Steroid Injections
A steroid injection (often referred to as a cortisone injection) delivers a dose of corticosteroid medication directly into a specific joint or soft tissue area
What is a Steroid Injection?
A steroid injection (often referred to as a cortisone injection) delivers a dose of corticosteroid medication directly into a specific joint or soft tissue area.
- It is not an anabolic steroid: These are different from the steroids used for muscle building.
- How it works: Corticosteroids mimic natural hormones in your body to powerfully reduce inflammation. By reducing swelling, the pressure on nerves and surrounding tissue is relieved, which reduces pain and restores movement.
- The mixture: We typically combine the steroid with a local anesthetic to make the injection as comfortable as possible and provide immediate, though temporary, pain relief while the steroid takes effect.
The Procedure: What to Expect
We use ultrasound guidance for our injections. Unlike “blind or landmark guided” injections (where the operator feels landmarks on the skin), ultrasound allows us to see the needle inside the body in real-time.
1. Preparation
The skin over the injection site is thoroughly cleaned with an antiseptic solution to minimize infection risk.
2. Visualisation
The clinician applies an ultrasound gel and uses an ultrasound probe to visualize the target structure (joint, bursa, or tendon sheath) and identify any nerves or blood vessels to avoid.
3. The Injection
Watching the screen in real-time, the clinician guides a fine needle precisely to the target area. Because we can see exactly where the needle is going, we can often avoid sensitive structures, making the procedure more comfortable.
4. Completion
The needle is removed, and a small plaster is applied. The actual injection process usually takes only a few minutes.
Why Ultrasound Guidance?
Research shows that ultrasound-guided injections are significantly more accurate than blind injections. This increased accuracy improves the effectiveness of the medication and reduces the risk of accidental injury to surrounding tissues.
Common questions
Steroid injections for musculoskeletal conditions do not cause weight gain. Weight gain is associated with oral steroids which are often taken regularly in tablet form. Injectable steroids when done for musculoskeletal structures do not have a weight increasing effect as the injection is specifically targeted to an anatomical structure (joint, bursa, tendon sheath etc.) the dosage is appropriate for the size of the structure injected which generally means that it is not higher than 40 mg of Depo Medrone. This dosage is limited and only administered as a one off and therefore will not result in any weight gain.
- Post-Injection Flare: Approximately 10% of patients experience a temporary increase in pain, usually lasting for 24 to 48 hours. This is called a “steroid flare”. Anecdotally steroid flares are less common with ultrasound-guided injections. This is quite likely because they are more accurate and therefore less likely to inflame or irritate tissues that are not targeted.
- Facial Flushing: Some people experience redness and warmth in their face. This effect can last for several days.
- Blood Sugar Increase: If you are diabetic, the glucose levels may rise for up to a period of a week following the injection. It is important to monitor glucose levels of post-injection.
Localized Changes
- Skin Changes: Occasionally, the skin around the injection site may lighten in color (depigmentation) or thin out, causing a small dimple (fat atrophy). This is more common in those with pigmented skin and is usually cosmetic and does not cause pain.
Serious complications are rare, especially when performed under ultrasound guidance by a qualified clinician. However, you should be aware of the following:
- Infection: With any procedure where the needle penetrates skin, there is a small risk of infection which is thought to be in the region of 1 in 10,000. It is important to monitor and be aware of signs such as developing a fever and redness and swelling of the injected body part. In these scenarios, people should attend urgent medical services immediately.
- Tendon Weakening: Frequent injections into the same area can weaken tendons over time. For this reason, we generally limit the frequency of injections.
- Allergic reactions: Occasionally a person might be allergic to one of the constituents of the steroids or local anaesthetic.
Steroids are used to reduce inflammation and pain. Ultrasound guidance provides precise delivery thereby reducing potential side effects and potentially increasing the likelihood of benefit.
Patient information leaflets & Consent form
Procedure information downloads and consent form.
Injection Consent Form
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