How do steroid joint injections work?

Steroid joint injections work by reducing inflammation and reduce the pain associated with the conditions mentioned above. Steroid injections can also reduce the pain temporarily in some conditions such as frozen shoulder and wrist tendon sheath inflammation, this helps in physiotherapy, rehabilitation and increasing the level of activity. It can take one week for the joint steroid injection to show the full effect.

What are the limitations of the joint steroid injections?

Steroid joint injections have their own limitations and should be avoided/ used with caution in conditions such tennis elbow/plantar fasciitis.

Can we combine steroid injections with other products?

In certain conditions, steroids can be injected in combination with Platelet Rich Plasma or hyaluronic acid to improve the effects. Physiotherapy is also an important adjuvant to improve the mobility and function of the joint.

Which steroids are used for the joint injections?

These include hydrocortisone, methyl prednisolone (Depomedrone) and triamcinolone (Kenalog)

How often can you have joint steroid joint injections?

You can have joint steroid injections every three to four months. We would not recommend their administration more than twice a year. This reduces the chances of damage to the joint.

In what conditions should you not have a steroid injection?

Joint steroid injections should be avoided/ not done in the following conditions:

• Local infection in the skin at the site of injection / Infection in the joint
• Patients on blood thinners such as warfarin, apixaban etc
• In health condition affecting the way blood clots, such as haemophilia. This can increase risk of bleeding into the joint.
• In patients with Diabetes. In such individuals, steroids can cause significant increase the blood sugar level.
• Allergy to steroids or local anaesthetic.
• In pregnancy
• While breastfeeding. steroid joint injections are a relative contraindication for joint steroid injections although there is no evidence that they are harmful

What do you need to do prior to having a steroid joint injection?

• You will have a telephonic/video/face to face consultation with our doctor to assess if you are suitable for the procedure
• If possible stop/avoid pain killers such as ibuprofen, naproxen and diclofenac sodium.
• Wear comfortable clothes that allow easy access to the joint that is to be injected.
• Arrange for a family member or a friend to drive you home

What happens during the procedure?

• First the area is cleaned with an antiseptic solution
• The steroid is mixed with a small volume of local anaesthetic to reduce the pain and discomfort
• A small dose of local anaesthetic is injected in the skin and then the mixture of steroid and local anaesthetic is injected in the joint. The injection is guided by ultrasound to improve the accuracy of the injection
• The area is injection is covered with a sterile dressing.
• The health professional carrying out the injection will examine your joint and clean your skin with an antiseptic.
• You will be allowed to go home when you feel ok and your vital signs are stable

What are the Side-effects of steroid joint injections?

Side effects of steroid joint injections include:

• The pain and swelling can become worse for a couple of days in the joint that is injected.
• Feeling hot or having a flushed or red face.
• Infection in the joint
• Steroid joint injection can temporarily affect your periods.
• Increased blood sugar levels in patients with diabetes, hence it is generally
• Thinning, hypopigmentation and depression in your skin around the injection site. This is more common with multiple injections
• Mood changes can occur
• Damage to the joint or tendons, hence you can only have a limited number of injections per year

What is the aftercare steroid joint injections?

• Apply cold compress (Ice pack wrapped in a towel) on the area for 15 minutes each time. This will help to resolve swelling and bruising
• Doctor will prescribe you pain killers to control the post-procedure pain.
• Rest your joint for a day or two at least. You should be careful not to do too much using the joint for the first couple of weeks.
• In terms of mobility, take it easy for a couple of days.
• It can take up to a week for the steroid injection to start working and easing your pain. Your health professional may give you some gentle exercises to do. You can slowly build these up as your symptoms improve.
• If you feel the area of injection looks red and inflamed, immediately contact the clinic.