treatment of knee rheumatoid arthritis. 52
"Contrary to our hypothesis and to a generally held clinical view, we found that multimodal physiotherapy provided no beneficial long-term effect on complete recovery or much improvement, recurrence, pain, disability, or quality of life, thereby not supporting the hypothesis that the combined approach is superior. However, physiotherapy should not be dismissed altogether because in the absence of the corticosteroid, it provided short-term benefit across all outcomes, as well as the lowest recurrence rates ( percent) and 100 percent complete recovery or much improvement at 1 year."