Several current and many emerging osteoarthritis (OA) treatments are intra‐articular (IA) injections. However, little is known about physicians’ perceptions and beliefs regarding IA injections or their considerations when deciding whether to recommend them to patients. We aimed to investigate physician‐perceived benefits and drawbacks of offering IA injections. We interviewed 18 physicians from academic and community practices. We identified four categories of themes that influenced providers’ recommendations to their patients regarding injections:

  1. The physician’s knowledge, beliefs, and concerns, including their propensity to rely on guidelines versus clinical experience, and understanding of the efficacy and risks associated with injectables, such as possible cartilage damage;
  2. The characteristics of the injectable product, such as ease or number of administrations needed;
  3. Individual patient‐specific factors, including OA severity, comorbidities, and patient preference for and expectations of specific IA injections;
  4. Financial and administrative factors, including insurance coverage and out‐of‐pocket costs.

In conclusion, physicians factor the uncertain efficacy of injectable treatments and the need to manage patient expectations into their decision to offer IA therapies. These findings may help in the delivery of IA injections for OA and the development of injectable products.