Peripheral joint injections may help identify or treat selected joint pain involving the shoulder, hip, knee, ankle, foot, or other joints.
Learn how Dr. Siefferman performs peripheral joint injections to diagnose and treat painful joint conditions, helping reduce discomfort and improve mobility.
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Hi, I’m Dr. Jason Siefferman. I’m a physiatrist, interventional pain medicine specialist, and medical director at Manhattan Pain Medicine.
If there is pain in a peripheral joint, the question is why?. Based on that reason, we may choose an injection therapy. The range of injection therapies include:
Regenerative medicine, which helps stimulate a healing response in the joint and the structures around the joint, depending on which structures are targeted.
Steroid, which can calm down inflammation in the moment, but doesn’t really fix anything long-term.
Hyaluronic acid, which is a jelly lubricant that we use in the joint to help cushion and lubricate any arthritic changes within the joint.
When we do this injection, we are generally doing it in the office, except for some which we do under X-ray guidance at a surgical center. We use a sterile field, meaning the skin is sterilized to minimize the risk of infection. We use a cold spray to numb the skin so the poke is minimized. We use ultrasound guidance to ensure proper placement and the injection is quick and easy.
There’s generally local anesthetic involved so that there is no pain immediately afterwards, which gives us diagnostic confirmation of what pain was coming from that joint. Then we wait to see what the effect of the injection is. Each different injected substance has a different timeframe for an expected response, which we’ll talk about before we choose a treatment path. We generally see you back at that point and look for the response. Is it as we expected? Did we miss something? Is there something we need to do differently? We’ll adjust the treatment plan and go forward from there.
Peripheral joint injections are targeted procedures used to evaluate or treat selected joint pain outside the spine, including pain in the shoulder, elbow, wrist, hand, hip, knee, ankle, or foot. Depending on the diagnosis, an injection may be used diagnostically, therapeutically, or both.
At Manhattan Pain Medicine, peripheral joint injections NYC care begins with a diagnosis-first evaluation to determine whether pain is coming from the joint itself, nearby tendons or ligaments, inflammatory disease, nerve irritation, hypermobility, pelvic mechanics, or another source. Ultrasound guidance may be used when appropriate to improve precision and support treatment planning.
MPM specialists evaluate whether a peripheral joint injection may be appropriate by first clarifying the likely pain generator. Joint pain can come from arthritis, autoimmune inflammation, joint instability, hypermobility, EDS-related mechanics, ligament strain, tendon irritation, foot and ankle conditions, pelvic mechanics, or referred pain from another region.
MPM reviews the patient’s symptoms, exam findings, imaging, prior injections, medication history, inflammatory disease history, physical therapy response, bracing response, and functional goals. This helps determine whether a steroid injection, diagnostic anesthetic injection, PRP, prolotherapy, regenerative medicine, rehabilitation, rheumatology coordination, or another pathway may be more appropriate.
Jason W. Siefferman, MD
Medical Director | Interventional Pain Management | Headache Medicine
Nino Mikaberidze, MD
Director of Rheumatology & Internal Medicine
Luis Aranguren, MD
Interventional Pain Management
Tayyaba Ahmed, DO
Physical Medicine & Rehabilitation | Pelvic Pain
Adam Rosenberg, PA-C
Board-Certified Physician Assistant
Jordan Shankle, PA-C
Board-Certified Physician Assistant
Patients often search for joint injections in Manhattan when pain has not improved enough with rest, medication, bracing, physical therapy, or prior injections. Some patients are looking for relief from arthritis or inflammation. Others need help determining whether a joint is truly the source of pain.
MPM approaches peripheral joint injections as part of pain generator identification and coordinated treatment planning. A joint injection may help reduce inflammation in selected cases, but it may also help clarify whether the joint itself is contributing to symptoms. This is especially important when pain could be coming from nearby tendons, ligaments, nerves, muscles, the spine, autoimmune disease, hypermobility, or pelvic mechanics. MPM also helps patients understand the difference between steroid injections, cortisone injections, PRP, prolotherapy, regenerative medicine, and other image-guided procedures. The goal is to match the injection to the diagnosis, not to treat every joint pain pattern the same way.
Peripheral joint injections fit within MPM’s Musculoskeletal issues, Autoimmune and Inflammatory, and Hypermobility expertise. For musculoskeletal pain, injections may help evaluate or treat selected joint pain involving the shoulder, hip, knee, ankle, foot, wrist, hand, or other peripheral joints. For autoimmune and inflammatory pain, injections may be considered when joint inflammation, swelling, or arthritis-related symptoms are part of the clinical picture.
For patients with EDS, hypermobility spectrum disorder, or joint instability, MPM evaluates whether pain is coming from the joint surface, ligaments, tendons, instability, muscle compensation, or nerve sensitivity. Injections may help selected patients, but they do not cure hypermobility, autoimmune disease, arthritis, or complex pain. The plan may also involve bracing, rehabilitation, rheumatology care, regenerative medicine, medication management, or specialist coordination.
Before a peripheral joint injection, MPM reviews the diagnosis, target joint, purpose of the injection, medication or injectate being considered, risks, alternatives, and post-procedure instructions. The skin is cleaned, and the injection is directed into or near the selected joint. Ultrasound guidance may be used when appropriate to support more precise placement.
Patients may feel pressure, brief discomfort, or soreness during or after the injection. If local anesthetic is used, temporary numbness or short-term relief may occur. If corticosteroid is used, relief may take longer and may vary by condition. A short post-injection flare can occur. Patients may need temporary activity modification and follow-up to assess response. If the injection does not help, MPM may reassess whether the pain source is joint-related or whether another structure or condition is contributing.
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I’ve suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I’m feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor’s office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Peripheral joint injections are targeted procedures used to evaluate or treat selected joint pain outside the spine. They may involve joints such as the shoulder, elbow, wrist, hand, hip, knee, ankle, or foot. Depending on the diagnosis, an injection may include local anesthetic, corticosteroid, or another injectate such as PRP or prolotherapy when appropriate. At MPM, peripheral joint injections NYC care begins with diagnosis-first evaluation to determine whether the joint is truly the pain source.
A peripheral joint is a joint outside the spine. Examples include the shoulder, elbow, wrist, hand, hip, knee, ankle, and foot joints. These joints can hurt because of arthritis, inflammation, injury, instability, hypermobility, tendon or ligament irritation, nerve irritation, or referred pain from another area. MPM evaluates whether pain is coming from the joint itself or from surrounding structures before recommending an injection.
Peripheral joint injections may be considered for selected pain involving the shoulder, elbow, wrist, hand, hip, knee, ankle, foot, or other peripheral joints. The decision depends on the diagnosis, anatomy, symptoms, imaging, safety factors, and treatment goals. Some joints may be better evaluated or treated with ultrasound guidance. MPM determines whether a joint injection is appropriate and whether another approach, such as tendon, ligament, nerve, or regenerative treatment, is more relevant.
Joint injections may help selected patients with arthritis-related pain, especially when inflammation inside or around the joint is contributing to symptoms. Corticosteroid injections may reduce pain and inflammation in some cases, but relief may be temporary and is not guaranteed. Arthritis pain can also involve cartilage changes, bone changes, ligament strain, tendon pain, nerve irritation, or altered mechanics. MPM evaluates the arthritis pattern and overall joint condition before recommending an injection.
Peripheral joint injections may be considered for selected autoimmune or inflammatory joint pain when inflammation is localized and the injection fits the broader care plan. However, autoimmune conditions such as rheumatoid arthritis, lupus, Sjogren’s, vasculitis, or connective tissue disease often require medication management and rheumatology coordination. A joint injection does not replace disease-directed care. MPM evaluates whether joint pain is inflammatory, mechanical, instability-related, neuropathic, or mixed before recommending treatment.
Joint injections may help selected hypermobility or EDS-related joint pain when a specific joint is inflamed or contributing to symptoms. However, injections do not cure EDS, hypermobility spectrum disorder, or joint instability. Pain may come from ligament laxity, muscle guarding, tendon overload, nerve irritation, central sensitization, or recurrent microtrauma. MPM evaluates whether the joint itself is the right target and whether bracing, stabilization, prolotherapy, PRP, rehabilitation, or another approach may be more appropriate.
They can be either diagnostic, therapeutic, or both. A diagnostic injection may use local anesthetic to help determine whether a joint is the source of pain. A therapeutic injection may use medication or another injectate to reduce inflammation or support treatment goals. In some cases, the response to an injection helps guide next steps. MPM uses the injection purpose to decide the target, technique, injectate, and follow-up plan.
The medication or injectate depends on the diagnosis and treatment goal. Some injections may use local anesthetic to help confirm a pain source. Others may use corticosteroid to reduce inflammation in selected cases. PRP, prolotherapy, or other regenerative approaches may be considered for selected joint, ligament, or tendon-related pain patterns. MPM reviews the risks, benefits, alternatives, and safety factors before selecting an injectate.
The terms steroid injection and cortisone injection are often used interchangeably. They generally refer to corticosteroid injections used to reduce inflammation and pain in a targeted area. Steroid injections may be helpful for selected inflammatory or arthritis-related joint pain, but they are not appropriate for every patient or every joint condition. Repeated steroid injections may carry risks, including tissue effects, elevated blood sugar, and possible joint-related concerns. MPM uses them selectively.
A standard joint injection often uses local anesthetic, corticosteroid, or both. PRP and prolotherapy are different regenerative medicine approaches. PRP uses platelet-rich plasma prepared from the patient’s blood. Prolotherapy uses an injected solution, often dextrose-based, to stimulate a local tissue response in selected ligament, tendon, or joint-related targets. MPM determines which option, if any, fits the diagnosis, tissue target, stability pattern, safety profile, and goals.
Ultrasound guidance may be used for selected peripheral joint injections when it supports accuracy, safety, or diagnostic confidence. Ultrasound can help visualize the joint, surrounding tissues, blood vessels, nerves, and needle path during certain procedures. It may be especially useful for smaller joints, deeper joints, complex anatomy, or prior failed injections. MPM determines whether ultrasound guidance is appropriate based on the target and clinical question.
The duration of benefit varies by diagnosis, joint involved, injectate used, severity of disease, activity level, and whether the injection addresses the true pain generator. Some patients may have short-term relief, while others may have longer benefit. Some may have little or no improvement. MPM uses the response to help guide next steps, which may include rehabilitation, bracing, medication management, regenerative medicine, imaging, rheumatology care, or another treatment.
Repeat injections depend on the diagnosis, response, risks, joint condition, medication used, and overall care plan. Steroid injections should not be repeated automatically, and excessive use may increase the risk of tissue thinning, tendon or ligament weakening, blood sugar elevation, or possible joint-related adverse effects. MPM reassesses benefit, duration of relief, side effects, and alternative options before considering another injection.
Risks may include pain flare, soreness, bruising, bleeding, infection, allergic reaction, temporary numbness or weakness, incomplete relief, and temporary or no benefit. Steroid-related risks may include elevated blood sugar, tissue thinning, tendon or ligament weakening, and possible cartilage concerns with repeated exposure. Urgent evaluation is needed for fever, spreading redness, severe swelling, sudden inability to bear weight, new weakness, new numbness, hot swollen joint, loss of pulses, limb discoloration, or rapidly worsening symptoms.
Joint injections may not be appropriate when pain is not coming from the joint, when infection is suspected, when there is severe uncontrolled bleeding risk, when the joint problem requires surgery, or when another condition needs urgent evaluation. They may also be delayed if symptoms are rapidly worsening or medically unstable. MPM evaluates whether the pain is joint-related or whether tendon, ligament, nerve, inflammatory, spine, pelvic, or systemic causes should be addressed differently.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Jason W. Siefferman, MD
Jason W. Siefferman, MD
MPM
Peripheral joint injections are targeted procedures used to evaluate or treat selected joint pain outside the spine. These injections may involve the shoulder, elbow, wrist, hand, hip, knee, ankle, foot, or other peripheral joints. Depending on the diagnosis and treatment goal, an injection may include local anesthetic, corticosteroid, or another injectate such as PRP or prolotherapy when appropriate.
At Manhattan Pain Medicine (MPM), peripheral joint injections NYC care begins with diagnosis-first evaluation. The goal is to determine whether the joint is truly the source of pain and whether an injection is the right next step.
A diagnostic joint injection may use local anesthetic to help determine whether a specific joint is contributing to pain. If the patient has meaningful short-term relief after the anesthetic, that may support the joint as a pain generator. This information can help guide next steps.
A therapeutic injection may be used to reduce inflammation, improve pain temporarily, or support participation in rehabilitation when clinically appropriate. Corticosteroid injections may help selected patients with arthritis, inflammatory joint pain, bursitis-related overlap, or localized inflammation. Relief varies and may be temporary. An injection is not a cure and should not replace a broader treatment plan.
Peripheral joint injections may be considered for selected shoulder, hip, knee, ankle, foot, wrist, hand, or elbow pain. Patients may have arthritis-related pain, inflammatory symptoms, orthopedic injuries, hypermobility-related joint pain, EDS-related instability, foot pain, or persistent musculoskeletal symptoms after conservative care.
Joint pain may also be part of autoimmune disease, including rheumatoid arthritis, lupus, Sjogren’s, vasculitis, or undifferentiated connective tissue disease. In those cases, injections may help selected localized symptoms, but disease-directed medication management and rheumatology coordination may still be needed.
Patients with EDS, hypermobility spectrum disorder, or joint instability may experience recurrent joint irritation, subluxation sensations, compensatory muscle guarding, tendon overload, or nerve sensitivity. Peripheral joint injections may be considered when the joint itself appears inflamed or pain-generating, but injections do not correct the underlying hypermobility.
For hypermobility-related pain, the broader plan may include stabilization, bracing, physical therapy, pacing, proprioceptive work, prolotherapy, PRP, medication management, or specialist coordination. MPM evaluates whether the injection target makes sense within that larger framework.
Steroid or cortisone injections are typically used to reduce inflammation in a targeted area. PRP and prolotherapy are regenerative medicine approaches with different goals. PRP uses platelet-rich plasma prepared from the patient’s blood. Prolotherapy uses an injected solution, often dextrose-based, to stimulate a local tissue response in selected ligament, tendon, or joint-related targets.
The right approach depends on the diagnosis. A patient with inflammatory arthritis may need a different plan than a patient with ligament instability, tendinopathy, cartilage degeneration, nerve pain, or mechanical overload. MPM helps determine whether the injection should be diagnostic, anti-inflammatory, regenerative, or whether another treatment should be used instead.
Ultrasound guidance may be used for selected peripheral joint injections. It can help visualize the joint, surrounding tissues, nearby nerves, blood vessels, and the needle path. This may be especially useful for smaller joints, deeper joints, complex anatomy, prior failed injections, or situations where diagnostic accuracy is important.
Ultrasound guidance does not guarantee pain relief, but it can support more precise targeting when used appropriately. The value of an injection still depends on choosing the right target and matching the treatment to the diagnosis.
After a joint injection, patients may experience soreness or a temporary pain flare. If local anesthetic is used, temporary numbness or short-term relief may occur. If corticosteroid is used, benefit may take longer and may vary. Patients may need temporary activity modification after the procedure.
If the injection does not help, that result can still be clinically useful. It may suggest that the pain is not primarily joint-driven or that another pain generator is involved. MPM may then evaluate nearby tendons, ligaments, nerves, the spine, inflammatory disease, hypermobility, pelvic mechanics, or another source.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness or weakness, steroid-related side effects, elevated blood sugar, tissue thinning, tendon or ligament weakening, cartilage concerns with repeated steroid exposure, incomplete relief, and temporary or no benefit.
Patients should seek urgent evaluation for fever, spreading redness, severe swelling, sudden inability to bear weight, new weakness, new numbness, suspected infection, hot swollen joint, major trauma, loss of pulses, limb discoloration, chest pain, shortness of breath, or rapidly worsening symptoms.
For selected patients, peripheral joint injections may help clarify or treat joint-related pain. MPM’s role is to determine whether the joint is the right target and whether injection care fits safely within the broader treatment plan.
