A small joint injection delivers anti-inflammatory medication directly into the smaller joints of the hand, wrist, or foot to ease arthritis pain and inflammation when rest, splinting, and medication alone are not enough.
OVERVIEW
What a small joint injection is and how it works
The small joints of the hand, wrist, and foot are among the most-used joints in the body, so when arthritis or inflammation settles into them, even simple tasks like buttoning a shirt or taking a step can become painful. A small joint injection places medication, typically a corticosteroid combined with a local anesthetic, into or around the affected joint to calm inflammation and reduce pain.
The corticosteroid is an anti-inflammatory that acts locally within the joint, while the local anesthetic provides rapid, short-term relief and helps confirm the joint as the source of pain. Because these joints are small and lie close to nerves, tendons, and blood vessels, our physicians typically use ultrasound guidance — or fluoroscopic (X-ray) guidance for certain wrist and midfoot joints — to position the needle precisely and protect surrounding structures.
This procedure can be both diagnostic and therapeutic. The immediate numbing from the anesthetic helps your physician determine whether a specific joint is generating your pain, while the steroid may offer longer-lasting relief that develops over the following days. It is one of several joint and soft tissue injections we offer as part of a broader pain management plan.
CONDITIONS
What a small joint injection treats
Small joint injections target painful conditions affecting the finger, thumb, wrist, midfoot, and toe joints, most often related to arthritis or localized inflammation.
Commonly treats
YOUR VISIT
What to expect
Before
Your physician reviews your history, exam findings, and any imaging to confirm a small joint injection is appropriate. Tell us about blood thinners, allergies, diabetes, or a possible active infection, as these may affect timing. No general anesthesia is needed, so most patients can eat normally and drive themselves home.
During
You are positioned comfortably and the skin is cleaned. Using ultrasound or fluoroscopic guidance, your physician advances a thin needle into the joint and slowly injects the medication. The injection itself usually takes only a few minutes, and the entire visit is typically brief.
After
You may feel quick relief from the anesthetic, which can wear off within hours before the steroid begins working over the next several days. Mild soreness at the injection site is common and is often eased with ice. Most people resume normal activities the same day, while giving the joint some short-term rest.
Image guidance & recovery
Image guidance improves accuracy in these small, delicate joints and helps confirm the medication reaches the intended space. Recovery is typically quick. Your physician will explain how your response guides next steps, which may include hand therapy, bracing, or additional treatments.
QUESTIONS
Frequently asked questions
How long does relief from a small joint injection last?
Relief varies from person to person and depends on the underlying condition. The local anesthetic provides immediate but temporary numbing, while the corticosteroid may take a few days to take effect and can provide longer-lasting relief for some patients. Because results differ, your physician will discuss realistic expectations for your specific joint and diagnosis.
Is a small joint injection diagnostic or therapeutic?
It can be both. The anesthetic helps confirm whether a particular joint is the source of your pain (diagnostic), while the steroid is intended to reduce inflammation and pain over time (therapeutic). Your physician will explain which goal applies in your case.
How is this different from a major joint injection?
A small joint injection targets the smaller joints of the hand, wrist, and foot, whereas a major joint injection treats larger joints such as the shoulder, hip, or knee. The medications and goals are similar, but the smaller joints often call for added precision with image guidance.
RELATED CARE
Related procedures
Depending on your diagnosis, your physician at Columbia Pain & Spine Institute may recommend one of these related treatments at our Gresham or Portland, Oregon offices.
Major Joint Injection
Targeted relief for larger joints such as the shoulder, hip, and knee affected by arthritis.
Carpal Tunnel Injection
Steroid injection at the wrist to ease numbness and pain from carpal tunnel syndrome.
Tendon Injection
Focused treatment for painful tendon inflammation around the hand, wrist, and foot.