Corticosteroid is an anti-inflammatory medication, which is used to reduce inflammation, pain and swelling of irritable joints and soft tissue conditions. It is widely used in a variety of musculoskeletal conditions in clinical practice. Research evidence suggests that corticosteroid injection is effective in reducing pain and symptoms, and improving function in the short-term (1-3-months).
Corticosteroid injection reduces inflammation and pain by inhibiting both chemical and cell-mediated aspects of inflammatory responses to disease and injury. This results in reduction in inflammation and discomfort. The effects of cortisone part of the injection can take few days to few weeks to take effect. Some of this difference may depend on the nature, duration and severity of the presenting condition.
When pain becomes a barrier to your normal function and physiotherapy treatment, the short-term effectiveness of a Corticosteroid injection provides a ‘window of opportunity’, allowing your physiotherapist to treat the underlying cause of your pain and problem, and facilitate your return to normal function quicker.
- Osteoarthritis of shoulder, elbow, thumb, finger, knee, ankle and big toe joint
- Frozen shoulder
- Subacromial impingement syndrome- rotator cuff tendinopathy and/ or subacromial bursitis
- Tennis elbow and golfer’s elbow
- De-Quervain’s tenosynovitis
- Trigger finger
- Greater trochanteric pain syndrome
- Plantar fasciitis
Yes, Corticosteroid is a very safe and effective treatment when it is used appropriately. The injection is performed using a strict aseptic technique, which delivers the injection accurately to the target area.
We take our patients’ condition and safety very seriously. You will be given a thorough examination including the understanding of your current/past medical history, current medications, and known allergies prior to injection. There are certain conditions that may be contraindicated to the use of Corticosteroid injection (such as any systematic/local infection), which may increase the risk of side-effects (such as diabetes, and patients on anti-coagulants). These will be discussed prior to injection to reduce any risk.
Side effects of Corticosteroid injection are very rare (for instance, incidence of infection is estimated to be approximately 1: 40,000 risk), and often very minor. The therapeutic benefits often outweigh the possible side-effects which may include; post-injection flare-up for 1-2 days, facial flushing, small area of fat loss or change of colour of skin, slight vaginal bleeding, temporary increase of blood sugar if you are diabetic, skin bruising if you are on blood-thinning drugs.
Anaphylactic reaction is extremely rare. It happens because your body has an extreme allergic reaction. Please let us know if you have had any adverse drug reaction to a local anaesthetic in the past. We take patients’ safety very seriously. You will be thoroughly examined prior to injection to ensure it is appropriate and safe for you; an aseptic technique is performed; our clinic is well-equipped with emergency care; you will also be asked to wait in the clinic for 25 minutes following the injection to monitor any adverse effect.
Injection of Corticosteroid and local anaesthetic are often used together for diagnostic and therapeutic use. If local anaesthetic is used, you should experience pain relief within minutes. Corticosteroid usually starts working within 24-48 hours but may take longer, and it usually continues to work for 3-6 weeks, providing short-term pain relief. The duration of effect varies from person to person, depending on their individual conditions, degenerative changes, and presenting symptoms.
This depends on the presenting symptoms and the condition being treated. In most cases, one injection is sufficient to reduce pain to a manageable level. For some chronic conditions such as a frozen shoulder and greater trochanteric pain syndrome, a second injection may be offered to relieve severe pain, if the first injection provides only partial or short-term relief. It must be noted that Corticosteroid injection has its side effects with repeated use, particularly in weight-bearing joints. It is recommended to have no more than three injections in one area within a year. If repeated injection remains unsuccessful, alternative treatment options or further diagnostic investigation will be discussed with you.
In order to maximise the benefit from your injection and lower the risk of any potential side-effects, you will be asked to ‘relatively’ rest the injected area for 2-3 weeks. Relative rest does not mean complete rest, it means rest from aggravated activities and movements. If your job is likely to aggravate the symptoms, you may consider taking leave or reducing your duties for a few weeks. You can take your normal pain medications following injection if required. An after-care advice sheet and appropriate exercise will also be provided following the injection. You will be provided with a review appointment 2-3 weeks following the injection.
Corticosteroid and local anaesthetics are prescribed medication, so a prescription is required. Dr Sharon Braddock is a qualified independent prescriber, so can provide a private prescription for both Corticosteroid and local anaesthetic on the day of your injection appointment, alleviating the necessity to return to your GP. Pain medication can also be prescribed where necessary.