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HealthInfo Canterbury

Steroid injections

Steroid injections are also known as cortisone injections, Kenacort injections, and corticosteroid injections. This page is about low-dose steroid injections given up to a few times per year.

Steroid injections are used to treat pain in your joints and soft tissue (muscles, tendons and ligaments), including pain caused by inflammation. They're also used for some nerve problems and some tendon problems.

Conditions that are commonly treated by steroid injections include:

Steroid injections provide pain relief for a few months but usually don't cure the problem. Some studies even suggest they may prolong problems. Other treatments, used before or as well as injections, include anti-inflammatory medication, exercises, acupuncture and physiotherapy.

Some GPs can give steroid injections. So can specialists such as orthopaedic surgeons and sports physicians. Radiologists give some steroid injections using ultrasound to help guide the needle.

Steroid injections have been widely used for 30 years and health professionals understand their benefits and risks.

If you're pregnant or breastfeeding, tell your doctor before getting a steroid injection.

How do steroid injections work?

Steroid injections deliver powerful anti-inflammatory medication directly to your painful area. The steroid may take a few days to work but it may help for two months or longer. Usually, you only need one injection, but sometimes you need several injections over several months.

Health professionals recommend that you have no more than three or four steroid injections a year in a joint, and they are at least six weeks apart.

What will you feel?

Depending on your condition, your injection will be into your muscle, joint, or soft tissue. Local anaesthetic may be mixed with the steroid so that your injected area goes numb. Joint injections are usually not very painful if it's easy to insert the needle into the joint space. Elbow or foot injections are usually more painful because the liquid stretches your soft tissue more in these areas.

Steroid injections are generally very safe.

What will happen after the injection?

The local anaesthetic will wear off within a few hours and your injected area may be sorer for one to three days. You can use cold compresses and paracetamol to help relieve the pain. Your doctor may prescribe some other pain relief or anti-inflammatory medication for you to take while you wait 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 day or two, or at least avoid strenuous exercise.

If you're also having physiotherapy, your physiotherapist may decide to give you more intensive treatment for the few months after the injection while your joint is less painful.

What are possible minor side effects?

Most people have no side effects but some people have minor reactions to the injection.

Are there more serious side effects?

More serious side effects are very unlikely but occasionally happen. If you're concerned about a possible reaction to the injection, discuss it with your GP as soon as possible.

Joint infection

A joint infection is very uncommon but is serious. If the pain in your injected area is severe for more than 48 hours, you should see your doctor immediately. You should also see your doctor immediately if your joint becomes more painful and hot, especially if you feel unwell.

Cartilage and tendon damage

Frequent injections may cause cartilage damage, especially in weight-bearing joints such as your knee. Injections are rarely put into large tendons, such as your Achilles tendon. This is because the steroid may weaken your tendon and increase the risk of it rupturing.

Nerve damage

There is a risk of the steroid injection getting into the nerves near your injection site making them wither and die.

Effects on the rest of the body

Over time, your body absorbs the steroids from the injection. Steroid injections give you a low dose of steroids compared with those taken as pills for medical problems such as asthma. It's possible, although unlikely, that you may have mood changes or other psychiatric reactions following a steroid injection.

Steroid medication can also cause problems with immunity, bones, muscles, and skin, but these are highly unlikely with steroid injections that your doctor gives you.

What should I do after an injection?

Keep taking all your usual medications unless your doctor tells you otherwise.

Get immunised as usual.

You don't need to change the amount of alcohol you drink after having a steroid injection (though you should stay within the low-risk alcohol drinking guidelines whether or not you've had a steroid injection).

Written by HealthInfo clinical advisers. Updated October 2017.

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Review key: HILJP-228010