If you considering a steroid joint injection, please make an appointment with one of our clinicians to discuss and, if appropriate for you, we will place you on the waiting list. Then one of our team will contact you to arrange an appointment in our Steroid Injection Clinic.

The Joint Injection Procedure

A quick steroid injection given under aseptic technique into the joint space (shoulder/elbow/wrist/thumb/knee/hip/hand/feet) by a trained practitioner.

In addition to the information below, the NHS website provides more information as well: Steroid injections - NHS

Common reasons to have the steroid injection at our practice

Joint injections are commonly used to treat various joint-related conditions, particularly when other, more conservative treatments (like rest, physical therapy, oral medications, or over-the-counter pain relievers) have failed to provide sufficient relief, or when the symptoms are severe enough to interfere with daily activities.

Here are some common reasons why someone might receive a joint injection:

Osteoarthritis

One of the most common reasons for joint injections is to treat osteoarthritis, especially when it causes significant pain and inflammation. The injection can help reduce pain, inflammation, and improve joint function.

Bursitis

Bursitis, which is the inflammation of the fluid-filled sacs (bursae) that cushion the joints, can be treated with joint injections to relieve pain and inflammation in the affected joint.

Tendinitis

Tendon inflammation, or tendinitis, can be treated with injections, particularly if other treatments like rest or physical therapy haven't worked. The injection can reduce inflammation and provide pain relief.

Frozen Shoulder (Adhesive Capsulitis)

Joint injections are often used for treating frozen shoulder, a condition where the shoulder becomes stiff and painful. The injection can help reduce inflammation and improve range of motion.

Some possible side effects of a steroid joint injection

While these injections can be highly effective for providing relief, they do come with potential side effects, which can vary depending on the substance used and the individual’s response. The risks can be quantified in terms of their occurrence.

Common (Likely to Occur in Many Patients- 1 in 100 to 1 in 10)

• Pain or Swelling at the Injection Site: Occurs in many patients, typically within the first few days post-injection. This is a common side effect.
• Flare-up of Pain ("Steroid Flare"): Temporary increase in pain within a few hours to a day after the injection. This is relatively common, especially in the first 24-48 hours.

Uncommon (May Occur in Some Patients, but Not Likely- 1 in 1000 to 1 in 100)

• Increased Blood Sugar: Occurs in some patients, particularly those with diabetes. It is uncommon for healthy individuals, but monitoring is important for diabetics.
• Skin Thinning or Discoloration: More common with repeated injections but may occur in some patients who have frequent corticosteroid injections at the same site.
• Infection: While the risk is generally low, it’s an uncommon side effect when proper sterilization is followed. However, it can be more common for those with weakened immune systems. Infection can be of the overlying skin or of the joint injected.

Rare (Infrequent, Occurs in a Small Number of Patients- 1 in 10 000 to 1 in 1000)

• Tendon or Ligament Weakening: Occurs with frequent or repeated corticosteroid injections near tendons or ligaments. This is a rare long-term risk after multiple injections.
• Joint Damage: This typically occurs only after long-term use or frequent injections. It is a rare but possible long-term risk.
• Nerve Damage: This is a rare complication, occurring if the needle damages a nearby nerve. Nerve damage can cause numbness, tingling, or weakness.
• Unwanted Side Effects (Corticosteroids): Side effects like mood changes, insomnia, weight gain, or gastrointestinal issues are rare, especially with a single injection. These are more likely with long-term or repeated steroid use.
• Allergic Reactions: Extremely rare, but possible, especially to the corticosteroid or numbing solution used in the injection.

Extremely Rare (Very Unlikely to Occur- less than 1 in 10 000)

• Severe Allergic Reactions: Anaphylactic reactions to the substances used in the injection are extremely rare, occurring in less than 1% of cases.

This classification helps to understand the general frequency of these side effects, though individual risk can vary depending on factors like medical history, the specific substance injected, and the skill of the practitioner.

Some of these risks are low risk, mild and temporary such as pain or swelling at the injection site. They tend to resolve quickly with minimal intervention needed.

Some of these side effects are more significant and may require attention or monitoring but are not usually long-lasting for example increased blood sugar or infection.

High risks side effects are more severe and require close monitoring, possible adjustment of treatment or a higher level of caution for example joint damage or nerve damage, tendon or ligament weakening.

Joint injections can be very effective for pain relief and inflammation reduction, but there are several contraindications (situations where the procedure should be avoided or used with caution) due to potential risks. These include:

1. Active Infection or Skin Infection at the Injection Site

Example: If the skin around the joint is infected, or if there's an existing joint infection (septic arthritis), injections should be avoided.

2. Allergy to Components of the Injection

Example: If a patient has a known allergy to corticosteroids or a specific numbing agent, the injection should not be performed.

3. Uncontrolled Diabetes

Corticosteroid injections can raise blood sugar levels, which can be risky for people with poorly controlled diabetes.

Example: If a patient’s blood sugar is difficult to manage, the risks of using corticosteroids might outweigh the benefits.

4. Severe Osteoporosis

Injections, particularly those with corticosteroids, can weaken bones, making them more susceptible to fractures, especially in patients with osteoporosis.

Example: If the patient has severe bone thinning, corticosteroid injections may worsen bone density.

5. Active Bleeding Disorders or Anticoagulant Therapy

Joint injections can cause bleeding or bruising. In patients with bleeding disorders or those on blood thinners (e.g., warfarin, aspirin), there is a higher risk of significant bleeding complications.

Example: If a patient has hemophilia or is on anticoagulant therapy, joint injections should be carefully considered or avoided.

6. Pregnancy (For Corticosteroid Injections)

The safety of corticosteroid injections during pregnancy is not fully established, so they should generally be avoided unless the benefits clearly outweigh the risks.

7. Joint Instability

If the joint is unstable (e.g., due to ligament or tendon injury), injecting into the joint might worsen the instability or cause further damage.

Example: If there is significant ligament damage, the injection might not provide the expected benefits and could risk aggravating the instability.

8. Recent Joint Surgery

If a patient has recently undergone joint surgery, introducing an injection could interfere with the healing process or increase the risk of infection.

Example: Patients who have had recent joint replacement or arthroscopy should generally avoid injections until healing is complete.

9. Advanced or Severe Joint Degeneration (End-Stage Arthritis)

In patients with end-stage arthritis, injections may not be effective, and the joint may no longer respond to the treatment. Surgical options might be more appropriate.

Example: A patient with advanced osteoarthritis or joint deformity may not experience significant relief from injections.

At Crossley Street Surgery, we strive to provide the best care possible. However, there are certain procedures, such as injections into the feet or the elbow, that may not be standard practice for all clinicians. It’s important to note that not all injecting clinicians may provide these treatments, and we want to ensure that any decision made about your care is in line with current best practices. If you have any specific requests or concerns, please feel free to discuss them with us so we can determine the most appropriate treatment for you.