The meniscus is a cartilage pad within the knee cushioning the joint. Meniscal tears cause pain, swelling and difficulty bearing weight through the leg. Cortisone injections are a common treatment for knee problems, but do they benefit torn menisci? Based on UK recommendations, this article reviews the evidence for using cortisone injections to treat meniscal tears.

Understanding meniscus tear symptoms

Common symptoms of torn meniscal cartilage include:

  • Popping, clicking or locking sensations
  • Knee pain when twisting, squatting or jumping
  • Perceived instability – knee “giving way”
  • Effusion – swelling due to irritated joint lining
  • Stiffness and reduced knee flexion

These arise from unstable cartilage flaps catching inside the joint space.

How corticosteroid injections can help

Cortisone shots involve injecting a fast-acting steroid like dexamethasone along with local anaesthetic into the knee joint or adjacent to it. Potential benefits for torn menisci include:

  • Powerfully reduces inflammation, causing swelling and pain
  • Temporarily improves range of motion
  • Provides diagnostic information – pain relief identifies intraarticular joint pathology

However, the risks like infection and cartilage damage mean cortisone injections are not recommended as first-line treatment.

Evidence of effectiveness

UK guidelines advise:

  • Cortisone offers temporary symptom relief for most knee conditions. Benefits typically last at least 1-2 months.
  • It does not improve mechanical symptoms like catching or instability from meniscus tears directly or accelerate healing.
  • The best uses are for symptomatic relief while awaiting surgery or to break the pain cycle. Should not replace definitive treatment.

So, while some pain relief is expected, functional deficits from unstable meniscal flaps usually persist long-term.

Case studies

Here are two examples of UK doctors integrating cortisone injections into meniscus tear care pathways:

Jim, 55, plumber – 3-month-old unclear knee pain. Diagnostic injection significantly improved his symptoms, confirming a joint pathology. MRI then demonstrated a meniscus tear amenable to arthroscopic surgery, at which the tear was trimmed, relieving his pain.

Gina, 49, teacher – Chronic knee arthritis flared after a large meniscus tear, causing new catching pains. Poor surgical candidate, so treated with physiotherapy, brace and a series of lubricating hyaluronic acid injections over 6 months, providing moderate enduring benefits.

This shows cortisone injections have a role in diagnostic aid and adjuvant pain relief rather than substituting definitive surgery when mechanical deficits are present.

Conclusion

In summary, while corticosteroid shots reliably reduce inflammation and pain levels associated with meniscal tears, they do not mend unstable cartilage nor restore normal kinetics when pieces move abnormally inside the joint space. UK guidelines support cortisone injections to distinguish intraarticular pathology or improve non-operative management temporarily, but mechanical symptoms ultimately require surgery if persistent beyond 6 months. Discuss options tailored to your meniscal tear pattern with me.

References

  1. NHS (2024). Torn meniscus. https://www.nhs.uk/conditions/meniscus-tear/
  2. Patient.info. (2024). Meniscal Tears. https://patient.info/bones-joints-muscles/sports-injuries/meniscal-tears-knee-cartilage-injuries