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Musculoskeletal Disorders

Local Steroid Injections

When your joints are swollen and tender we often put a needle into your joints to draw out fluid and inject steroid into them. The steroid reduces the swelling and pain you have, so you can use your joint again. Joint injections are done for people with rheumatoid arthritis, osteoarthritis and many other conditions. Sometimes we inject into the tissues around joints as well because this can help with conditions such as tennis elbow.

We usually inject a small amount of steroid.We often inject some local anesthetic,which is a painkiller, into your joint. Your clinician will also decide whether to inject a local anesthetic at the same time. This does not reduce inflammation but will allow almost immediate temporary pain relief.

The local anesthetic will start to reduce your pain within a few minutes of the injection.This pain relief will last for 1-2 hours. The steroid will take longer to start working. Sometimes it can be nearly 1-2 days after the injection before you start to feel better.So while you are waiting for the steroid to work you can take painkillers such as Tylenol, or cold packs.The joint you have had injected will hopefully feel better for up to 3 months and sometimes longer, but everybody is different so it may not last this long. If you have had previous injections and they have not lasted this long then it would be advisable to have your condition re-assessed and a new treatment plan decided with your clinician.

Generally you will be able to leave after your injection, as long as you have felt well. Very rarely people can have an allergic reaction to the drugs. It is recommended to rest the joint that has been injected for 48 hours this helps the injection work better. If this is impractical then it is advisable to avoid any strenuous exercise for the following 48 hours. A general principle is to move the joint injected as normal but do not lift or push heavy objects for a week after the injection.

The steroid can make your blood sugar higher than normal. You need to check your blood more often for a week. You may need to increase your insulin. Contact your diabetes specialist for advice if your blood sugar is high.

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