Joint Injections

Steroid injections, also called corticosteroid injections, are anti-inflammatory medicines used to treat a range of conditions.

They can be used to treat problems such as joint pain, arthritis, sciatica and inflammatory bowel disease.

Steroid injections are only given by healthcare professionals. Common examples include hydrocortisone, triamcinolone and methylprednisolone.

How steroid Injections are given.

Steroid injections are given by a healthcare professional in a hospital, clinic or GP surgery. We run special clinics at Tavyside Health Centre & Lifton Surgery for these injections. 

They can be given in several different ways, including:

  • into a joint (an intra-articular injection)
  • into a muscle (an intramuscular injection)
  • into the spine (an epidural injection) – Hospital only
  • into the blood (an intravenous injection) – Hospital only

The injections normally take a few days to start working, although some work in a few hours. The effect usually wears off after a few weeks or months.

If you’re having an injection to relieve pain, it may also contain local anaesthetic. This provides immediate pain relief that lasts up to a few hours.

You should be able to go home soon after the injection. You may need to rest the treated body part for a few days.

If you would like to discuss booking in for a joint injection, please contact the care navigation team on 01822 613517 or complete one of our online forms which is available Monday-Friday 08:00-10:00. 

Joint Injection Appointments

This following information is for patients who have been recommended to book on to a joint injection clinic. Please read through this prior to attending your appointment.

Please be aware of the following:

  1. You are booked into the clinic, however this does not automatically mean you will receive a steroid injection. It means you will be assessed by a doctor who carries out these injections and if clinically appropriate will be able to carry this out during the appointment. There are various factors that can impact on the ability to carry out these injections but we will of course aim to do what is best for you on the day.

  2. If you are on antibiotics for an infection you may not be able to go ahead with the injection on the day. It would be preferable to rebook when you have finished your antibiotic course.

  3. If you have a Covid vaccination due then please note you should not have a steroid injection within one week beforehand or two weeks after the Covid vaccination. This is because there is a possibility the steroid injection may interfere with the vaccine and make it less effective.

  4. If you take warfarin you will require an INR within 24 hours of the steroid injection to ensure it is not too high to proceed (above 3.0). Please arrange a separate appointment for this with reception prior to your appointment. If this is not carried out we may not be able to carry out your steroid injection. If you have a target INR of 3.0 or above please discuss with a joint injector GP.

  5. If you are awaiting a joint replacement then please be aware that some surgeons will often not operate on a joint that has had a recent steroid injection. The timeframe varies between surgeons but if you are imminently due a joint replacement in the joint you wish to have injected then you may wish to avoid an injection so as not to risk a delay in your surgery.

Please inform the doctor if any of the following apply to you:

  1. You are allergic to local anaesthetic or dressings/ plasters. We use these routinely for joint injections and so we must know if this is known to be an issue.

  2. If you have any metal work in the joint you are hoping to have injected. This usually means you cannot have an injection in this joint (unless you are having a ‘trochanteric bursa’ injection).

  3. You are taking blood thinners. It is generally ok to be on blood thinners when having a joint injection but it may increase your risk of bruising or bleeding. If you are on warfarin you need an up to date INR within 24 hour of the appointment.

  4. You are diabetic and monitoring blood sugars. You may find the steroid injection raises your sugars slightly for a couple of weeks.
Consent

Prior to any steroid injection we will discuss with you the consent procedure. You may like to read this information below prior to your appointment.

 THE PROCEDURE & ITS BENEFITS

The steroid injection is generally a quick and straight forward procedure that can be very helpful for certain joint issues such as inflammation and pain. The injection contains both a steroid and local anaesthetic.

RISKS

There are some rare risks with steroid injections. The important ones to be aware of are listed below:

  • Infection- a very rare but a serious complication which requires urgent & same day medical assessment if suspected.
  • Bleeding or bruising.
  • Skin discolouration, thinning or dimpling around the injection site- most obvious in hands. Rare but more common with repeated injections at the same site.
  • Pain- it is common in the first 48 hours to have slight increased pain from the joint.
  • A rare risk of damage to underlying structures such as tendons or nerves or vessels.
  • If you are diabetic you may find your blood sugars to be slightly raised for a couple of weeks following an injection.
  • Allergic reaction to the local anaesthetic or steroid. This is very rare.
  • Rarely steroid injections can cause facial flushing or short term changes to the menstural cycle.

There is always the possibility that your steroid injection may not work. There is often no rhyme nor reason for which injections work and which do not. You may find one injection does work and a subsequent one does not. It is worth discussing with your GP if you wanted to consider further injections if this is the case.

AFTERCARE

It is best to rest the joint for 48 hours after an injection. Occasionally you may experience a ‘steroid flare’ where your symptoms are slightly worse for the first 48 hours. This is uncommon if the joint is rested. You will not notice benefit until around 7- 10 days after the injection. At this point it is important to start any physio or home exercises that you have been recommended as this is what will help to keep on top of your symptoms in the long term. Please ask your doctor for exercises if you are not clear on what would be helpful and we can email or text you appropriate exercises for your joint.

FUTURE INJECTIONS

We generally recommend to leave as long as possible between injections as there are long term risks with repeated steroid injections (skin changes, tendon damage, exposure to the risk of the injection itself). Some joint issues such as carpal tunnel or rotator cuff syndrome may not need any further injections. Other issues such as osteoarthritis generally will become symptomatic again after a period of time which can vary from 3-6 months or even years later.