The use of NSAID injections can complement steroid injections for knee and hip osteoarthritis (OA), extending intervals between treatments and mitigating infection risks before total knee arthroplasty.

To distinguish between Non-steroidal anti-inflammatory drugs (NSAID) injections and corticosteroid (steroid) injections considering different clinical studies for various orthopedic conditions.

The Web of Science platform, Embase, Medline bibliographic database and the Cochrane Central Register of Controlled Trials were explored for relevant studies. Random-effects pairwise meta-analyses were carried out for outcomes reported in 3 or more studies. Qualitative analysis was performed for other studies.

Overall, 28 articles comprising 2113 patients were included. In shoulder impingement syndrome patients, the meta-analysis of 5 clinical studies found no substantial difference in the visual analogue scale (VAS) score between shoulder subacromial NSAID injections and steroid injections after a month [weighted mean difference (WMD) −0.244; 95% CI, −1.232 to 0.745].

In knee osteoarthritis patients, the meta-analysis of 3 clinical studies found no substantial difference in VAS between NSAID intraarticular injections and steroid injections after a month (WMD 0.754; 95% CI, −0.413 to 1.921) and 3 months (WMD−0.089; 95% CI, −0.345 to 0.166).

There were no noteworthy differences between the NSAID and corticosteroid groups as per the trials examining pain outcomes for adhesive capsulitis (frozen shoulder), hip osteoarthritis and plantar fasciitis (Policeman's heel).

NSAID injections could serve as safe and effective alternatives to steroid injections, particularly for shoulder impingement syndrome (Swimmer's shoulder) and knee OA.