Why Choose Between Cortisone and Gel?
We Do Both.
Most clinics offer cortisone or gel. At JRI, we routinely combine both in one visit — immediate inflammation relief plus lasting joint cushioning. Fluoroscopy-guided. Medicare-covered.
Or call now: (800) 238-9307
*Based on 400K+ actual patient billing records at Joint Relief Institute. Individual costs vary.
The Problem With Choosing Just One
Cortisone Only
- Fast relief (2–3 days)
- Wears off in 6–12 weeks
- Limited to 3–4 per year
- May damage cartilage with repeated use
- Treats inflammation, not mechanics
Gel Only
- Lasts 6–12 months
- May protect cartilage
- Gradual onset (1–2 weeks)
- No immediate flare relief
- Patients wait for full effect
Combined at JRI
- Immediate + lasting relief
- Cortisone bridges the 1–2 week gel onset
- Gel provides months of cushioning
- One visit, one procedure
- Both covered by Medicare
How the Combined Approach Works
Cortisone: Immediate Relief
The corticosteroid component rapidly suppresses the active inflammation in your joint. Most patients notice significant pain reduction within 2–3 days. This “bridges the gap” while the gel takes effect.
Gel: Lasting Cushioning
The hyaluronic acid gel restores the lubrication and shock absorption that osteoarthritis has depleted. Relief builds over 1–2 weeks and typically lasts 6–12 months. Outcomes may improve with each treatment course.
What the research says: Published studies suggest that combining hyaluronic acid with corticosteroids may provide more rapid improvement in pain scores compared to either treatment alone. The corticosteroid addresses the inflammatory component while the hyaluronic acid restores joint mechanics — complementary mechanisms that may work better together than apart.
Sources: Bannuru et al., Arthritis Care Res, 2015. Campos et al., Rheumatology, 2013.
Cortisone vs. Gel vs. Combined
| Factor | Cortisone Only | Gel Only | Combined at JRI |
|---|---|---|---|
| How it works | Suppresses inflammation | Restores joint lubrication and cushioning | Immediate inflammation relief + lasting cushioning |
| Speed of relief | Fast (2–3 days) | Gradual (1–2 weeks) | Fast onset, sustained relief |
| Duration | 6–12 weeks | 6–12 months | Months of relief starting day one |
| Cartilage effect | May accelerate damage with repeated use | May help protect remaining cartilage | Cortisone bridges gap while gel protects long-term |
| Repeat treatments | Limited to 3–4 per year | Every 6 months (no annual limit) | Gel repeatable; cortisone only as needed |
| Medicare coverage | Yes | Yes (Part B) | Yes — both covered in same visit |
Why Joint Relief Institute
JRI doesn't just inject one product and send you home. Our combined protocol, fluoroscopy guidance, and selection of 12+ gel options set us apart.
Combined Protocol
We routinely combine cortisone and gel in one visit rather than forcing you to choose. Cortisone handles the immediate flare; gel provides months of cushioning.
Fluoroscopy-Guided Precision
Every injection uses real-time X-ray imaging to confirm precise placement inside the joint. Studies show blind injections miss up to 30% of the time. At JRI, every injection is confirmed.
12+ FDA-Approved Gel Options
Not all gels are the same. JRI offers over 12 hyaluronic acid products, matched to your arthritis severity, joint size, and treatment history. This personalized approach drives better outcomes.
400,000+ Procedures Performed
JRI physicians specialize exclusively in joint injections. With more than 400,000 treatments since 2015, our team has more experience with viscosupplementation than virtually any practice in the country.
Your Treatment Process
What Patients Say
My knees feel wonderful and brand new after my injections. I was scared of surgery but this worked beautifully.
My sister got relief with just 3 injections — no surgery needed! Anybody with knee pain, I recommend here. Now I'm ready for my cruise!
I wish that I had gone to them earlier. They told me exactly what my Medicare would cover. Courteous, concerned, and highly professional.
5 Convenient Locations
Chicagoland clinics in Glenview, Oak Brook, Orland Park, and Stony Island — plus our Minneapolis-area clinic in Edina, MN.
Check Your Insurance Coverage
Medicare and most insurance plans accepted
Frequently Asked Questions
Q1. Can cortisone and gel injections be given at the same time?
Yes. At Joint Relief Institute, we routinely combine cortisone and hyaluronic acid gel injections in the same visit. The cortisone provides immediate inflammation relief while the gel restores long-term cushioning. Published research suggests that combining hyaluronic acid with corticosteroids may provide more rapid improvement in pain compared to either treatment alone.
Q2. Why do most clinics only offer one or the other?
Many clinics treat cortisone and gel as competing options because they work through different mechanisms. However, those mechanisms are complementary, not contradictory. Cortisone targets inflammation while gel restores lubrication. JRI physicians specialize exclusively in joint injections and use fluoroscopy guidance, which allows precise delivery of both treatments in the same procedure.
Q3. Does Medicare cover the combined treatment?
Yes. Both cortisone injections and viscosupplementation (gel injections) are covered under Medicare Part B when medically necessary. At JRI, we verify your specific coverage before your appointment so there are no surprises.
Q4. How does the combined treatment work?
The cortisone component suppresses the active inflammation in your joint, providing relief within 2 to 3 days. The hyaluronic acid gel restores the lubrication and cushioning that osteoarthritis has depleted, providing relief lasting 6 to 12 months. Together, they bridge the gap: cortisone handles the immediate flare while gel builds lasting joint support.
Q5. Is there research supporting the combined approach?
Yes. Multiple studies have examined combining hyaluronic acid with corticosteroids for knee osteoarthritis. Research published in peer-reviewed journals suggests that the combination may provide faster onset of pain relief compared to hyaluronic acid alone, while maintaining the long-term benefits of viscosupplementation. A systematic review found that HA plus corticosteroid injections were associated with improved short-term outcomes.
Q6. How many gel options does JRI offer?
JRI offers 12 or more FDA-approved hyaluronic acid gel products, which allows your physician to match the specific formulation to your arthritis severity, joint size, and treatment history. This personalized selection, combined with fluoroscopy guidance for every injection, is a key reason outcomes improve with each treatment course.
Q7. What is fluoroscopy and why does it matter?
Fluoroscopy is real-time X-ray imaging used during injection to confirm the needle is placed precisely inside the joint space. Studies show blind (unguided) injections miss the joint up to 30% of the time. JRI uses fluoroscopy on every injection for 100% confirmed joint placement, which directly impacts treatment effectiveness.
Q8. Is the combined treatment right for everyone?
The combined approach may be appropriate for many patients with knee osteoarthritis, but your physician will evaluate your specific condition, imaging, and treatment history before recommending a plan. Some patients may benefit more from gel alone, cortisone alone, or a different sequencing. At JRI, treatment decisions are always individualized.
Stop Choosing. Start Healing.
Schedule a no-obligation evaluation. Our board-certified physicians will examine your knee and recommend the approach — cortisone, gel, or both — that's right for your specific condition.
Or call us: (800) 238-9307
Sources
[1] Bannuru RR et al. Comparative Effectiveness of Pharmacologic Interventions for Knee OA: A Systematic Review. Arthritis Care Res, 2015.
[2] Campos ALS et al. Viscosupplementation with corticosteroid: a randomized clinical trial. Rheumatology, 2013.
[3] Long-Term Outcomes of Single versus Multiple Courses of Viscosupplementation. PMC, 2021.
[4] EUROVISCO Consensus Guidelines for HA Viscosupplementation. J Orthopaedic Surgery and Research, 2024.
[5] Accuracy of Blind vs. Image-Guided Intra-Articular Knee Injections. J Clinical Medicine, 2022.
[6] Medicare Coverage Database: Hyaluronic Acid Injections for Knee OA. CMS, 2025.