Steroid injections Weronga rongoā whakakaha

Conditions that are commonly treated by steroid (cortisone) injections include:

• bursitis
• carpal tunnel syndrome
• osteoarthritis
• rheumatoid arthritis
• tennis elbow
• trigger finger

Steroid injections may provide pain relief for a few months, but do not usually cure the problem. Some studies even suggest they may prolong problems. Other treatments include:

• anti-inflammatory medication
• exercises
• acupuncture
• physiotherapy.

These treatments can be used before, or as well as, injections.

Steroid injections can be provided by healthcare providers such as:

• GPs
• orthopaedic surgeons
• sports doctors
• radiologists, using ultrasound or CT scans to help guide the needle.

If you are pregnant or breastfeeding, tell your healthcare provider before getting a steroid injection.

Steroid injections deliver anti-inflammatory medication directly to your painful area. The steroid may take a few days to work, but it may help for 2 months or longer.

Usually, you only need one injection. But sometimes you need several injections over several months.

Depending on your condition, your injection will be into your:

• muscle
• joint
• 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 is easy to insert the needle into the joint space. Elbow or foot injections are usually painful while they are being given. This is because the liquid stretches your soft tissue more in these areas.

You should have no more than 3 or 4 steroid injections a year in a joint. They should be at least 6 weeks apart — 3 months if possible.

Steroid injections are generally very safe.

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

• You may have bruising at the injection site. This will fade like any bruise.
• You may have bleeding at the injection site. Pressure with cotton wool or a tissue is all that is needed.
• Injections near the skin can thin the overlying tissue and leave a pale, dimpled area. This will fade over a year or so and is not painful.
• You might see an increase in blood vessels in the skin around your injection site. These are called spider veins.
• You may absorb a small amount of steroid from your injection site, and it may spread through your body. This can make your face flushed, which can last for a day or so.
• If you have diabetes, you may get a temporary rise in your blood sugar levels. You should monitor your blood sugar levels closely over the next few days.

Serious side effects are very unlikely but happen occasionally. If you are concerned about a reaction to the injection, discuss it with your healthcare provider as soon as possible.

Joint infection

A joint infection is very uncommon but serious. See your healthcare provider immediately if:

• the pain in your injected area is severe for more than 48 hours
• 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, causing serious damage to the nerve.

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. 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 the steroid injections that your healthcare provider gives you.

Keep taking all your usual medications unless your healthcare provider tells you not to.

Get immunised as usual.

You do not need to change the amount of alcohol you drink after having a steroid injection. But you should stay within the low-risk alcohol drinking guidelines, whether or not you have had a steroid injection.

Drinking responsibly