Steroid Injections

Steroid (cortisone) injections are sometimes used for injecting inflamed joints or soft tissues (tendons or bursa).  Steroid injections are not usually a first line treatment but are used to settle pain and improve movement if other options do not help or are not readily available.

Who should not have steroid injections?

Steroid injections are not given to anyone who has had a previous allergic reaction to cortisone, those who have impaired immunity, uncontrolled diabetes or infection at or near the injection site.

What to expect after an injection

Steroids usually take 2-3 days to take effect but this varies considerably from patient to patient and with different conditions.  Often local anaesthetic is combined with the cortisone and this has an immediate effect that wears off after a few hours.  Paracetamol may be required following an injection.

Side-effects or complications

These are very uncommon but may include:

  • Facial flushing – lasts about 24 hours if it occurs
  • Steroid flare – increased pain at the injection site lasting up to 3 or 4 days
  • Thinning or loss of skin colour at injection site
  • Fat atrophy – dimpling of the skin at the injection site – this may take many months to improve
  • Alteration in blood sugar levels for those who have diabetes
  • Very rarely infection can follow steroid injections (1 in 15000)

If the site becomes hot, red, swollen and increasingly painful following an injection, contact your GP as soon as possible.

  • Very rarely tendon rupture occurs. Some tendons are more prone to this than others.
  • Very rarely patients experience an acute allergic reaction.

After an injection

  • You should avoid activities that increased the pain prior to the injection for 3 to 4 days.
  • For several conditions you should start exercises suggested by your doctor to help to avoid recurrence of the inflammation.
  • Repeat injections may be given but not usually before one month or more than 3 to 4 times a year.