Steroid Injection Information

What is a Corticosteroid injection?

It is a synthetic (made in the laboratory) version of a naturally occurring hormone produced in the body that reduces inflammation

The Benefits

Steroid injections are used to reduce inflammation and pain in joints or for localised areas of pain. They can be a quick and effective treatment. However, the effects are usually temporary. They are normally given as a part of a wider rehabilitation program. People commonly have steroid injections for osteoarthritis or an inflammation of soft tissue. It is important to know that steroid injections will not treat the underlying cause of your condition but aims to treat your symptoms.

Like all medication, an individual’s response to a steroid injection cannot be predicted. Most patients experience an improvement in their symptoms lasting approx. 1-2 months. For some the beneficial effect will persist for several months. Some patients unfortunately gain little or no benefit.

What does a steroid injection contain?

A corticosteroid can help to reduce inflammation (this is not the same as anabolic steroids that people commonly associate with body builders). At Frome Medical Practice we use a longer acting steroid which aims to give you pain relief over a longer time frame.

The injector sometimes injects the corticosteroid along with a local anaesthetic, which is similar to the anaesthetic used at the dentist. This will provide you with temporary relief that normally lasts 30-60 mins.

How long does the steroid injection take to work?

This varies from person to person. The effects can be immediate but can take 2 - 4 weeks to work. Most commonly after 3 - 10 days you should feel relief.

The effect commonly lasts 3 - 6months. If the relief is short acting or ineffective, you may require a review of your condition or an alternative treatment method.

How often can I have the steroid injection?

This depends on the part of the body involved and will be jointly decided by your clinician and yourself. Usually one injection is sufficient, but if the pain is severe or has been there a long time, you may need more. The number of injections you can have in one session varies depending on the areas to be injected. There is a maximum safe dosage of steroid medication that can be given at one time. Normally there is a minimum of 3 months between injections.

Pregnancy is not considered a contraindication, but will be treated on a case-by-case basis. The injector will not be able to administer the injection if you have broken skin around the area to be injected.

Are there are times when I should not have the injection?

  • If you have an infection or are on antibiotics
  • If you are feeling unwell
  • Any allergic reaction or hypersensitivity to corticosteroids or anaesthetic
  • Recent trauma
  • Sepsis
  • Prosthetic joint (injection into that joint) 
  • Children (under 18)
  • Avascular areas - such as Achilles tendon

Precautions

  • Pregnancy
  • Breastfeeding
  • Metalwork or prosthetic joint adjacent to injection site
  • Poorly controlled diabetes
  • Anti-coagulant therapy
  • Vaccinations (4 weeks before or after)
 

Aftercare

  • You will be advised to keep the injected joint / soft tissues moving gently for the first 48 hours, avoiding heavy physical work, repetitive movements or your normal aggravating positions/movements
  • Driving yourself home is usually not a problem, but it is preferable to have someone drive for you
  • Keep the plaster on for at least 24 hours to avoid contamination
  • Manage post injection flare up with ice. Paracetamol can also help with this
  • Seek medical advice should there be an increase in pain with swelling, fever and malaise following injection
  • You should not receive any live vaccinations for up to 4 weeks after receiving injection

Is the injection painful?

There may be some pain during the injection. If pain does occur it subsides quickly. Most injections are painless.

Can I leave straight after the injection?

All medications pose a small risk of an allergic reaction to the medication. This can occur even if you have had the injection before. We therefore advise that patients wait in the reception area for 30 minutes by the front desk (or where a member of staff can see you) after their injection. If you feel unwell in that time please inform a member of staff.

What are the risks of the injection?

  • Side effects are rare after the injection. 
  • The most common side effects are post injection flare (normally in the first 24 - 48 hours after the injection.) This normally settles down after a few days then the symptoms should start to improve. Occasionally a small bruise can develop but will settle down after a couple of days. 
  • There is a small risk of damaging nerves, fat or muscle after the injection.
  • Some people experience facial flushing or changes in their periods.
  • Occasionally, people can notice depigmentation or dimpling of the skin following the injection. 
  • A very rare side effect is damage to tendon within the joints. This tends to be on tendons that are already damaged or weakened.  

Serious risks

  • A very rare side effect from the injection is infection.
  • Approximately 1 in 17,000 - 70,000 people may get an infection after receiving the injection.
  • If your joint becomes more and more painful, or very red and swollen, and you develop a fever and / or are unwell you should seek immediate medical attention via A and E.
  • Do not wait for this to settle down and do not ignore it. 
  • There is risk of anaphylactic / allergic reaction (1 in 70,000).
  • Symptoms of severe allergy include; wheezing or difficulty breathing, swelling of the face, throat or tongue, rash or itching, stomach cramps and vomiting, or feeling very unwell.
  • Call for immediate help if necessary.

Other information

If you have diabetes it is only safe to administer the injection if your blood sugars are well controlled. The injector may require a recent reading. The injection can increase your blood sugars up to 2 weeks after the injection. We therefore require patients to closely monitor blood sugars following an injection. 

If you are on blood thinning medication the injector may not be happy to inject. This applies particularly to NOAC and warfarin. 

Pregnancy is not considered a contraindication but will be treated on a case by case basis. 

Facebook Instagram Twitter