Corticosteroid injections can be used to treat a variety of conditions, including the following.
Steroid injections can effectively treat the joint inflammation that is seen in people with rheumatoid arthritis. They can also be used to relieve the pain of osteoarthritis (the most common form of arthritis) and gout.
Bursas are small, fluid-filled pads that allow tendons and muscles to slide easily over bones. The pain associated with inflammation of a bursa (bursitis) — a condition which usually affects the shoulders, elbows, hips and knees — can be treated with steroid injections.
Tendons are the thick bands of tissue that connect muscles to bones. Repeated motion and stress to a tendon can cause it to become inflamed — this is know.
When are corticosteroid injections used?
Although steroid injections can often effectively relieve the pain associated with musculoskeletal conditions, they are usually not used as the initial treatment option. Less invasive treatments, such as rest, oral pain reliever medicines, hot and cold compresses and physiotherapy, are usually tried first.
Make sure you tell your doctor about any other conditions you have and any medicines (including complementary medicines and dietary supplements) you are taking before having a steroid injection.
Is the injection painful?
Cortisone injections can sometimes be performed in your doctor’s office. Often, they are done under ultrasound or X-ray guidance, to make sure that the injection goes into the right spot. The injection itself can be uncomfortable, so your doctor may give you a local anaesthetic to numb the skin before the injection.
A local anaesthetic medicine such as lignocaine is also usually added to the corticosteroid injection. This anaesthetic can relieve your pain immediately, confirming the injection has hit the right spot. After a few hours, the anaesthetic will wear off, and you may feel some pain or discomfort until the anti-inflammatory effect of the steroid kicks in, which is usually after a couple of days.
Putting ice on the area and taking a pain medicine (such as paracetamol) may help relieve any discomfort in the meantime.
Do I need to restrict my activities after the injection?
After you have had a corticosteroid injection, you need to rest the affected area for 24 hours and avoid strenuous activity for 3-4 days.
Advantages of steroid injections
The main advantages of corticosteroid injections is that they relieve pain and inflammation. This can in turn can reduce swelling and improve mobility. The beneficial effects can last for several months.
In some cases, getting a steroid injection allows you to take part in physiotherapy or rehabilitation exercises to help longer-term improvement or recovery.
Risks and side effects
The most common side effects are pain and inflammation of the tissues surrounding the injection site, post-injection flare, or steroid flare, skin discolouration, nerve damage associated with steroid injections. There is a small risk of infection associated with the injections, Joint infections (septic arthritis).
See your doctor as soon as possible if:
- you experience pain for more than 48 hours after the injection;
- pain develops more than 2 days after the injection;
- the area becomes red, hot or swollen; or
- you develop a fever following the injection.
Corticosteroid injections should never be given if you have an infection, including an infection of the skin at the injection site.
Complications of cortisone shots can include:
- Joint infection
- Nerve damage
- Thinning of skin and soft tissue around the injection site
- Temporary flare of pain and inflammation in the joint
- Tendon weakening or rupture
- Thinning of nearby bone (osteoporosis)
- Whitening or lightening of the skin around the injection site
- Death of nearby bone (osteonecrosis)
- Temporary increase in blood sugar
Why it’s done
Cortisone shots may be most effective in treating inflammatory arthritis, such as rheumatoid arthritis. They can also be part of treatment for other conditions, including:
- Plantar fasciitis
- Psoriatic arthritis
- Reactive arthritis
- Rheumatoid arthritis
Limits on the number of cortisone shots
There’s concern that repeated cortisone shots might cause the cartilage within a joint to deteriorate. So doctors typically limit the number of cortisone shots into a joint.
In general, you shouldn’t get cortisone injections more often than every six weeks and usually not more than three or four times a year.
How you prepare
If you take blood thinners, you might need to stop taking them for several days before your cortisone shot to reduce your bleeding or bruising risk. Some dietary supplements also have a blood-thinning effect. Ask your doctor what medications and supplements you should avoid before your cortisone shot.
After the cortisone shot
Some people have redness and a feeling of warmth of the chest and face after a cortisone shot. If you have diabetes, a cortisone shot might temporarily increase your blood sugar levels.
After your cortisone shot, your doctor might ask that you:
- Protect the injection area for a day or two. For instance, if you received a cortisone shot in your shoulder, avoid heavy lifting. If you received a cortisone shot in your knee, stay off your feet when you can.
- Apply ice to the injection site as needed to relieve pain. Don’t use heating pads.
- Watch for signs of infection, including increasing pain, redness and swelling that last more than 48 hours.
- Don’t use a bathtub, hot tub or whirlpool for two days. You may shower.
Results of cortisone shots typically depend on the reason for the treatment. Cortisone shots commonly cause a temporary flare in pain and inflammation for up to 48 hours after the injection. After that, your pain and inflammation of the affected joint should decrease and can last up to several months.
Please call to book an appointment for treating common conditions like shoulder bursitis, tennis elbow, plantar fasciitis, inflammatory cause to surroundings of a joint. To assist symptom management with local ultrasound guided cortisone injection. No referral required. Please call the centre for more information. Private billing only. Procedure performed on certain days of the week only.