Local steroid injections
Local steroid injections can be a rapid and effective treatment for joint pain and inflammation, although the improvement is usually temporary. These injections have been tested and have helped many people. However, as with all drugs some people will have side effects.
What is a corticosteroid injection?
A corticosteroid is an anti-inflammatory medicine, which can be injected directly into the tissue that is causing your symptoms. It is a safer alternative to taking anti-inflammatory medication by mouth. It acts directly in the area injected and is not the same as steroids taken by bodybuilders or athletes.
Why should I have a corticosteroid injection?
The injection can help to relieve swelling, pain and stiffness caused by inflammation. This in turn will help you to start your rehabilitation and return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. It can also be helpful to aid in the diagnosis of your condition if it is not clear which structures are responsible for your pain. You may also have a local anaesthetic injected at the same time, which allows for temporary pain relief.
What are the risks?
* Flushing of the face for a few hours.
* Small area of fat loss or change in skin colour around the injection site.
* Diabetic patients may notice a temporary increase in blood sugar levels.
* Temporary bruising or bleeding if you are taking blood thinning tablets (such as aspirin or warfarin).
* Slight vaginal bleeding / menstrual irregularities (common in 80% of female patients).
* Allergic reaction to the drug. We recommend you to wait for a short time after your injection in the reception to check for any reactions.
* Infection: is a rare complication ( 1 in 1000 to 1 in 10,000) if the area injected becomes hot, swollen and painful for more than 24 hours, or if you feel generally unwell, you should contact the Springs Health Centre or 111 immediately.
You should not have the injection carried out if:
* Have any infection in the area or anywhere else in your body (this includes head colds, chest infections or urinary tract infections).
* Are allergic to local anaesthetic or steroid. You may have already had local anaesthetic for dental work, stitches or for the removal of a mole).
* Feel unwell.
* Are due to have surgery in that area soon.
* Are pregnant or breast feeding.
* Have poorly controlled diabetes.
* Do not want the injection.
Are there any other alternatives?
Alternatives to the injection include lifestyle changes (such as avoiding provocative activity) use of anti-inflammatory medicines and physiotherapy. Occasionally, a surgical opinion may be helpful
What Happens during the injections?
* You will be placed in a comfortable position. The skin is cleaned with antiseptic. A needle is gently positioned into the affected area and the solution is injected through the needle.
* A plaster will be placed over the site to keep it clean. A few minutes after the injection you will be examined again.
Will I feel any pain?
The injection is not particularly painful as the doctor is thoroughly trained in this procedure. There can be some initial stinging from the local anaesthetic. The area can be sore for a few hours after the procedure and in some circumstances for a few days after the injection.
What happens after the procedure?
If local anaesthetic is also used in the injection, your pain may start to improve within a few minutes although this may return when it wears off in 90 mins or more (similar to when you visit the dentist). The steroid usually starts to work after 24-48 hrs, but it may take a little longer. The effect of the injection varies from person to person and usually continues to last for about six weeks.
What do I need to do after I go home?
Depending on the cause of your pain, you may be asked to rest the area for a short period after the injection. This does not usually mean total rest, but refraining from activities that make your pain worse, after which you should try to gradually return to full function. This is to maximise the benefit given by the injection. DO NOT be tempted to rush back to exercise, or to ‘test out’ the area treated. If you are having other medical treatment within six weeks, you should tell the treating clinician that you have received a corticosteroid injection.