Steroid injection therapy is the injection of corticosteroid medications into painful joints or soft tissues to reduce pain and inflammation in the area.
This may be recommended if you are unable to tolerate oral anti-inflammatories, if your condition is too painful for you to manage with physiotherapy exercises, or if your progress has slowed down. Occasionally injections may be used to confirm a diagnosis if it is not clear where your symptoms originate from.
How could you benefit from injection therapy?
The injection can help to relieve swelling, pain and stiffness caused by inflammation. This can help you rehabilitate effectively and help you to return to normal activities sooner by ‘breaking the cycle’ of pain and inflammation. This is usually recommended to those suffering from overuse syndromes, when other types of physiotherapy don’t work.
It can also aid the diagnosis of your condition if it is not clear what is causing your pain. You may have a local anaesthetic injected at the same time to allow for temporary pain relief and to help locate where your pain is originating from.
Common conditions that could benefit from injection therapy:
• Arthritis
• Bursitis
• Carpal Tunnel Syndrome
• Capsulitis
• Epicondylitis (Tennis Elbow/Golfers Elbow)
• Shoulder impingement
• Tendonitis
• Trigger points
The most commonly used steroid drugs are known as hydrocortisone, methylprednisolone and triamcinolone. They have brand names too such as depo-medrone, and hydrocortistab. In addition, a local anaesthetic known as lidocaine is used.
You can receive injections to the joints (an intra-articular injection), the muscles (an intramuscular injection), the spine (an epidural injection) or the blood (an intravascular injection).
You may notice your joint pain increasing immediately following an injection, but this should abate within 48 hours. Often the pain can be easily controlled by using some ice wrapped in a towel around the affected area to reduce the pain. Often the pain will not be too bad as a local anaesthetic will be used.
Yes, you should still complete the exercises set by your physiotherapist. Your physiotherapist may also encourage you to complete more intensive mobilisation treatment in the days after the treatment while the joint is less painful.
You usually need to wait at least 6 weeks between injections. Doctors normally recommend no more than three injections to the same area in the space of 12 months.
It really depends on a number of factors. Some longer lasting, less soluble steroids can be effective for two months or longer. Sometimes improvement can be none at all. Factors include what else the patient may be doing to themselves, for example, if you have tennis elbow caused by playing tennis, and you have a steroid injection and then continue playing tennis or aggravating the problem you may get limited benefit. However, if you also make changes to your lifestyle, sports, do rehab exercises, and see a physiotherapist it is likely the effects of the steroid injection will last much longer.
This will depend on where the steroid is injected and what type of steroid you receive. Milder forms such as hydrocortisone tend to have weaker side effects than the stronger mixtures of methylprednisolone and triamcinolone. • Pain and discomfort for a few days in the injected area • Temporary bruising or collection of blood under the skin • A flushed complexion • An infection, causing redness swelling and pain • Paler skin at the injected area • Loss of fat at the injected area • A rise in blood sugar (more likely for diabetes sufferers) • Risk of tendon rupture
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