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HealthInfo Canterbury

Steroid injections

Steroid injections are also known as cortisone injections, Kenacort injections, and corticosteroid injections. This sheet discusses low dose injections given up to a few times per year.

Steroid injections are used to treat painful conditions of the joints and soft tissues, such as tennis elbow, inflammation caused by osteoarthritis, arthritis, and bursitis, and some nerve problems such as carpal tunnel syndrome. Steroid injections provide short term pain relief but usually do not cure the problem and some studies suggest they may prolong problems. Other treatments, used before or in addition to injections, include anti-inflammatory medication, exercises, acupuncture and physiotherapy.

Steroid injections have been widely used for 30 years and their benefits and risks are well understood. Read this information sheet and discuss it with your doctor so that you feel fully informed about the risks and benefits of the injection.

How do they work?

Steroid injections work by delivering a powerful anti-inflammatory directly to the painful area. The steroid may take a few days to become effective but may give benefit for two months or longer. Usually, only one injection is required, but sometimes several are required over a number of months to relieve the condition.

What will you feel?

Steroid injections are generally very safe and well tolerated.

Depending on the condition being treated, the injection is made into muscle, or into the affected joint, or soft tissue. Local anaesthetic is mixed with the steroid so that the area goes numb after the injection. Generally, if the needle is easily inserted into the joint space, joint injections are not very painful. Elbow or foot injections are more painful because the liquid stretches the tissue.

After the injection

The local anaesthetic wears off within a few hours and the injected area may be more sore for 24 to 48 hours. Cold compresses and paracetamol will help relieve this pain. Your doctor may prescribe some oral pain relief or anti-inflammatory medication to take while waiting for the steroid to take effect.

If your injection was into a weight-bearing joint, you should rest it as much as possible for the first one or two days, or at least avoid strenuous exercise. If you are also having physiotherapy, the physiotherapist may decide to give more intensive mobilisation treatment after the injection while the joint is less painful.

You may experience minor reactions to the injection, such as:

More serious problems

These are all very unlikely but do occur occasionally. If you have any concerns about a possible adverse reaction to the injection, please discuss as soon as possible with your GP.

Infection

Infection is very uncommon but it is serious and should be considered if pain continues to be severe for more than 48 hours. If the joint becomes more painful and hot you should see your doctor immediately, especially if you feel unwell.

Cartilage and tendon damage

Frequent injections may cause cartilage damage, especially in weight-bearing joints such as the knee. Injections are rarely put into large tendons, such as the Achilles tendon, in view of concerns that the medication may weaken the tendon.

Effects on the rest of the body

The steroids from the injection are absorbed over time and are a low dose compared with those taken as pills for medical problems such as asthma. Mood changes and other psychiatric reactions could occur. Steroids also cause a long list of problems with immunity, bones, muscles, and skin, which are highly unlikely with single or even a few injections.

Other do's and don'ts after an injection

Do keep taking all usual medications unless told otherwise by the doctor.

Do get immunised as usual.

You don't need to alter your alcohol intake, up or down.

Do tell your doctor if you are pregnant or breastfeeding. Injections can be used for carpal tunnel in pregnancy and while breastfeeding.

A full data sheet can be viewed on the Medsafe website: www.medsafe.govt.nz.

Page reference: 110460

Review key: HILJP-228010